Perioperative Medicine Web-Based Curriculum & Reference

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PERIOPERATIVE MEDICINE

Web-Based Curriculum & Reference

Editors

Kurt J. Pfeifer, MD, FACP

Steven L. Cohn, MD, FACP

Medical College of Wisconsin

State University of New York - Downstate

Pregnancy

Michael P. Carson, MD & David A. Halle, MD

	RISK MANAGEMENT
	Medication Management

	For prescribing medications to pregnant patients, the FDA category system is oversimplified and not stratified by amount, duration, or timing of exposure during pregnancy. Instead of this system, ask yourself the 4 prescribing questions for pregnant patients (on the right) and rely on a dedicated text, clinician or web resource.
	Suggested References for Pharmacotherapy in Pregnancy
	Briggs GG, ed. Drugs in Pregnancy & Lactation [10] Information on medication teratogenicity can be found at http://orpheus.ucsd.edu/ctis/.


4 PRESCRIBING QUESTIONS FOR PREGNANT PATIENTS
1) Is the medication a “could use” vs. “should use” medication? Is it for a medical condition that requires treatment, or is it an issue of symptoms that the patient may be willing to tolerate? 2) What could happen to the patient's health if the medication is withheld? Would her health be compromised? This often helps the practitioner and patient consider the consequences if the medication is not given. 3) What data is available to guide your decision? Don’t say “no” when the real answer is “I don’t know”. 4) What are the patient's feelings about the treatment after you have reviewed the indications, your reasoning, your concerns, and the data? Collaborating with the patient will improve your comfort level in these complex situations.