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REPRO II Exam 2 > Pharmacology of Pregnancy - Linger > Flashcards

Pharmacology of Pregnancy - Linger Flashcards

1
Q

lipophilic drugs

A

cross placenta easily

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2
Q

small molecular weight

A

cross placenta easily

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3
Q

polar compounds

A

need high concentration gradient to cross placenta

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4
Q

fetal metabolism of drugs

A

slower rate

-due to lack of enzyme expression, reduced activity of metabolic enzymes, reduced availability of cofactors

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5
Q

teratogen

A

results in characteristic set of malformation

  • exerts effects at particular stage
  • dose-dependent incidence
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6
Q

prenatal death

A

1-2 weeks

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7
Q

major morphologic abnormalities

A

3-8 weeks

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8
Q

physiologic defects

A

> 9 weeks

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9
Q

vit B6

A

pyridoxine

antiemetic drug

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10
Q

MOA pyridoxine

A

precursor to pyridoxal - function in metabolism

also aids in release of liver and muscle glycogen and GABA synthesis and heme

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11
Q

antihistamines

A

H1 antagonists

antiemetic

doxylamine
diphenhydramine
dimenhydrinate
meclizine

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12
Q

diphenhydramine

A

H1 antagonist

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13
Q

dopamine antagonists

A

used as antiemetic

promethazine
prochlorperazine
droperidol

muscarinic blocking

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14
Q

ondansetron

A

serotonin antagonist

  • selective for 5-HT3 receptor
  • prevention of nausea and vomiting
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15
Q

preeclampsia in pregnancy tx

A

tx if BP > 150/100
-severe HTN

labetalol - non-selective beta blockers
hydralazine - dilates arterioles
nifedipine and nicarpidine - CCBs

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16
Q

nifedipine

A

CCB

tx for preeclampsia

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17
Q

preexisting HTN tx in pregnancy

A

ACE (-), ARBs, direct renin inhibitor - NOT in pregnancy**

labetalol
methyldopa
nifedipine
thiazides

18
Q

methyldopa

A

reduces BP by stimulating central alpha adrenergic receptors
-decreased sympathetics to heart, kidney, vasculature

reduces peripheral vascular resistance
also reduction in HR and CO

undesired effect - sedation

19
Q

moderate to severe HTN in pregnancy

A

methyldopa

20
Q

thiazide MOA

A

inhibit NaCl cotransporter in distal convoluted tubule

21
Q

management of gestational DM

A

exercise

pharm - anti-hyperglycemics - insulin**

22
Q

insulin prep with low antigenicity

A

minimize transplacental transport

23
Q

rapid acting insulin analogs

A

lispro
aspart

both used for GDM

24
Q

leading cause of infant mortality

A

preterm birth

in US

25
Q

tocolytics

A

suppress preterm labor

26
Q

beta-adrenergic receptor agonists

A

bind beta2 receptors

  • increases adenylyl cyclase
  • increased cAMP
  • decrease myometrial contractility

eventially desensitized

27
Q

ritodrine

A

beta-adrenergic receptor agonist - not in US

28
Q

adverse beta-adrenergic receptor agonists

A

tachy, low BP, bronchial relaxation

29
Q

mag sulfate

A

tocolytic

  • MOA unknown
  • thought to compete with calcium at plasma membrane
  • hyperpolarize membrane - inhibit myosin - reduce myometrial contractility
30
Q

CI for mag sulfate

A

mother with myasthenia gravis

31
Q

women with myocardial compromise or cardiac conduction defects

A

careful use of mag sulfate

32
Q

indomethacin

A

COX inhibitor
-most commonly used tocolytic of this class

reduce PG formation - reduce myometrium contraction

33
Q

concerns with indomethacin

A

constriction of ductus arteriosus and oligohydramnios

34
Q

oxytocin

A

induction of labor

35
Q

MOA oxytocin

A

stimulate uterine muscle contraction

  • activating oxytocin receptors
  • stimulates PG release
  • milk ekection
36
Q

misoprostol

A

prostaglandin E

induction of labor

ripen cervix

37
Q

management of pain during childbirth

A

systemic or local

local - epidural, spinal - most popular

neuraxial - local - most effective - bupivicaine, ropivacaine

38
Q

benzos and barbituates

A

not analgesis - anxiolytic

-cross placenta and affect fetus - bad

39
Q

systemic for pain

A

morphine
fentanyl
meperidine

40
Q

opiod agonist-antagonists

A

nalbuphine

butorphanol

REPRO II Exam 2 (21 decks)

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