Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical part B > Drug use in pregnacy and lactation > Flashcards

Drug use in pregnacy and lactation Flashcards

1
Q

what are some of the issue with use of drugs in pregnancy

A 
lack of studied 
societal beliefs - exaggerated 
risk to mother and fetus of not taking meds
overly cautious HCP 
first doctor visit weeks into pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

conditions that may require drug use during pregnancy

A 
cough,cold, AR 
NV 
depression 
epilepsy 
gestational diabetes 
asthma
UTI hypertension 
prenatal supplementation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

define teratogen and examples

A

agent that irreversibly alters growth, structure, or function of the developing embryo or fetus
virus, chemicals, drug, environment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

define teratology

A

study of birth defects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is the implantation period

cause of malformations?

A

from implantation to contraception, first 2 weeks

significant insult will cause death, will not cause malformations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

describe embryonic period

A

2-8 weeks after conception

organogenesis - time of formation of organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

when is the period of greatest vulnerability to teratogens

A

embryonic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

describe the fetal period

A

9 weeks to birth
growing and maturation
can still get abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

potential adverse effects of teratogens

A

spontaneous abortion
cogenital anomalities - structural
fetal effects- functional, greoth restriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

when can adverse effects of teratogens manifest

A

immediately or in the future

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

mechanism of toxicity

A

covalent bonding
inhibition of proteins/enzymes
peroxidation of lipids and proteins
receptor-ligand interactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

pysiological changes during pregnancy

A

decrease gastric emptying
increased blood volume, decrease plasma proteins
increase liver blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what effect does pregnancy have on drugs

A

decrease t1/2, clearance, and peak plasma concentrations

increase clearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how do drugs cross the placenta

A

passive diffusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

criteria for a teratogen

A 
teratogenic in animals
effect can be characterized
can cross the placenta 
consistent epidemiological studies 
exposure during critical development period
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

anticonvulsant defects

A

neural tube development

cranialfacial, cleftplate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

ace inhibitor defects

A

microencephaly
renal disease
cardiovascular malformations
death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

coumadin derivatives defects

A

warfarin syndrome
hemorrhage
embyropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

methotrexate defects

A

cranial facial
skeletal
neural
mental retardation

20
Q

isotretinoin defects

A

cranial facial
cardiac defects
hydrocepalus
spontaneous aborption

21
Q

signs of fetal alcohol syndrome

A

small eye openings
flattened cheek bones
mental retardation
growth retardation

22
Q

cigarette defect

A

cleft plalate and lip
toxic
decreased oxygen
decreased fetal growht

23
Q

FDA classifications of risk in pregnancy

A 
A: good studies showed no risk
B: no evidence of risk to humans 
C: risks can't be ruled out
D: evidence of risk 
X: contraindicated
24
Q

drawbacks of FDA classification

A

limited data
infrequenctly updated
inconsistent assignment
simplified, doesnt take a lot of things into account

25
Q

population birth defect rate

A

1-3%

26
Q

problems with codiene in breast feeding

A

metabolized by cyp 219 and some mothers are extensive metabolizers
accumulates after 4 days and can cause death

27
Q

treatment goals

A

treat mother if possible
prevent adverse effects to baby
preserve ability to breast feed
provide education

28
Q

hwo does drug transfer into breast milk

A

diffusion: transcellular, intercellular, inophore

29
Q

explain difference in ph of milk and plasma and where drugs will concentrate

A

plasma = 7.4 and milk = 7.1
acidic drugs will be trapped in plasma
basic drugs will be trapped in the milk

30
Q

drug factors to consider for drugs in lactation

A

type of drug and adverse effcts
how much excreted in breast milk
is it prescribed for infants? likely safe
pharmacokinetics - bioavaialability, half life

31
Q

patient factors to consider for drugs in lactation

A

age of patient
indciation - benefit vs risk
duration
underlying conditions

32
Q

ideal medication in breast feeding

A 
low lipophilicity 
large molecule 
short half life 
used in infants 
weak acid 
high protein binding 
low oral bioavailability
33
Q

what is the milk plasma ratio

A

concentration in milk/ concentration in plasma

34
Q

formula for infant dosage

A

drug concentration in milk x volume of milk

35
Q

formula for daily dose

A

avg concentration in milk x volume ingested in 24 hours

36
Q

formula for infant dose

A

daily infant dose / standard infant dosing

37
Q

relative infant dose formula

A

infant dosage / maternal dose

38
Q

are antibiotics compatible with breastfeeding? some side effects?

A

yes
diarrhea
rash

39
Q

which analgesics are safe in breast feeding

A 
acetaminophen 
nsaids except ASA
morphine
hydromorphone
methadone
40
Q

which analgesics should you caution in breast feeding

A

codiene because ultra metabolizers
oxycodone
meperidine

41
Q

which benzos should you choose when breast feeding

A

lorazepam

short half life and short course

42
Q

are vaccines compatible when breast feeding

A

yes

43
Q

is alcohol compatible with breast feeding

A

in moderation
large doses decrease milk production
chronic use may delay psychomotor development
try delay breastfeeding 2 hours after

44
Q

is nicotine compatible with breast feeding

A

no
increased risk of SIDS better to use NRT
M/P ratio = 2.9

45
Q

whens the best time to take meds when breast feeding

A

right after breast feeding

Clinical part B (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions