Chapter 7

Question 1

Drug administration during pregnancy and lactation

Answer 1

drug therapy should be avoided if possible until after if possible

Question 2

Placenta

Answer 2

is a semi-permeable membrane

water soluble, ionized or drugs bound to plasma proteins are less likely to cross

Question 3

Fetal membrane

Answer 3

can break down and detoxify certain drugs as they cross the placenta

Question 4

GI changes during pregnancy

Answer 4

delayed emptying
slowed transit time
decreased gastric acidity

Question 5

Respiratory changes during pregnancy

Answer 5

increased tidal volume and pulmonary dilation

Question 6

Distribution and metabolism changes during pregnancy

Answer 6

increased cardiac output
increased blood volume
changes in regional blood flow
alterations in lipid levels

Question 7

Excretion changes during pregnancy

Answer 7

blood flow to kidneys increases 40%-50%

Question 8

Teratogen

Answer 8

causes death or abnormality to the fetus
occus in 3% of pregnancies
fetal risk dependent on what part of gestation is happening

Question 9

First trimester

Answer 9

implantation to 60 days
skeleton and organs form
greatest risk for defects

Question 10

Second trimester

Answer 10

4-6 months
major organs formed
less risk of defects

Question 11

Third trimester

Answer 11

7-9 months
increased blood flow to the placenta
membrane becomes thinner
lack of mature metabolic enzymes and efficient excretion mechanisms

Question 12

Medication and lactation

Answer 12

drugs that are water soluble, ionized or attached to plasma proteins are less likely to enter breast milk
lipid soluble medications pass through breast milk
radioactive drugs=NO BREASTFEEDING

Question 13

Infancy

Answer 13

birth to 12 months

first 28 days=neonatal

Question 14

Infant IM injections

Answer 14

vastus lateralis preferred site

gluteal site contraindicated

Question 15

Infant IV

Answer 15

inserted into the scalp and feet

Question 16

Toddlerhood

Answer 16

1-3 years

Question 17

Toddler IM injections

Answer 17

vastus lateralis preferred site

Question 18

Toddler IV

Answer 18

inserted into the scalp and feet

possibly peripheral site in later toddlerhood

Question 19

Pre-school

Answer 19

3-5 years

can sometimes comprehend the differance between health and illness and use of medication

Question 20

Pre-school IM injections

Answer 20

Ventrogluteal site is less painful

Question 21

Pre-school IV

Answer 21

Peripheral veins

Question 22

School age

Answer 22

6-12 years old

Question 23

School age IM

Answer 23

Ventrogluteal

Question 24

Adolescence

Answer 24

13-16 years old

Question 25

Young adulthood

Answer 25

18-40 years old

Question 26

Middle adulthood

Answer 26

40-65 years old

Question 27

Later adulthood

Answer 27

65+ years old

Question 28

Later adulthood absorption

Answer 28

decreased absorption | increased gastric pH

Question 29

Later adulthood distribution

Answer 29

increased body fat causes increased storage of lipid soluble drugs, decreased therapeutic response, decreased cardiac output

Question 30

Later adulthood metabolism

Answer 30

decreased enzyme production in the liver and decreased viceral blood flow cause decreased metabolism

Question 31

polypharmacy

Answer 31

taking multiple drugs, using many pharmacies and MD's

Question 32

Later adulthood excretion

Answer 32

decreased excretion rate | risk reaching toxic levels due to impaired renal function