Module 1: Chapter 7 Life Span: pregnant or Breast-feeding women

Question 1

True or False: Most drugs given during pregnancy will not pass to the fetus

Answer 1

False: unlike the BBB the placenta allows most drugs to travel through the maternal circulation to the fetus

Question 2

what is the most important consideration in drug therapy for pregnant women

Answer 2

the potential adverse effects on the developing fetus

Question 3

true or false: some health problems occur secondarily to pregnancy and require drug therapy

Answer 3

true

Question 4

how is a fetus treated if it has health problems

Answer 4

drugs are administered to the pregnant woman with the intent of treating the fetus as the drug passes through the placenta

Question 5

physiological and anatomic changes occur during pregnancy that can alter the _______ of drugs

Answer 5

pharmacokinetics

Question 6

what systems are primary anatomic and physiologic changes seen in with a pregnant woman

Answer 6

endocrine
GI
cardiovascular
circulatory 
renal system

Question 7

What are the changes in the GI system influenced by during pregnancy

Answer 7

pregnancy hormones and pressure from growing uterus

Question 8

what hormone decreases gastric tone and motility and prolongs stomach emptying time

Answer 8

progesterone

Question 9

what hormone also promotes functional respiratory system changes during pregnancy

Answer 9

progesterone

Question 10

tidal volume during pregnancy increases by what

Answer 10

30-40%

Question 11

tidal volume increases by what % in minute volume by term

Answer 11

50%

Question 12

what will the effect of inhaled medications during pregnancy

Answer 12

increased absorption due to increased tidal volume

Question 13

hemodynamic changes in the cardiovascular system alter drug _________ and _________

Answer 13

distribution and metabolism

Question 14

are drugs that are passed through out the mothers body are usually passed in large amounts in breast milk

Answer 14

no, usually in minimal amounts

Question 15

are all drugs present in breast milk well absorbed by the neonate

Answer 15

no

Question 16

is drug metabolism altered by pregnancy or breast feeding

Answer 16

no

Question 17

by the third trimester the renal blood flow has increased by what % compared to pre-pregnancy level

Answer 17

40-50%

Question 18

what does glomerular filtration rate increase by in pregnancy

Answer 18

50%

Question 19

can drug excretion rates be increased during pregnancy

Answer 19

yes

Question 20

what are the two dramatic physical changes occur in the mother during pregnancy

Answer 20

CO is increased by 50% at 32 weeks

second trimester on arterial blood pressure is decreased

Question 21

what are teratogenic effects

Answer 21

physical defects on a fetus

Question 22

true or false: precise effects of drug therapy on a fetus are mostly undetermined

Answer 22

true

Question 23

how are drugs identified as a teratogen

Answer 23

based on the findings of animal teratology studies

Question 24

what are category A drugs

Answer 24

drugs that fail to demonstratre a risk to the fetus

Question 25

what are categroy b drugs

Answer 25

animal studies that fail to demonstrate a risk but there are no controlled human studeins in pregnant women; or animal studies that demonstrate fetal risk that was not confirmed in controlled human studies in pregnant women

Question 26

what are category c drugs

Answer 26

animal studies demonstrate fetal risk no controlled human studeins in pregnant women to rule out fetal risk drugs are given if the benefit justifies the risk

Question 27

what are category D drugs

Answer 27

controlled human studies demonstrate positive evidence fetal risk in life-threatening situations, the benefit may be acceptable despite the risk

Question 28

what are category x drugs

Answer 28

controlled human studies demonstrate fetal risk. the fetal risk outweighs any possible benefit. use in pregnant or potentailly pregnant women is contraindicated

Question 29

what happened in 2005 regarding the american academy of pediatrics committee on drugs

Answer 29

published its updated recommendations on drugs and breast-feeding

Question 30

what does the report publihsed by the american academy of pediatrics committee on drugs identify

Answer 30

several categories of drugs and their potential to cause problems with breast-feeding

Question 31

true or false: common symptoms of pregnancy do not mask the adverese effects of drug therapy

Answer 31

false they do

Question 32

when is the critical period of organogenesis

Answer 32

from implantation up to approximately 58-60 days after contraception

Question 33

what is organogenesis

Answer 33

development of organs

Question 34

when should drugs that cause teratogenic effects definitely not be administered

Answer 34

during the period of organogensis

Question 35

are drug interactions changed during pregnancy and breast-feeding

Answer 35

no

Question 36

what are 3 common complications of pregnancy

Answer 36

heartburn hypotension nausea

Question 37

what are the 4 prior conditions of concern in pregnant women that need to be closely monitored

Answer 37

cardiovascular seizure disorders depression diabetes mellitus

Question 38

why are cardiovascular conditions of concern when a woman becomes pregnant

Answer 38

because changes in teh cardiovascular system occur

Question 39

why are seizure disorders of concern in a woman that becomes pregnatn

Answer 39

because antiseizure medication have been shown to be teratogenic

Question 40

why is depression a condition of concern when a woman with depression becomes pregnant

Answer 40

unclear about long-term effects on the fetus

Question 41

why is the condition of DM a concern in a woman that becomes pregnatn

Answer 41

increased incidents of congenital abnormalities

Question 42

why are teenaged girls at addition risk for teratogenic drug effects

Answer 42

because of sharing of prescription medication

Question 43

true or false: alcohol is a known human teratogen

Answer 43

treu

Question 44

what effect does cocaine abuse have on a fetus

Answer 44

causes adverse fetal effects and is suspected to be a human teratogen

Question 45

what effect does opiate abuse have on a fetus

Answer 45

not appear to significantly increase the risk for congenital anamolies

Question 46

can cultural beliefs affect whether a woman accepts certain drug therapies while she is pregnant or breast-feeding

Answer 46

yes

Question 47

true or flase: limitiing drug use in pregnancy decrease maternal and fetal adverse effects

Answer 47

true

Question 48

should some drugs be considered absolutely safe when administered during pregnancy

Answer 48

no

Question 49

what should women of childbearing age be assessed for before any drug therapy is initiated

Answer 49

pregnancy

Question 50

what should be considered before drug therapy during pregnancy

Answer 50

nonpharmacologic alternatives

Question 51

when evaluating a pregnant patient during drug therapy what must you be careful to distinguish between

Answer 51

discomforts of pregnancy from possible adverse drug effects

Question 52

the nurse's role in conseling about pregnancy and fetal drug effects ideally begins before when

Answer 52

the pregnancy