perinatal pharmacology Flashcards
post-conceptional age - “post-fertilization”
if the date where the sperm fertilized the egg is known the due date can be predicted 38 weeks post conception
post- LMP
the due date is 40 weeks after the first day of last menstrual cycle
T/F. in the post LMP method is it assumed that a woman is pregnant for the first two weeks post LMP
false
TI pregnancy
day 1 LMP to 13 weeks and 6 days
major organ developement and fertilization
T2 pregnancy
14 weeks to 27 weeks and 6 days
rapid growth and development
T3 pregnancy
28 weeks to 40 weeks
organ maturation
are there any alterations in maternal pharmacodynamics
its usually not apparent for most drugs but physiological effects that come with pregnancy can necessitate initiation of drug therapy
what factors affect maternal drug absorption
increased likelihood of vomiting can effect whether or not the drug is actually being absorbed
there is also increased gastric pH due to the decrease gastric secretion
decreased gastric emptying can increased drug absorption
increased cardiac output can impact drug distribution
factors affecting drug biotransformation
enzyme induction:
cyp3a4, cyp 2d6, cyp2c9, cyp2a6-
enzyme inhibition:
cyp1a2, cyp2c19,
factors that affect maternal drug excretion
increased renal plasma flow
increased glomerula filtration rate
increased drug secretion rate
are the PD or PK mostly affected by pregnancy
PK
what can fetal toxicity result from
maternal drug transfer
why may dose adjustments be necessary for neonatal drug therapy
renal and hepatic elimination pathways are often immature in newborns including glucuronidation enzymes, which is why some babies have jaundice
list the considerations for drug exposes to infants through breast milk
volume of milk being consumed by baby
concentration of drug in milk
maternal drug concentration
drug absorption and clearance by baby
what impacts the amount of drug that makes it to the milk from mother
drug clearance
dosage regimen
route of administration
breast physiology including milk
composition and hormonal regulation
