Postpartum Pharmacology

Question 1

What are the stages of milk development during lactation?

Answer 1

Colostrum → Transitional milk → Mature milk

Question 2

What regulates milk content in lactation?

Answer 2

Lactocytes

Question 3

Which hormones are essential for milk production and ejection?

Answer 3

Prolactin and oxytocin

Question 4

What effect do dopamine antagonists have on milk production?

Answer 4

Increase milk production

Question 5

What effect do dopamine agonists have on milk production?

Answer 5

Suppress milk production

Question 6

List some benefits of breastfeeding.

Answer 6

• ↓ Risk of NEC
• ↓ Risk of otitis media
• ↓ Risk of respiratory infections
• ↓ Risk of SIDS
• ↓ Risk of leukemia
• ↓ Risk of diabetes
• ↓ Risk of asthma

Question 7

What is the recommended duration for exclusive breastfeeding according to AAP/WHO?

Answer 7

6 months

Question 8

How long should breastfeeding continue according to AAP/WHO?

Answer 8

Up to 1–2 years as mutually desired

Question 9

What are galactagogues?

Answer 9

Substances that stimulate, maintain, or increase breastmilk production

Question 10

What are some non-pharmacologic methods to support lactation?

Answer 10

• Hydration
• Skin-to-skin contact
• Massage
• Frequent feeds

Question 11

What is the pharmacologic option metoclopramide used for in lactation?

Answer 11

Increase prolactin

Question 12

What is a major risk associated with metoclopramide?

Answer 12

Tardive dyskinesia

Question 13

What is fenugreek used for in lactation?

Answer 13

Increase breastmilk production

Question 14

What is a significant risk associated with fenugreek?

Answer 14

Hypoglycemia or allergic reaction

Question 15

What is the role of human milk fortifiers?

Answer 15

Adds protein, calcium, and phosphorus

Question 16

What is the recommended daily dose of iron for infants?

Answer 16

2 mg/kg/day

Question 17

What is the recommended dose of vitamin D for infants if consuming less than 28 oz of formula?

Answer 17

400 IU daily

Question 18

What should be avoided as a breastmilk additive due to arsenic risk?

Answer 18

Rice cereal

Question 19

What type of cereal is preferred for thickening?

Answer 19

Oat cereal

Question 20

How do most drugs transfer into breastmilk?

Answer 20

In minimal, non-toxic amounts

Question 21

What factors affect drug transfer into milk?

Answer 21

• Molecular weight
• Bioavailability
• Volume of distribution (Vd)
• Peak serum concentration
• Lipophilicity
• Protein binding
• PKa & ion trapping

Question 22

What is the safety metric AID stand for?

Answer 22

Absolute Infant Dose

Question 23

What is considered a safe RID (Relative Infant Dose) percentage?

Answer 23

<10%

Question 24

How is RID calculated?

Answer 24

(infant dose mg/kg/day) / (maternal dose mg/kg/day)

Question 25

What RID percentage indicates caution, especially for psychotropic medications?

Answer 25

>25%

Question 26

What should be considered in risk evaluation tools for drug safety during lactation?

Answer 26

* Maternal dose * Infant health * Drug properties

Question 27

What type of databases provide drug safety data for lactation?

Answer 27

Reference databases like LactMed