Wk 2 - Pregnancy Pharmacology

Question 1

Placental exchange routes:

Answer 1

Passive transfer (most common)
Facilitated diffusion (minor role)
Active transport
Phagocytosis / pinocytosis

Question 2

Placental passive transfer occurs across concentration gradient, and is affected by:

Answer 2

Surface area

Thickness of membrane

Question 3

Drugs are most likely to cross placenta with these characteristics:

Answer 3

Low molecular weight
Lipid soluble
Un-ionized
Unbound to proteins

Question 4

Decreased placental blood flow will…

Answer 4

…decrease drug transfer, and decrease drug clearance from fetus

Question 5

Heparin is _____ for pregnant mothers because the molecules are ______ and won’t cross placenta

Answer 5

Safe

Large

Question 6

Active transfer for placental transport requires ____ and ______ in placenta

Answer 6

Energy,

carrier proteins

Question 7

P-gp _______ the fetus.

INHIBITION of P-gp will ______ fetal exposure to drugs (verapamil, cyclosporine inhibit p-gp).

Answer 7

Protects

increase exposure

Question 8

These two drugs (and others) inhibit P-glycoprotein (which can as a result expose the fetus to harmful drugs):

Answer 8

verapamil, cyclosporine

Question 9

More breast milk = more ______ the drug

Answer 9

diluted

Question 10

_____ pH drug more likely to remain in plasma vs milk.

Answer 10

Higher

Question 11

Lipophilic drugs will _______ milk

Answer 11

transfer into

Question 12

Low protein binding of drug will result in _______ milk

Answer 12

transfer into

Question 13

Low molecular weight drugs will _________ milk

Answer 13

transfer into

Question 14

Low ionized drugs will _______ milk

Answer 14

transfer into

Question 15

Only ______ drug will cross placenta

Answer 15

unbound “free drug” crosses (i.e. highly protein bound drugs WON’T cross placenta)

Question 16

Pregnancy registries purpose is to

Answer 16

monitor outcomes of pregnancies exposed to medical products

Question 17

Pregnancy registries are ______

Answer 17

Prospective observational data; NOT random controlled trials

Question 18

The anti-epileptic drug can cause _______ in the baby

Answer 18

lamotrigine / lamictal; cleft palette

Question 19

This acne drug can cause these congenital malformations in the fetus:

Answer 19

Isotretinoin / Accutane; abnormalities of the face, eyes, ears, skull, central nervous system, cardiovascular system, thymus, and parathyroid glands

Question 20

This SSRI antidepressant can cause these congenital malformations in the fetus ______

Answer 20

Paxil / paroxetine; cardiac (ASD, VSD)

Question 21

In pregnancy, plasma albumin ______, and unbound drug _______

Answer 21

plasma albumin decreases

unbound drug increases

Question 22

In pregnancy, both body weight and plasma volume ______, and volume of distribution _______

Answer 22

increases

increases

Question 23

In pregnancy, body fat ______, and volume of distribution of lipophilic drugs _______

Answer 23

increases

increases

Question 24

In pregnancy, gastric motility is ________, leading to ______ drug absorption

Answer 24

delayed

delayed

Question 25

In pregnancy, hepatic drug flow ______, and drug clearance _______

Answer 25

increases

increases

Question 26

In pregnancy, renal drug flow and GFR ______, and renal clearance _______

Answer 26

increases

increases

Question 27

In pregnancy, gastric acid secretion ______, and oral bioavailability of anionic drugs ________.

Answer 27

decreases

decreases

Question 28

In prenancy, CYP450 enzyme activity and drug metabolism _______

Answer 28

changes

Question 29

In pregnancy, ________ result in decreased drug absorption, bioavailability, and blood concentration

Answer 29

nausea and vomiting