Week 3 pregnancy & lactation (everything) Flashcards Preview

SUM'20 - Advanced Principles > Week 3 pregnancy & lactation (everything) > Flashcards

Flashcards in Week 3 pregnancy & lactation (everything) Deck (125)
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1

***Physiological changes of pregnancy may alter drug disposition and effect through:

Indirect and Direct effects

2

**example of a DIRECT physiological change

Direct Effects - ex. Placental transfer

3

*** Even after delivery drugs may affect

breastfeeding

4

*** example of a INDIRECT physiological change

Indirect Effects - Changes in placental and uterine function

5

Pregnant women in U.S. average 4.2 medications (study from 2006-2008)
97% take at least

1 medication

30.5% of the 97% take at least 5 medications

6

Most common medications taken during pregnancy

Antiemetics
Antibiotics
Analgesics

7

***most common medications taken during pregnancy; at least 10% taking drugs with long term effects on CNS**

Antidepressants
Anticonvulsants
Antipsychotics

****

8

**concerns of medications during pregnancy:

Teratogenicity Effects ( not only congenital abnormalities but non-birth development such as puberty) **

9

Teratogenicity Effects of medications results

examples

Fetal Loss
Congenital Malformation
Fetal Growth Restriction
Preterm Labor

10

Genetic difference responsible for

some variations in genetic response

11

Pregnancy does not obviously modify

pharmacogenetic

12

Obstetric conditions are related to

complex genetic factors

13

**Metabolism of codeine to morphine greatly affected by

polymorphisms ( means “many form” and it occurs when we have many classes that are related to each other by inheritance) **

14

*** exam** Recently recognized mothers who are ultra-rapid metabolizers of codeine may transfer morphine

through breast milk to cause neonatal CNS depression and even death

15

Major physiologic changes during pregnancy alter drug disposition

Absorption and Uptake

16

physiologic changes in pregnancy alter Oral absorption and bioavailability

not usually affected by pregnancy

17

physiologic changes in pregnancy alter Intestinal motility

decreases

18

physiologic changes in pregnancy on gastric emptying

Gastric emptying only delayed during labor or administration of opioids

19

physiologic changes in pregnancy on FRC

Reduced FRC (functional residual capacity)

20

physiologic changes in pregnancy on minute ventilation:

Increased minute ventilation

21

increased minute ventilation increases pulmonary uptake of:

increases pulmonary uptake of inhalation anesthetic agents

22

renal blood flow increases what percent

60-80%

23

GFR increases what percent

50%

24

If a drug is excreted unchanged by the kidneys - how do we adjust the dose

increase the dose

(due to increased GFR - renal BF increases 60-80%)

25

if a drug is metabolized by the liver - what must we do to the dose

increase or decrease depending on metabolic pathway involved

26

bioavailability- the fraction of an administered drug that reaches systemic circulation- how is this changed in pregnancy

not usually changed significantly

27

physiologic changes of pregnancy will affect individual drugs depending on what?

their physicochemical characteristics (physical and chemical) and metabolic pathways

28

**exam during pregnancy what three drugs do you increase metabolism of?

phenytoin
morphine
midazolam

29

**exam - during pregnancy what two drugs do you decreases metabolism of

caffeine
theophylline.

30

**exam- name the drug used for mild analgesic and antipyretic during pregnancy.

does it have a teratogenic risk associated with this drug?

There is no know teratogenic risk associated with the use of ACETAMINOPHEN