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)
Loading flashcards...
61

fetal anticonvulsant syndrome refers to

the board orofacial, cardiovascular and digital malformations

62

fetal hydantoin syndrome

craniofacial abnormalities, and limb abnormalities

63

fetal carbamazepine associated with

spinal bifidia

64

fetal barbital syndrome associated with

decreased intellectual and cognitive development of neonates

65

fetal valproate syndrome

epicentral folds, shallow orbits, hypertelorism low ears flat nasal bridge

66

total body water increases

8%

67

intravascular volume increases what percent

Intravascular volume increases by 40% thus,

68

what type of drugs have increase volume of distribution

hydrophilic drugs- neuromuscular blockers

69

*** what drug has the highest teratogenic risk?

valproate

followed by:
Phenytoin
Phenobarbitone
Topiramate

70

anesthetic drugs do they go to the breast milk

no

71

ketamine give or avoid

avoid- do not give postoperative infusion of drugs

72

what diabetic drug should be used with caution while breast feeding

metformin- use with caution

73

sulfonamides are they safe while breast feeding

no

74

amiodarone while breastfeeding can cause what complications

iodine release- thyroid dysfunction.

75

phenobarbital and diazepam

can accumulate in the baby coming from breast milk.

76

intravascular volume increases by what %?

40%

77

*** due to the increased intravascular volume during pregnancy, hydrophilic drugs (such as NMB) have an increased:

volume of distribution ***

78

** body fat increases during pregnancy. given large vol of distribution what does this also impact?

lipophilic drug protein binding **

79

plasma albumin concentration is reduced about 70% -- what does this mean?

less protein binding locations

- increased concentrations of free drugs

80

increased concentrations of free drug (not pr bound) is offset by

increased clearance (GFR)

81

*** Total (free bound) concentration of a drug will decrease and we may need to

reset therapeutic target range lower to compensate **

82

*** these two drugs require monitoring and modification of dose b/c of changes in pr-binding:

Theophylline ***
Phenytoin

83

first trimester exposure to diazepam increase the R/O

cleft lip (with or w/o cleft palate)
neural tube defects
intestinal atresia
limb defects

84

perinatal use of diazepam has been associated with:

hypotonia
hypothermia
resp. depression

85

overall, it appears risks are small but benzo's should only be used in the first trimester if the perceived benefit offsets the possible

teratogenic risks

86

*** what drug has the highest teratogenic risk?

valproate

followed by:
Phenytoin
Phenobarbitone
Topiramate

87

the most common serious neurologic problem during pregnancy

epilepsy

88

this type of antidepressant does not appear to be associated w/ congenital abnormalities or neurodevelopmental problems

tricyclics

89

this type of antidepressant should be avoided in pregnancy

maoi's

90

this type of antidepressant cross the placenta to varying degrees

SSRIs