17) Pharmacotherapy in pregnancy and breastfeeding: Flashcards
why must pregnant women be given careful consideration in drug therapy
exhibit altered pharmacokinetics or pharmacodynamics responses
potential to cross the placenta abd cause adverse fetal effects
which drugs easily cross the placental barrier
- small mw
- unchanged at physiological pH
- highly lipid soluble
which drugs slowly cross the placental barrier
-weak acids
-ionized at physiological pH
high mw
stongly bind to PP
other factotr influencing transplacental drug movement
maternal-to-fetal concentration gradients,
phK and phD in preg
⦁ cardiac output increases up to 40%;
⦁ renal blood flow, glomerular filtration and plasma volume increase;
⦁ plasma albumin concentration decreases
what is the risk-benefit analysis of drug use in pregnant women
5 point scale from category A to X used for drug administration in pregnancy
⦁ Category A
safest
considerable data available concerning the use of the drug in pregnant women and the risk of fetal harm appear negligible
⦁ Category B
Animal studies showed no risk and there is little human data,
or the animal studies showed some risk that wasn’t confirmed in humans
⦁ Category C
no animal or human studies
or
animals risk but no human studies
⦁ Category D
evidence of human fetal risk, but the benefits of the drug may still overweigh risks in certain situations.
⦁ Category X
animal or human studies show a fetal risk outweighing any potential benefit to the mother.
Drugs in this category pose definite and high risk if used during pregnancy.
pregnancy and DB drug recc
I: strict insulin contral
CI: sulfonylurea
pregnancy and HTN drug recc
methyldopa, prazosin
CI
- beta blockers
- diurretics
- ccb
pregnancy and UTI
cefalopsorines
CI
-sulfonamide
drugs during breastfeeding
drugs can be excreted into breast milk which can be exposed to baby
