A1 - Drug use in pregnancy and minor ailments

Question 1

Time period of the first trimester and when is it measured from

Answer 1

1-12 weeks
Day 1 of the last period

Question 2

Time period of the second trimester

Answer 2

12 - 27 weeks

Question 3

Time period of the third trimester

Answer 3

28 - 40 weeks

Question 4

What are the 3 stages of development in pregnancy

Answer 4

pre embryonic
embryonic
foetal

Question 5

Pre embryonic stage

Answer 5

0-17 days - implantation of the feritlised ovum

Question 6

Embryonic stage

Answer 6

18-56 days
major organ systems development

Question 7

foetal stage

Answer 7

8-38 weeks
maturation, development and growth

Question 8

3 main issues to deal with in pregnancy

Answer 8

taken medicines unaware they are pregnant

want to become pregnant but require essential treatment for a chronic condition

they need treatment for a condition after they are aware fo oregnancy ie hypertension / nausea and vomiting

Question 9

Pharmacokinetic changes of absorption in pregnancy (3)

Answer 9

reduced gut motility - although does not cause many consequences

increased lung function

increased skin blood circulation

Question 10

Pharmacokinetic changes of distribution in pregnancy (4)

Answer 10

reduced plasma proteins
increased plasma volume
increased body water
increased fat disposition

Question 11

Pharmacokinetic changes of metabolism in pregnancy (3)

Answer 11

enzyme induction increased
affect on drugs is difficult to predict
drugs with narrow therapeuitc ranegs have to be monitored

Question 12

What 2 drugs need adjusted doses for pregnant woman because of changes to metabolism

Answer 12

methadone / phenyotin - higher maintenance dose

thepphylline - lower doses

Question 13

Pharmacokinetic changes of elimination in pregnancy (2)

Answer 13

increased golmerular flitration
increased penicliin & digoxin elimination

Question 14

Define teratogens

Answer 14

agents that dorectly or indirectly cause structural and functional abnormalities in the foetus , or child after birth which may not become apparent until later life ie spina bifida or intellectual/ behavioural disorders

Question 15

How does timing of exposure to teratogens affect pregnancy (3)

Answer 15

pre embryonic phase - ‘all or nothing’ - cells divide quicly so embryo dies or completely develops

embryonic phase - greatest risk for embryonic defects (phase where most major organs developed etc)

foetal phase - less suseptible to toxic effetcs but structural and functional abnormalities and growth retardation can occur