Ch. 9: Pregnancy

Question 1

How many pregnant patients take drugs?

Answer 1

• 2/3 take at least one medication; most take more
• chronic disorders
• infectious diseases of cancer
• pregnancy-related problems
• drugs of abuse (alcohol, cocaine, and heroin)

Question 2

Physiologic Changes and Impact on Drug Disposition and Dosing

Answer 2

• third trimester: renal blood flow is doubled and renal excretion is accelerated
• tone and mobility of bowel decrease causing prolongation of drug effects

Question 3

Adverse Reactions

Answer 3

• affect both mother and fetus
• heparin causes osteoporosis
• prostglandins stimulate uterine contraction
• pain relievers used during delivery can depress respiration in the neonate

Question 4

Teratogenesis

Answer 4

• birth defect: gross malformations and neurobehavioral and metabolic anomalies
• less than 1% of all births defects are caused by drugs
• identification can be difficult
• only a few drugs are considered proven teratogens

Question 5

Teratogenesis and Stage of Development

Answer 5

• conception through week 2
• ebroyonic period: weeks 3-8 (gross malformations produced by teraotgens)
• fetal period: week 9- (functions disrupted with teratogen exposure)

Question 6

Breast-Feeding

Answer 6

• can be excreted in breast milk, and occur in the infant
• take drugs immediately ATER breast-feeding
• avoid drugs with long half-lives
• choose drugs that tend to be excluded from milk and are least likely to affect the infant
  0 avoid drugs that are known to be hazardous