Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Female Repro Pharm > Drug use During Pregnancy > Flashcards

Drug use During Pregnancy Flashcards

1
Q

What are 4 physiological changes in a pregger woman that influence the effect of drugs on the body?

A
  1. GI changes: decrease gastric acid secretion, high pH
  2. CV changes: plasma volume expansion, increased cardiac output (which influences change in drug distribution and elimination)
  3. Blood composition: decreased albumin levels (changed binding of drugs)
  4. Renal changes: increased blood flow and increased GFR (increased renal clearance of drugs)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the changes in hepatic enzyme activity in pregger women?

A

Increased metabolism by CYP3A4, CYP2D6 (often need more drugs to get same effect. Example: methadone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Caudal regression syndrome is associated with what disorder?

A

Maternal diabetes mellitus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Thalidomide’s significance?

A

This drug was tested in dogs, which metabolize drugs differently than we do. The dogs were fine, but in humans it caused severe limb abnormalities in children (there was specific link between time of exposure and defect). This taught us that the placenta is not a barrier, we need to pick our testing animal carefully and that there is a precise relationship between time of exposure to drug and the defect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

FDA category A drug

A

Category A: No risk, human studies done

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

FDA category B drug

A

Category B: Animal studies show no risk but no human studies OR animal studies show increased risk and human studies show no risk.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

FDA category C drug

A

Category C: Animal studies show increased risk, no human studies OR no human or animal studies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

FDA category D drug

A

Category D: Proven risk for humans, but benefits may outweigh risks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

FDA category N drug

A

Category N: Drug is not classified

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

FDA category X drug

A

Category X: Proven risk for humans, animals or both, risks outweigh benefits.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Example of Category A drug

A

Prenatal vitamins, T4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Example of Category B drugs

A

Penicillin or Acetaminophen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Example of Category C drugs

A

Nifedipine, Sumatriptan (migraine meds) Lamotrigine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Example of Category X drug

A

Warfarin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What category do ACE inhibitors fall under?

A

C and D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Example of Category D drug

A

Valproic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What can ACE inhibitors cause in children

A

CV anomalies

Fetal Renal failure

Olioghydramnios

Pulmonary Hypoplasia

Stillbirth

18
Q

Anti-seizure medications increase your risk for

A

Neural tube defects

19
Q

What’s an example of an acne medication that can cause spontaneous abortion in 40% of cases

A

Isotretinoin (Accutane)

20
Q

Based on the trimester of warfarin exposure, what are the possible effects on the fetus?

A

1st trimester: Fetal Warfarin Syndrome

2nd trimester: Mental retardation, blindness

3rd trimester: hemorrhage, stillbirth

21
Q

What kind of problems can result from the use of Diethylstilbestrol (DES)

A

Mullerian Anomalies or Vaginal Clear Cell Carcinoma

22
Q

What can DES be used for now (not contraception)

A

Palliative care for inoperable breast cancer and progressive inoperable prostate cancer

23
Q

What are the adverse effects of using Metronidazole in pregnancy?

A

NONE in pregnancy but….

  1. Carcinogenic in rodents
  2. Mutagenic in bacteria
  3. No associated malformation in humans
  4. Avoid 1st trimester
24
Q

What are the adverse effects of using Sulfonamides during pregnancy?

A
  1. Competes with bilirubin-binding sites
  2. Potential for hyperbilirubinemia
  3. No known malformations
25
Q

What are the adverse effects of using Aminoglycosides in pregnancy??

A
  1. Potential for ototoxicity (ear problems) (1-2%)
  2. No associated malformations
26
Q

What are some adverse effects of Quinolones in pregnancy?

A
  1. High affinity for bone/cartilage
  2. Arthropathy in children
  3. No known malformations
27
Q

What’s bad about drinking whisky* while pregnancy?

*Read: alcohol

A

Dose-dependent Effects:

≥ 3 oz. EtOH/day: 50% abnormal

1-2 oz EtOH/day:functional & growth disturbances

<1 oz EtOH/day: usually no effect

28
Q

Real bad outcome of drinking alcohol while pregnancy (hint: it has FETAL and ALCHOL in the name)

A

Fetal Alcohol Syndrome:

  • Absent Philtrum (space between base of nose and upper lip)
  • Midface Hypoplasia
  • Low Nasal Bridge
  • Low Set Ears
  • Microcephaly (small head)
  • Shortened Palpebral Fissures (opening between the eye lids)

On a practice question, saddle nose came up. I jumped straight to Syphilis. Don’t do that, it could be FAS…

29
Q

What’s a bad outcome associated with cocaine use during pregnancy (that’s right folks, cocaine)

A

Vascular disruption

30
Q

What about using LSD during pregnancy?

A

NO CLINICAL EFFECTS. Huh.

31
Q

Smokin a J while pregnant? What’ll happen?

A

Dose related IUGR (intrauterine growth restriction)

32
Q

Taking amphetamines while pregnant? Just going cray while having a baby, its totally fine. Nawt.

A

IUGR, cardiac defects, facial clefts

33
Q

Heroin/Methadone use while pregnant?

A

Neonatal withdrawal

34
Q

What drugs can you used to prevent preterm births?

A
  1. 17-OH progesterone
  2. Tocolytics (MgSO4, Beta mimetics, indomethacin, Ca2+ channel blockers)
35
Q

Drugs that you can use to induce labor?

A
  1. Oxytocin
  2. Cervical ripening agents (their words not mine) such as prostaglandin E1 and dinoprostone (giving the mom something to get that DINO inside her out. Ha. Ha)
36
Q

What’s the problem with giving Misoprostol aka Cytotec (an inducer of labor, also used in abortions) during pregnancy?

A
  1. increased risk of miscarriage (40%!)
  2. Use during 1st trimester is associated with Mobius syndrome
37
Q

What is Mobius syndrome and what can cause it again?

A

Caused by: Misoprostol

Sx: cranial nerve VI/VII palsy, limb malformations, craniofacial abnormalities

38
Q

What category does the FDA put Misoprostol/Cytotec in?

A

Category X Which means that it has proven risk for humans, animals or both, risks outweigh benefits.

39
Q

How can you treat hemorrhage during prganncy/labor

A
  1. Oxytocin
  2. Methyl Ergonovine (Methergine)
  3. Prostaglandin E1, F2 alpha
40
Q

What do you use MgSO4 for in pregnancy women?

A

Prophylaxis for seizures/eclampsia

41
Q

What do you use Beta-Methadone for

A

Fetal benefits: treats

  1. Pulmonary immaturity
  2. Neonatal necrotizing enterocolitis
  3. Intracranial bleeding
42
Q

HIGH YIELD: How to you prevent neonatal group B strep?

A

Give penicillin to the mother DURING LABOR

Female Repro Pharm (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions