Drugs and Pregnancy Flashcards
Category A Examples
Folic Acid
Choline
Niacin
Category A
Proven to be safe for mother and fetus
Category B
Studies in animals show no evidence of harm
Or harm to animals, but no harm to humans
Eg, APAP
Category C
Largest group
Adverse effects in animals
No studies in humans
OR no studies performed in either
Eg, ASA
Category D & examples
Human studies have shown risk to fetus.
Benefits may outweigh risk
Eg, ACEIs, Lithium, Phenytoin, Carbamaapine
ASA in 3rd Trimester
Category X
Teratogenic Risks outweigh any possible benefit
Eg, Estrogen, Alcohol, Androgens, Coumarins, Statins, Thalidomide, Mifepristone, Misoprostol
New pregnancy model
1) Clinical management
2) Summary risk assessment
3) Discussion of animal and human data
3 New catagories
- 1 Pregnancy
- 2 Lactation
- 3 Females and Males of Reproductive Potential
What two preconception/prenatal effects cause low birth weight?
1) Intrauterine growth retardation
2) Premature labor and Delivery
Evidence of Nicotine and reproductive problems
- Cross the placenta readily
- Nicotine blocks apoptosis
- increases synthesis of neurotrophins
- nAChRs expressed very early in gestation
- Dev. Expression increases nAChR density
- Ach regulates neuron growth
- Synthesis/release of ACh shouldn’t being until late gestaion
What is the “out of sequence” hypothesis
In utero nicotine exposure impares precesses normalliy regulated by endogenous ACh –> long term consequences
What was the effect of nicotine in mice on open field behavior
Male, nicotine exposed mice hyper active
Nic evoked DA overflow?
Striatal
Increased IC50, decreased overflow
Nic evoked NE overflow?
Hippocampal
Decreased EC50. Increased outflow
What studies have shown NRT is effective in pregers population?
нет, Zero, none, zilch, nada,
