Drugs in Pregnancy Labor and Lactation

Question 1

Factors that influence drugs’ passage across placenta

Question 2

How drugs affect fetus

Question 3

How drugs affect the fetus depends on

Question 4

Stages at which fetus is affected

Question 5

Effect of drugs administered during implantation stage

Answer 5

May lead to failure of pregnancy

eg. Methotrexate (anticancer drug)

Alcohol

Question 6

Effect of drugs adminstered during organogenesis

Question 7

Teratogenicity of thalidomide

Question 8

Teratogenicity of Retinoids

Answer 8

Skeletal deformities (strong)

Question 9

Teratogenicity of methotrexate

Answer 9

Cleft palate/hydrocephalus

Question 10

Teratogenicity of Phenytoin

Question 11

Teratogenicity of Valproate

Question 12

Teratogenicity of Warfarin

Answer 12

Nasal hypoplasia

Question 13

Teratogenicity of diethylstilbestrol

Answer 13

Adenocarsinoma of vagina in teenage years of the daughter

Question 14

Teratogenecity during the G and D stage

Question 15

Drugs given at end of pregnancy ie before or during labor

Question 16

Effect of Asprin

Question 17

Effects of Sulfonamides

Question 18

Effect of BZDs and Opiates

Question 19

More teratogenic drugs

Answer 19

Question 20

FDA RISK CATEGORIES

Answer 20

Question 21

Effect of Pregnancy on Distribution

Question 22

Effect of drug on elimination

Question 23

Common chronic conditions in pregnancy

Question 24

Concerns with antiepileptic drugs

Question 25

Factors controlling transfer of drug to breast milk

Answer 25

* Lipid solu * MW * Ionization * Blood flow **Note:** most enter blood but at small amounts

Question 26

Drugs safe during breast feeding

Question 27

Drugs avoided during breast feeding

Question 28

Minimizing effects during breast feeding

Answer 28

* Avoid if possible * Safest effective medicine * LOWEST possible dose * Take immediately after breast feeding * Lactation risk guidelines