Fetal + Neonatal Pharmacology

Question 1

What could be used to stimulate lung maturation in fetuses?

Answer 1

corticosteroids

Question 2

What could be used for ductus arteriosus patency?

Answer 2

NSAIDs promote closure

Question 3

Which are more likely to cross the placenta: Mol Wt. < 600 or MW >1000

Answer 3

drugs with mol. wt >1000 do not cross. Rationale for heparin use in pregnancy

Question 4

What does category A mean?

Answer 4

studies in pregnant women show no demonstrated risk to fetus in all trimesters

Question 5

What does category B mean?

Answer 5

animal studies may or may not have shown a risk but it hasn’t shown risk in pregnant women.

Question 6

What does category C mean?

Answer 6

animal studies show risk and there isn’t enough info from pregnant women to show risk or safety

Question 7

What does category D mean?

Answer 7

evidence of human fetal risk, but potential benefits may make them acceptable

Question 8

What does category X mean?

Answer 8

animal and human studies show fetal defects. Risk outweights benefit.

Question 9

What physiologic factors put fetuses at greater risk for toxic events than adults?

Answer 9

slower GI and faster absorption. More body water than lipids.
Limited protein binding leads to high free drug
Immature enzymes
Larger brain/body ratio
permeable BBB
immature kidneys

Question 10

How long would a male teratogen (sperm mutations) take to have effect?

Answer 10

sperm takes 64 days to develop so look for incidents 2 months after taking drugs