Module 1: Chapter 7 Life Span: pregnant or Breast-feeding women Flashcards
True or False: Most drugs given during pregnancy will not pass to the fetus
False: unlike the BBB the placenta allows most drugs to travel through the maternal circulation to the fetus
what is the most important consideration in drug therapy for pregnant women
the potential adverse effects on the developing fetus
true or false: some health problems occur secondarily to pregnancy and require drug therapy
true
how is a fetus treated if it has health problems
drugs are administered to the pregnant woman with the intent of treating the fetus as the drug passes through the placenta
physiological and anatomic changes occur during pregnancy that can alter the _______ of drugs
pharmacokinetics
what systems are primary anatomic and physiologic changes seen in with a pregnant woman
endocrine GI cardiovascular circulatory renal system
What are the changes in the GI system influenced by during pregnancy
pregnancy hormones and pressure from growing uterus
what hormone decreases gastric tone and motility and prolongs stomach emptying time
progesterone
what hormone also promotes functional respiratory system changes during pregnancy
progesterone
tidal volume during pregnancy increases by what
30-40%
tidal volume increases by what % in minute volume by term
50%
what will the effect of inhaled medications during pregnancy
increased absorption due to increased tidal volume
hemodynamic changes in the cardiovascular system alter drug _________ and _________
distribution and metabolism
are drugs that are passed through out the mothers body are usually passed in large amounts in breast milk
no, usually in minimal amounts
are all drugs present in breast milk well absorbed by the neonate
no
is drug metabolism altered by pregnancy or breast feeding
no
by the third trimester the renal blood flow has increased by what % compared to pre-pregnancy level
40-50%
what does glomerular filtration rate increase by in pregnancy
50%
can drug excretion rates be increased during pregnancy
yes
what are the two dramatic physical changes occur in the mother during pregnancy
CO is increased by 50% at 32 weeks
second trimester on arterial blood pressure is decreased
what are teratogenic effects
physical defects on a fetus
true or false: precise effects of drug therapy on a fetus are mostly undetermined
true
how are drugs identified as a teratogen
based on the findings of animal teratology studies
what are category A drugs
drugs that fail to demonstratre a risk to the fetus
what are categroy b drugs
animal studies that fail to demonstrate a risk but there are no controlled human studeins in pregnant women; or animal studies that demonstrate fetal risk that was not confirmed in controlled human studies in pregnant women
what are category c drugs
animal studies demonstrate fetal risk
no controlled human studeins in pregnant women to rule out fetal risk
drugs are given if the benefit justifies the risk
what are category D drugs
controlled human studies demonstrate positive evidence fetal risk
in life-threatening situations, the benefit may be acceptable despite the risk
what are category x drugs
controlled human studies demonstrate fetal risk. the fetal risk outweighs any possible benefit.
use in pregnant or potentailly pregnant women is contraindicated
what happened in 2005 regarding the american academy of pediatrics committee on drugs
published its updated recommendations on drugs and breast-feeding
what does the report publihsed by the american academy of pediatrics committee on drugs identify
several categories of drugs and their potential to cause problems with breast-feeding
true or false: common symptoms of pregnancy do not mask the adverese effects of drug therapy
false they do
when is the critical period of organogenesis
from implantation up to approximately 58-60 days after contraception
what is organogenesis
development of organs
when should drugs that cause teratogenic effects definitely not be administered
during the period of organogensis
are drug interactions changed during pregnancy and breast-feeding
no
what are 3 common complications of pregnancy
heartburn
hypotension
nausea
what are the 4 prior conditions of concern in pregnant women that need to be closely monitored
cardiovascular
seizure disorders
depression
diabetes mellitus
why are cardiovascular conditions of concern when a woman becomes pregnant
because changes in teh cardiovascular system occur
why are seizure disorders of concern in a woman that becomes pregnatn
because antiseizure medication have been shown to be teratogenic
why is depression a condition of concern when a woman with depression becomes pregnant
unclear about long-term effects on the fetus
why is the condition of DM a concern in a woman that becomes pregnatn
increased incidents of congenital abnormalities
why are teenaged girls at addition risk for teratogenic drug effects
because of sharing of prescription medication
true or false: alcohol is a known human teratogen
treu
what effect does cocaine abuse have on a fetus
causes adverse fetal effects and is suspected to be a human teratogen
what effect does opiate abuse have on a fetus
not appear to significantly increase the risk for congenital anamolies
can cultural beliefs affect whether a woman accepts certain drug therapies while she is pregnant or breast-feeding
yes
true or flase: limitiing drug use in pregnancy decrease maternal and fetal adverse effects
true
should some drugs be considered absolutely safe when administered during pregnancy
no
what should women of childbearing age be assessed for before any drug therapy is initiated
pregnancy
what should be considered before drug therapy during pregnancy
nonpharmacologic alternatives
when evaluating a pregnant patient during drug therapy what must you be careful to distinguish between
discomforts of pregnancy from possible adverse drug effects
the nurse’s role in conseling about pregnancy and fetal drug effects ideally begins before when
the pregnancy
