Module 2 Pharm Flashcards
Which system does not change with pregnancy?
a) endocrine
b) kidney
c) liver
d) GI
a)endocrine
How much does renal blood flow increase in pregnancy (and thus GFR)?
Twice (doubles)
What can be a consequence of increased GFR?
a) accelerated drug clearance
b) decreased drug clearance
c) decreased metabolism
d) toxicity
a)accelerated drug clearance
What percentage of congenital anomalies are due to genetic factors?
a) 10%
b) 15%
c) 20%
d) 25%
d)25%
When are teratogens most dangerous?
a) preimplantation/presomite
b) embryonic
c) fetal
d) more than one of the above
a)preimplantation/presomite
The period from conception to week 2. Teratogens act in ALL or NOTHING fashion.
Teratogen exposure in embryonic period causes what?
a) death of conceptus
b) gross malformations
c) function issues
d) none
b)gross malformations can occur if teratogen exposure occurs in embryonic period (1st trimester)
Teratogen exposure in fetal period (2nd and 3rd trimester) can result in brain/behavior/functional issues
True or false: proof of teratogenicity means a drug will cause a congenital anomaly at every exposure?
False.
True of false: lack of proof of teratogenicity does not mean a drug is safe?
True
What causes neonates and infants to be at risk for drug reactions?
a) immature liver
b) immature kidney
c) immature immune system
d) one or more of the above
e) none of the above
d) one or more of the above
rationale: infant organ systems are immature which places them at risk for drug sensitivity
In infants and children, there is a risk for drug effects which are ______ and ______.
a) mild and short
b) intense and prolonged
c) intense and short
d) none
b) intense and prolonged
Because drugs remain above MEC longer than in adults
True or false: dosing infants on body size alone is safe.
False. This is not safe as the issue with drug sensitivity relates to immature organ systems and immature pharmacokinetic processes.
An infants’ GI may affect drugs via:
a) delayed gastric emptying
b) increased gastric emptying
c) low (acidic) gastric pH
d) high (basic) gastric pH
e) one or more of the above
Answer:
a & c
Infant gut has delayed and erratic emptying so drugs may be more absorbed. Additionally, gastric acidity is low so acid-labile (loving) drugs have an increased absorption
IM administration of drugs in infants is _____ than in adults.
a) faster
b) slower
c) the same
b) slower
Low blood flow through muscles slows the absorption rate of IM drugs
Transdermal administration in infants is ____ than in adults.
a) faster
b) slower
c) the same
a) faster
Skin is thin and blood flow greater to the skin so there is a risk for toxicity associated with topical drugs.
Drug protein is limited in the infant due to:
a) low albumin
b) competition from endogenous compounds
c) low perfusion
d) increased hepatic metabolism
e) one or more of above
answer:
a &b
Drug binding to protein is limited due to low albumin (less places to bind) and competition with endogenous compounds (less places to bind). This causes free drug levels to be higher.
