OB Book pgs 63-70 Drug Transfer

Question 1

Factors affecting drug transfer across the human placenta
include: (6)

Answer 1

lipid solubility, protein binding, tissue binding, pKa, pH, and blood flow

Question 2

Although the free, unbound fraction of drug
equilibrates across the placenta, the total drug concentration is greatly affected by both

Answer 2

the extent of protein binding and
the quantity of maternal and fetal proteins

Question 3

Plasma levels of propofol in the neonate depend on what 2 things?

Answer 3

the maternal dose and the time elapsed between drug administration and delivery of the neonate.

Question 4

propofol may have what effects on the neonate?

Answer 4

sedative

Question 5

what 2 factors increase both placental tissue uptake and transplacental transfer of propofol?

Answer 5

Increased maternal blood flow and reduced protein binding

Question 6

Propofol is highly protein-bound to _____

Answer 6

albumin

Question 7

What drug causes calcium channel–dependent vasodilation of human placental vessels in vitro?

Answer 7

propofol

Question 8

T/F Ketamine rapidly crosses the placenta

Answer 8

true

Question 9

Human in vitro placental perfusion studies
with an equal concentration of albumin in the maternal and fetal perfusates confirm that ______ rapidly crosses the placenta in both maternal-to-fetal and fetal-to-maternal direction

Answer 9

methohexital

Question 10

Which benzo is characterized as being Highly un-ionized, lipophilic, and 95% protein-bound?

Answer 10

diazepam

Question 11

Which benzo is Less lipophilic and requires almost 3 hours after administration for the F/M ratio to reach unity?

Answer 11

lorazepam

Question 12

Which benzo is more polar?

Answer 12

midazolam

Question 13

T/F All opioids cross the placenta and can cause neonatal central nervous system and respiratory depression

Answer 13

True

Question 14

The extent of placental transfer and duration of effects of opiods on the fetal and neonate depend on ______

Answer 14

individual drug characteristics

Question 15

Historically, which opiod was often administered to
mothers for systemic analgesia during labor?

Answer 15

meperidine

Question 16

Intravenous maternal administration of which opiod results in rapid transfer across the human placenta within 90 seconds?

Answer 16

meperidine

Question 17

Human placental perfusion studies in vitro demonstrated rapid placental transfer in both maternal-to-fetal and fetal-to-maternal directions with what 3 factors?

Answer 17

with equal clearance profiles, minimal placental tissue binding, and no placental drug metabolism.

Question 18

T/F Morphine rapidly crosses the placenta

Answer 18

TRUE