Obstetric Pharmacology & Clinical PK Flashcards
What is pregnancy dating in days
~280 days
What is pregnancy dating in weeks
~40 weeks
what is pregnancy dating in months
~9 months
How long is the first trimester
1-3 months
how long is the second trimester
4-6 months
how long is the third trimester
7-9 months
when do physiologic changes happen in maternal mothers
first trimester
when does physiologic changes peak in maternal mothers
second trimester
How is gastrointestinal affected in maternal mothers
- delayed gastric emptying
- increased gastric pH
- reduced intestinal motility
- nausea and vomiting
Which of the following decrease absorption
Nausea and vomiting
how does body composition affect maternal mothers
- increases body fat
- increases blood volume
- hydro and lipophilic drugs increase this
how does increased cardiac output affect maternal mothers
they are also pumping blood to placenta for the baby
how does protein binding affect maternal mothers?
- decreased albumin concentrations
2. increased medication affinity compared to fetus
which of the following crosses the membrane better?
lipophilic
what hormones increase in maternal mothers?
- estrogen
2. progesterone
what CYP450 increase function in maternal mothers
- 2C9
- 2D6
- 3A4
what CYP450 decrease function in maternal mothers
- 1A2
2. 2C19
what increases during the elimination process in maternal mothers
GFR
what factors affect placental drug transfer and effects on the fetus
- properties of medication
- rate of medication placental diffusion
- amount of medication reaching the fetus
- duration of medication exposure
- distribution properties of medication in fetal tissue
- stage of fetal development at exposure
- effects of medications used in combination
What does not cross the placenta
- insulin
- heparin
what transporters take drug away from the fetus
- Pgp
- BCRP
- MRP3
how does drug cross the placenta
- passive diffusion
- facilitated transport
- active transport
how does protein binding affect the fetus
- increased fetal albumin
2. decreased medication affinity compared to mother
what medication properties should be considered in placental pk
- lipophilicity
- ionization
- molecular weight
- protein binding (do not cross the placenta)
what acts as a first pass metabolic step
placenta
where does drug travel to after the placenta
liver and then it may recirculate through the liver prior to exiting through placenta
