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Clinical PK Exam 3 > Obstetric Pharmacology & Clinical PK > Flashcards

Obstetric Pharmacology & Clinical PK Flashcards

1
Q

What is pregnancy dating in days

A

~280 days

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2
Q

What is pregnancy dating in weeks

A

~40 weeks

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3
Q

what is pregnancy dating in months

A

~9 months

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4
Q

How long is the first trimester

A

1-3 months

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5
Q

how long is the second trimester

A

4-6 months

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6
Q

how long is the third trimester

A

7-9 months

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7
Q

when do physiologic changes happen in maternal mothers

A

first trimester

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8
Q

when does physiologic changes peak in maternal mothers

A

second trimester

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9
Q

How is gastrointestinal affected in maternal mothers

A
  1. delayed gastric emptying
  2. increased gastric pH
  3. reduced intestinal motility
  4. nausea and vomiting
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10
Q

Which of the following decrease absorption

A

Nausea and vomiting

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11
Q

how does body composition affect maternal mothers

A
  1. increases body fat
  2. increases blood volume
    - hydro and lipophilic drugs increase this
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12
Q

how does increased cardiac output affect maternal mothers

A

they are also pumping blood to placenta for the baby

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13
Q

how does protein binding affect maternal mothers?

A
  1. decreased albumin concentrations

2. increased medication affinity compared to fetus

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14
Q

which of the following crosses the membrane better?

A

lipophilic

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15
Q

what hormones increase in maternal mothers?

A
  1. estrogen

2. progesterone

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16
Q

what CYP450 increase function in maternal mothers

A
  1. 2C9
  2. 2D6
  3. 3A4
17
Q

what CYP450 decrease function in maternal mothers

A
  1. 1A2

2. 2C19

18
Q

what increases during the elimination process in maternal mothers

A

GFR

19
Q

what factors affect placental drug transfer and effects on the fetus

A
  1. properties of medication
  2. rate of medication placental diffusion
  3. amount of medication reaching the fetus
  4. duration of medication exposure
  5. distribution properties of medication in fetal tissue
  6. stage of fetal development at exposure
  7. effects of medications used in combination
20
Q

What does not cross the placenta

A
  • insulin

- heparin

21
Q

what transporters take drug away from the fetus

A
  1. Pgp
  2. BCRP
  3. MRP3
22
Q

how does drug cross the placenta

A
  • passive diffusion
  • facilitated transport
  • active transport
23
Q

how does protein binding affect the fetus

A
  1. increased fetal albumin

2. decreased medication affinity compared to mother

24
Q

what medication properties should be considered in placental pk

A
  1. lipophilicity
  2. ionization
  3. molecular weight
  4. protein binding (do not cross the placenta)
25
Q

what acts as a first pass metabolic step

A

placenta

26
Q

where does drug travel to after the placenta

A

liver and then it may recirculate through the liver prior to exiting through placenta

Clinical PK Exam 3 (5 decks)

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