Perinatal Pharmacology

Question 1

Teratogen definition

Answer 1

An agent that induces congenital anomalies during embryo or fetogenesis

Question 2

4 most common causes of congenital malformations

Answer 2

Unknown
Genetics
Maternal condition
Drugs

Question 3

How high is the risk for problems during the 
1. Pre-implantation
2. Embryonic development
3. Fetal development
stage?

Answer 3

1. Low
2. High (organogenesis)
3. Moderate risk
   Brain is always at high risk!

Question 4

What kind of drugs cross the placenta?

Answer 4

Small, lipophilic, uncharged, non-protein bound drugs

Passive diffusion

Question 5

3 ways drugs can get to the fetus

Answer 5

Transplacental
Intraamniotic
Direct to fetus (umbilical vein or IM injection)

Question 6

Are weak acids or bases the ones that get trapped in breast milk?

Answer 6

Weak bases

Question 7

How is absorption different in infants?

Answer 7

Higher gastric pH
Erratic gastric emptying time and reduced intestinal surface area in neonates
Thinner stratum corneum
Greater surface area:mass ratio

Question 8

How is distribution different in infants?

Answer 8

TBW highest at birth and decreases with age

Concentration and binding affinity both decrease

Question 9

How is metabolism different in infants?

Answer 9

Neonates not born with full complement of metabolic enzymes

Expression and activity gradually increase over time

Question 10

How is excretion different in infants?

Answer 10

GFR and renal tubular secretion are only at 20% of normal

Question 11

Optimal dosing for infants based on what 4 things

Answer 11

Plasma drug [ ]
Body surface area
Weight
Age