pharm of prego

Question 1

drug transfer across placenta

Answer 1

dependent upon lipid solubility and polarity

Question 2

thiopental

Answer 2

barbituate used in C-sections

rapdily crosses placenta

Question 3

succinylcholine and tubocurarine

Answer 3

used in C-sections

highly charged and cross placenta slowly

Question 4

heparin

Answer 4

safe togive in prego

Question 5

warfarin

Answer 5

crosses placenta and is teratogenic

Question 6

what tissues can be effected by drugs differently during prego

Answer 6

repro- breast and uterus

Question 7

what tissues are not effected differently during prego?

Answer 7

heart
lungs
kidneys
CNS

Question 8

examples of fetal Rx

Answer 8

corticosteroids to stimulate lungs
antiarrhythmics
zidovudine to prevent HIV transmission

Question 9

diethylstillbestol

Answer 9

increased risk for adenocarcinoma when child get to puberty

Question 10

teratogen characteristics

Answer 10

drug use results in characteristic set of malformations
exerts effects at particular stage of fetal development
dose-dependent incidence

Question 11

antiemetics

Answer 11

pyridoxine 
antihistamines
dopamine antagonists
serotonin antagonisits
glucocortiocoids

Question 12

pyridoxine

Answer 12

vit B6

precursor to pyridoxal increases GABA synthesis

Question 13

antihistamines

Answer 13

anticholinergic activity

doxylamine most common used in combo with pyridoxine

Question 14

when do you Tx preeclampsia with antiHTN

Answer 14

> 150/100

Question 15

antiHTNs for preeclampsia

Answer 15

labetalol
hydralazine (aa not vv)
nifedipine and nicardipinde (block LCaChs

Question 16

what should NOT be used to Tx HTN in prego

Answer 16

ACE inhibitors
angiotensin R blockers
direct renin inhibitors

Question 17

what should be used to Tx preexisitng HTN

Answer 17

labetalol
methyldopa
nifedipine
thiazide diuretics

Question 18

thiazide diuretics ADR

Answer 18

hypokalemic metabolic alkalosis
hyperglycemia
hyperlipidemia
hyponatremia

Question 19

Tx of GDB

Answer 19

insulin

lispro and aspart

Question 20

tocolytics

Answer 20

beta agonists
magnesium sulfate
CaCh blockers
COX inhibitors

Question 21

beta agonists

Answer 21

tachyphylaxis
ritodrine most commonly used
many adverse effects - tachy, low BP, bronchial relaxation

Question 22

magnesium sulfate

Answer 22

unknown MOA- possibly interferes with mysoin light-chain kinase
few adverse effects (diaphoresis and flushing)
CI in MG

Question 23

CCBs

Answer 23

questionable safety

Question 24

COX inhibitors

Answer 24

Indomethacin most commonly used
reduced PGs
primary fetal concerns is constriction of ductus arteriosus and oligohydramnios

Question 25

induction of labor

Answer 25

oxytocin

vaginal PGs

Question 26

oxytocin MOA

Answer 26

sitmulates uterine mm contraction via Gq -> stimualtes release of PGs and leukotrienes
also causes milk ejection

Question 27

opioids

Answer 27

does cross placenta dn decreased FHR and respirations

Question 28

neuroaxial analgesics

Answer 28

spinals and epidurals