Pharmacology in Pregnancy and Breast Feeding

Question 1

why may a woman be on medication during pregnancy

Answer 1

asthma 
hypertension 
epilepsy
migraine 
mental health disorder

Question 2

what are the pharmacokinetic changes during pregnancy

Answer 2

absorption
distribution
metabolism
excretion

Question 3

what are the changes in absorption

Answer 3

oral route-may be more difficult due to sickness, decreased gastric emptying
IM- blood flow increase so absorption increase
inflation- increases CO
absorption overall decreases

Question 4

what are the distribution changes during

Answer 4

increase in plasma volume and fat changes distribution

decrease in plasma proteins

Question 5

what are the metabolism changes during pregnancy

Answer 5

oestrogen and progesterones can indue or inhibit liver enzymes
increasing or reducing metabolism

Question 6

what are the excretion changes in pregnancy

Answer 6

GFR increased soo increase in excretion

Question 7

what are the pharmacodynamic changes

Answer 7

prgenancy may affect the site of action response to drugs- concentration of drug and mechanism of drug

Question 8

what are the functions of the placenta

Answer 8

attach the fetus to the uterine wall
provide nutrients to the fetus
allos transfer of waste produced

Question 9

what goes from mother to fetus

Answer 9

oxygen
glucose 
amino acids 
antibodies 
virus 
drugs
vitamins

Question 10

what goes from the fetus to the mother

Answer 10

Co2
urea
waste products

Question 11

what does placental transfer depend on

Answer 11

molecular weight-smaller

Question 12

where is fetal excretion

Answer 12

into aminitoc fluid

Question 13

when is teratogenicity

Answer 13

first trimester
biggest risk between 3-8 weeks
oxidative stress
neural crest cell disruption

Question 14

when is fetotoxicity

Answer 14

second and third trimester

Question 15

what two types of drugs stop folate production

Answer 15

block conversion of folate by binding to enzyme

block other enzymes

Question 16

what does folate disruption lead to

Answer 16

neural tube defects -isoteretinon
aortic arch anomalies
oesophageal atresia

Question 17

what is fetotoxicity

Answer 17

toxic effect on fetus later in pregnancy
growth retardation
fetal death
ACE inhibitors

Question 18

what are known drugs to cause teratogenic affect

Answer 18

anticonvuslants- valporate
anticoagulants-warfarin
alcohol
retinoids

Question 19

what are the issues with drugs and lactation

Answer 19

most drugs will be present in lactation at smaller dose

Question 20

what drugs to avoid when breast feeding

Answer 20

cytotoxic
immunosuppressants
anti-convulsants
lithium  
if liscenced and safe in paediatric use it should be safe

Question 21

what are the principles of prescribing in pregnant women

Answer 21

warm of risks

discuss contraception