Pregnancy

Question 1

Clomiphene

Answer 1

Pregnancy
-weak partial agonist at estrogen receptor but..
MOA
•Clomiphene blocks hypothalamic estrogen receptors, thus inhibiting estradiol’s negative feedback on hypothalamus
oCausing an increase secretion of GnRH then FSH and LH
-Overall result is to stimulate ovulation
TX
-single 50mg tablet daily for 5 consecutive days, increasing by 50mg increments in subsequent cycles until ovulation is induced

Question 2

Enalapril, Lisinopril

Answer 2

Pregnancy
-Angiotensin-Converting Enzyme (ACE) Inhibitors 
-“–prils”
MOA
-inhibit peptidyl dipeptidase
  oAlso inhibits plasma kininase which inactivates bradykinin (potent vasodilator) used for BP
C/I
-*sig. renal failure in infants

Question 3

Opioids

Answer 3

Pregnancy
-fetuses exposed to opioids through mom can have Neonatal Abstinence Syndrome (NAS)-> present w/ withdrawal symptoms
SX
•Tremors (trembling)
•Irritability (excessive crying)
•High-pitched crying
•Seizures
•Vomiting

Question 4

Teratogenic Mechanisms

Answer 4

Pregnancy
•Direct effects on maternal tissue affecting the fetus
•Interference with passage of oxygen/ nutrients through the placenta
•Direct effects on differentiation of tissues
oVitamin A
•Deficiency of critical substances
oFolic acid (spina bifida)

Question 5

Folic Acid Deficiency

Answer 5

Pregnancy

•Neural Tube Defects i.e. Spina bifida

Question 6

Thalidomide

Answer 6

Pregnancy

•Phocomelia – malformation of limbs–> look like seals

Question 7

Fetal Alcohol Syndrome

Answer 7

Pregnancy
Symptoms:
oPoor Growth
oDecreased muscle tone and poor coordination
oDelayed development: thinking, speech, movement, or social skills (3 of 4)
oHeart Defects (heart murmur)
•Alcohol Use Increases risk of Miscarriage
-distinct anatomical changes when baby exposed to alcohol in utero → small head, small jaw, *low nasal bridge, *epicanthal folds, *thin upper lip

Question 8

Tobacco Smoking/Nicotine

Answer 8

Pregnancy
Symptoms:
oIntrauterine growth restriction
oStillbirth 
oNeurobehavioral deficiency
oRisk Factor for SIDS