Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neuro Pharmacology > Pregnancy Pauly > Flashcards

Pregnancy Pauly Flashcards

1
Q

When are neurotransmitters and their receptors synthesized during development?

A
  1. Prior to onset of synaptogenesis, suggesting a trophic role in the developing brain.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What do abused drugs affect the pharmacology of?

A
  1. Endogenous NT systems like DA, ACh, 5-HT, GABA, Opiate, Etc.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the categories of maternal complications in pregnancy?

A
  1. Unknown factors 63%
  2. Genetic Problems 25%
  3. Other environmental factors 10%
  4. Drug Exposure 2%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What determines the outcomes following prenatal drug exposure?

A
  1. Types of exposure
  2. Timing of exposure
  3. Dose, route of frequency
  4. Co-Exposures
  5. Genetics of the fetus and mother.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are things to do when planning to become pregnant?

A
  1. Multivitamins that provide 400 ug/d folic acid
  2. Verify vaccination records, and test for STDs
  3. Discuss use of Rx, OTC, Alcohol, Tobacco, and other drugs with MD.
  4. Discuss prior obstetric problems.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What cat drug exposure at any stage of pregnancy cause?

A
  1. Miscarriage
  2. Fetal growth retardation
  3. Covert Embryopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which trimester is the fetus at greatest risk?

A

1st trimester.

Toxicity from drug exposure may be fatal, or have no effects at all.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the “all or nothing stage”

A

Fertilization to GD20

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What happens between GD20-GD56?

A

Organogenesis and cell differentiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is a teratogen?

A

A drug or other exposure that causes serious adverse effects to the fetus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When is Thalidomide most strongly teratogenic?

A

Days 21-45 of development.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does the nervous system develop from?

A

Ectoderm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why is folic acid required during pregnancy?

A
  1. so the neural tube closes via a bi-directional process called “zippering”.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What happens if the neural tube does not close?

A

Spina Bifida

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is generally thought to be the safest stage of development for drug exposure?

A

2nd trimester.

  • But drugs interfere w/ subtle aspects
  • Teratogenicity is not likely
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

During the 3rd trimester how fast do synapses form?

A

40,000 synapses/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What does the FDA require about reproductive toxicity studies?

A
  1. That they be performed in 2 mammalian species on any drug that might be administered to women.
    - Usually rats or mice, plus rabbits.
    - 3 drug doses evaluated.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are factors that need to be checked when doing reproductive toxicity studies?

A
  1. Maternal/Paternal Fertility
  2. Altered Maternal/Fetal weight gain
  3. Gestational age at birth
  4. Increased # of fetal resorption
  5. Number of live/dead offspring
  6. Internal and external malformations of the fetus
  7. Change in sex distribution.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the Category A drugs we need to know?

A

Folic Acid, Choline, Niacin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What does Category A mean?

A

Adequate, well controlled studies in prego women have proven these drugs are safe for mother and do not increase risk for fetal abnormalities.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What does Previous Category B mean?

A
  1. A studies no evidence of harm; H studies not performed
    OR
  2. A studies adverse effects noted; H studies no evidence of harm in well-controlled

(False positives seen in animal studies though)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What does previous category C mean?

A
  1. A studies AE noted; H studies not performed.
    OR
  2. A studies nor H studies performed.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Why is Category C the most nebulous category?

A
  1. Entry level for most drugs due to animal testing.

2. C drugs may be safer than B drugs or could be X drugs.

24
Q

What does Previous Category D mean?

A
  1. H studies well controlled and/or simple observational studies have shown risk to fetus.
    - Benefits could outweigh risk to fetus though.
    - Must be used with extreme caution.
    - Safer alternatives usually available.
25
Q

What are drugs in Category D?

A

ACE inhibitors, Lithium, Phenytoin, Carbamazepine, Valproic acid, Most BZD, Nicotine patch.

26
Q

What prego category is ASA in?

A
  1. C

2. D in 3rd trimester.

27
Q

What prego category is APAP in?

A

B

28
Q

What does previous category X mean?

A
  1. Studies in animals or prego have demonstrated positive evidence of fetal abnormalities.
  2. Some X drugs induce labor
29
Q

What are the known teratogens?

A
  1. Estrogen
  2. Alcohol
  3. Anti-Progesterones
  4. Androgens
  5. Coumarins
  6. Diethylstilbestrol
  7. Statins
  8. Thalidomide
  9. Misoprostol.
30
Q

What is Misprostol?

A
  1. Synthetic PGE1 analog that reduces production and/or secretion of stomach acid.
  2. Induces Labor
31
Q

What is the new FDA model for drugs.

A
  1. Clinical management statement
  2. Summary risk assessment.
  3. Discussion of both animal and human data.
32
Q

What must the Adverse Developmental Outcomes statement include?

A
  1. Structural abnormalities.
  2. Embryo
  3. Functional Impairment
  4. Alterations to growth.
33
Q

When are drugs OK for pregnant women?

A
  1. Safe alternatives are available for the mother.
  2. Drugs developed specifically for use during prego.
  3. PK studies in category A drugs.
  4. Avoiding the organogenesis stage would be wise.
34
Q

What is Neonatal Abstinence Syndrome (NAS)

A
  1. Constellation of signs/symptoms displayed by the neonate upon withdrawal of a gestational drug exposure.
35
Q

What are the symptoms of NAS?

A
  1. Excessive high pitched cry
  2. Sleep wake disturbances/irritability
  3. Exaggerate reflexes/tremor
  4. Feeding problems, GI and autonomic changes
  5. Changes in movement/ interactional capacity
  6. A general poor neonatal adaptation process.
36
Q

If the NAS is related to opioid exposure what does the Tx involve?

A
  1. Typically tapering regiment w/ opioid containing medications or clonidine.
37
Q

What prego category is nicotine gum?

A

Category C

38
Q

What prego category is NRT?

A

Category D (Except nicotine gum)

39
Q

What prego category is Zyban, Chantix?

A

Category C.

40
Q

What effects are seen in preconception/prenatal from tobacco smoke?

A
  1. 2X increase in infertility (male and female)
  2. 2-4X increase in ectopic pregnancy
  3. Placental dysfunctions.
  4. Intrauterine growth retardation (not from nutrition def.)
  5. Premature L&D
  6. # 4+5= Low birth weight.
41
Q

What effects are seen in neonates from tobacco smoke?

A
  1. 2X increase in # of stillbirths.
  2. Continued growth retardation
  3. Impaired pulmonary development
  4. Autonomic nervous system dysfunction
  5. Nicotine withdrawal?
  6. Increased tremor
  7. Impaired orientation.
  8. 2-4X increased in incidence of SIDS.
42
Q

What effects are seen in Adolescents from tobacco smoke?

A
  1. Increased incidence of pulmonary dysfunction
    - Asthma, allergies, bronchitis, RDS
  2. Increased behavioral disorders
    - 3X negative toddler behavior
    - 5X conduct disorder 7-12yo
    - 2X more likely to commit felony as an adult.
  3. Impaired cognitive development.
    - Reduce speech and language
    - Learning diabilities
    - Increased ADHD in boys.
43
Q

What components of tobacco smoke cause reproductive problems?

A
  1. CO
  2. Hydrogen Cyanide
  3. Ammonia
  4. Carcinogens
  5. Heavy metals
  6. Nicotine
44
Q

What evidence is there that nicotine plays a role in reproductive problems?

A
  1. Nicotine and other tobacco shit crosses placenta.
  2. Nicotine can block apoptosis
  3. Nicotine increases NGF, BDNF, GDNf in CNS cause anti-apoptotic.
  4. nAChRs are expressed in very early stages of gestation.
  5. Increases nAChR density
  6. ACh known to regulate neuron growth, migration, dendrtitic outgrowth and formation of synapses.
  7. Synthesis of ACh doesnt begin until GD18 normally.
45
Q

What is the hypothesis that nicotine causes problems?

A

In utero nicotine exposure is an out of sequence developmental cue that impairs processes normally regulated by endogenous ACh, resulting in long term negative consequences.

46
Q

Does gestational nicotine exposure alter pattern of maternal weight gain?

A

NO

47
Q

When does nicotine cause persistent changes during development and where?

A
  1. GD1-PN21

2. Alpha 4/beta 2 nAChR density

48
Q

What is Fetal Alcohol Spectrum Disorder?

A
  1. an umbrella term describing many developmental problems secondary to prenatal alcohol exposure.
49
Q

What is the only recreational/illicit drug that is clearly teratogenic?

A
  1. Alcohol
50
Q

What is the most preventable cause of mental retardation?

A

Dont drink alcohol while prego.

51
Q

How do you diagnose FASD?

A
  1. Prenatal maternal alcohol use.
  2. Growth deficiency
  3. CNS- cognitive, motor, speech, social interactions.
  4. Microcephaly
  5. Primary dysmorphic facial features.
52
Q

What are the primary dysmorphic facial features involved with FASD?

A
  1. Short Palpebral Fissures
  2. Indistinct Philtrum
  3. Thin Upper lip.
53
Q

What is Fetal Alcohol Syndrome characterized by?

A
  1. Morphological, growth, and functional problems.
54
Q

What is Partial Fetal Alcohol Syndrome Characterized by?

A
  1. All of FAS but to lesser extent.
55
Q

What is Alcohol-Related Neurodevelopmental Disorder Characterized by?

A
  1. No morphological signs

2. Functional problems.

56
Q

What is Tx for FASD?

A
  1. Very individualized depending on symptoms.
  2. Environmental enrichment is useful in animals
  3. Intensive, case management approaches appear to have some efficacy in most cases.

Neuro Pharmacology (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions