Pregnancy Pharmacology Quiz Flashcards
Plasma volume, and the volume of distribution of water soluble medications increases during pregnancy. Please identify the correct answer:
A) Water soluble medications are eliminated by the kidney
B) The elimination half life of water soluble medications is proportional to the volume of dsitribution
C) The elimination half life of water soluble medications is not related to the volume of distribution
D) A and B are correct
E) A and C are correct
D
Renal blood flow increases during pregnancy. Identify the most correct statement:
A) Add an ACE inhibitor to offset the increase in renal blood flow
B) Renal clearance of water soluble medications will increase and the elimination half life will decrease
C) Renal clearance of water soluble medications will increase and the elimination half life will also increase
D) None of the above
B
Identify the risk factors for VTE that are seen during pregnancy.
A) Venous stasis, activation of pro-coagulation factors, and inhibition of anticoagulation factors
B) There are none
C) VTE are seen whenever oral contraception is withdrawn
D) VTE are increases whenever patients cut back on smoking
A
Identify the correct statement:
A) Warfarin should be used to treat pregnancy associated VTE because it is inexpensive, effective when taken orally, and safe and effective
B) Dabigatran should be used to treat pregnancy associated VTE because it is new
C) LMWH are a safe and effective choice for treating pregnancy associated VTE
D) It is best to not treat patients during pregnancy
C
Which statement best describes the effect of pregnancy on the pharmacokinetic parameters of LMWHs?
A) You should lower the dose and increase the dosing interval because the kidneys are preserving fluid during pregnancy
B) You should increase the dose to offset the amount of LMHW that is distributed to the fetus
C) Since clearance is increase, the dose frequency usually needs to be increased from once a day to twice a day
D) Since clearance is increased, the dose frequency usually needs to be decreased from twice a day to once a day
C
A general approach to reduce the risk of human teratogenesis was discussed in class. Which statement is NOT a part of this general approach?
A) Consider all women of child bearing potential as antenatal patients
B) Stop all medications during pregnancy and resume in the post natal period
C) Counsel about pregnancy every tie a new medication is prescribed for a patient of child bearing potential
D) When a known teratogen must be used take active steps to prevent pregnancy
B
Codeine is a prodrug and the active form is ________
Tramadol is a (metabolite/prodrug)
Morphine, prodrug
Children and breast feeding infants who are efficient metabolizers (ultra rapid metabolizers) of codeine, and/or tramadol when exposed to these drugs are:
A) Unlikely to experience effective analgesia
B) At increased risk for serious toxicity such as respiratory depression
C) Unlikely to experience pharmacologic side effects
D) At the same risk of adverse events as patients who are not efficient metabolizers of these medications
B
Your patient today is a 26 year old pregnant woman presenting with a severe URI likely due to a bacterial pathogen. Which antibacterial medication effective for this indication also appears to be the safest to use during pregnancy?
A) Tetracycline
B) Erythromycin
C) Ciprofloxacin
D) Azithromycin
E) Amikacin
D - several classes of antibacterial (Aminoglycosides, sulfonamides, tetracyclines, fluoroquinolones) are best avoided in pregnancy. While azithromycin is considered to be a safe choice, clarithromycin is embryotoxic in animals
DES is never used in pregnancy because it is associated with:
A) Feminization of male offspring
B) Deep vein thrombosis
C) Miscarriages
D) infertility and development of vaginal cancer in female offspring
E) Virilization of female offspring
D - DES is an estrogen agonist. In the past, use during pregnancy resulted in fetal damage that increased the risk of infertility and a rare form of vaginal cancer in female offspring. Other estrogenic medications are not associated with these effects.
Estrogens do increase the risk of thrombosis, but this is not the reason for the contraindication in pregnancy.
When nicotine replacement therapy is used during pregnancy as an aid in smoking cessation:
A) It is shown to increase smoking cessation rates
B) One trial found an association with better developmental outcomes
C) Nicotine replacement may be less harmful to the fetus than smoking
D) All are correct
D - smoking cessation counseling is the preferred option for pregnant women who smoke. Nicotine is known to cause adverse maternal and fetal effects, but NRT may be less harmful to the fetus than smoking, which has been associated with an increased incidence of low birth weight deliveries and peri- and post-natal complications
