Brainscape's Knowledge GenomeTM

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


See full index

Clinical Pharmacology > Prescribing In Special Groups 1 > Flashcards

Prescribing In Special Groups 1 Flashcards

1
Q

What is the time during pregnancy wheere the foetus is at high risk

A

First trimester

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

What is a general advice about treating a disease that may affect pregnancy

A

It is better to not stop the drug is the disease can affect the pregancy e.g epilepsy, hypertension

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

In pregancy which factor of pharmokinetics changes

A

Absorption

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

How does absorption change in pregnancy

A
  • Large foetus can affect gastric emptying and gut transit time
  • muscle blood flow changes so IM injection absorption can be increased
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are teratogens

A

Substance, organism, physical agents or deficiency state capable of inducing abnormal structute of function such as gross structural abnormalities, functional deficiency e.g deafness, intrauterine growth restriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the causes of congenital malformation

A 
Unknown 
Multifactorial
Maternal illness
Genetic 
Teratogenic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the first 2 weeks in pregnancy known as

A

All or nothing effect

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

What is the all or nothing effect

A

The embryo either recovers or spontanous loss can occur

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

Which time period is the time with highest risk for drugs to cause congenital malformation

A

3-8 weeks

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

Why does 3-8 weeks of pregnancy have a high risk of congential malformation due to drugs

A

This is the time period when the organs form

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

What is the 2nd to 3rd timester known as

A

Growth phase

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

What affect can drugs have from 2nd to 3rd trimester

A

Fetotoxicity

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

What is fetotoxicity

A

When the drugs affect the growth or have toxic effects on tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the rules in prescribing during pregnancy

A
  1. Assume all drugs will cross the placenta unless they have a high molecular wight e.g heparin
  2. Try to avoid drugs in the first trimester
  3. Avoid drugs known to be harmful and only prescibe if the benefit to mother outweighs harms to fetus e.g antiepileptics
  4. Check all drugs in the BNF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

List the drug class that you need to avoud in the first trimester of pregnancy

A 
Androgens 
Cytotoxic drugs 
Lithium 
Quinolone antibiotics
Retinoids
Sodium valproate
Thalidomide
Warfarin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which drug class has the highest risk of teratogenic effect in the first trimester

A

Sodium valproate

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

Which drug clasess should be avoided in second to third trimester in pregnancy

A 
Ace inhibitors and arbs 
Aminoglycosides
NSAIDs and aspirin 
Opiates and benzodiazepines 
Sulphonamides 
Tetracyclines
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What adverse effect can aceinhibitors have on the foetus

A

The aminiotic fluid is what the baby pees, the ace inhibitro can act on the RAAS so they fetus doesnt pee as much and this causes less fluid aroung the baby, this is known as oligohydramnios

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the effect of tetracycline in the fetus

A

Tetracycline binds to calcium and cause yellow discolouration of the teeth
Also inhibits bone growth

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

What might need to be done to the doses of drugs in pregnancy

A

Increased

21
Q

Is avoiding breastfeeding to take prescribed drugs a good option

A

No because the benefits of breast feeding will be lost such as immunitty and reduced risk of allergy in the infant

22
Q

Before prescribing in breastfeeding what needs to be considered

A 
Amount of drug delivered to infant in breast milk
Infant pharmocokinetics (ADME)
Infant pharmocodynamic (effect of drug on infant)
23
Q

What drug characteristics have a reduced passage into the breast milk

A

High molecular weight
High protein binding
Low lipid solubility
Low ph

24
Q

Which drugs have a high molecular weight

A

Insulin and heparins

25
Q

Which drugs have high protein binding

A

Warfarin

NSAIDs

26
Q

Which drugs have a low lipid solubility

A

Loratadine

27
Q

Which drugs have a low ph

A

Amoxicilin

28
Q

Which drugs need to be avoided in breastfeeding

A 
Amiadrone 
Antithyroid drugs
Benzodiazepines 
Lithium salts
Radioactive iodine
Statins
Sulphonamides
29
Q

What is the age band for premature baby

A

Less than 36 weeks of gestation

30
Q

What is the age band for newborn (neonate)

A

0 to 27 days

31
Q

What is the age band for an infant

A

28 days to 23 months

32
Q

What is the age band for a child child

A

2 years to 11 years old

33
Q

What is the age band for adolescents

A

12 to 16/18 years old

34
Q

What differs in children and in infants

A

Pharmokinetics (ADME)

35
Q

How does absorption change is oral adminstration is given

A

Slower gastric empyting can occur which can take 6-8 months to reach adult level

36
Q

How does absorption change if there is intramuscular administration

A

IM absorption erratic due to reduced muscle mass and variability of blood flow to and from the injection site

37
Q

How does absorption change if there is percutaneous administration

A

It is increased in the younger becuase there is a thinner stratum corneum and increased skin hydration

38
Q

If there is a higher volume of distribution of a durg what is the concentration of drug required

A

Low

39
Q

In metabolism what can be different

A

Hepatic enzymes in phase 1 and 2 can act slow so metabolism can be slower and the drug can build up rapidly

40
Q

What can affect the excretion

A

Kidneys can be immature in the first 6 months so drugs excreted by the kidney can become built up

41
Q

How is the dose in children calculated as an approximate

A

Childs body surface x adult dose

42
Q

Who should not have this formula use on

A

Pre term neonate

Infants

43
Q

How is dosing classed for children over 12 years

A

As adults

44
Q

What are the special routes of administration in children

A

Intraoessous route

Buccal route

45
Q

What is the intraoesseous route

A

Using highly vascularised bone marrow to deliver fluid

46
Q

When is the intrassoeous route used

A

Only in emergency

47
Q

What is the buccal route for adminstration

A

Non invasive route used for permeable drugs

48
Q

Which drugs should be avoided in children

A

Intravenous chloramphenical
Aspirin
Tetracycline
Codeine

Clinical Pharmacology (6 decks)

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