reproductive pharmacology

Question 1

How is the ADME effected by pregnancy ?

Answer 1

1) Absorption is delayed as gastric emptying is delayed
2) Distribution = body has increased amounts of water and fat = lower concentration of water soluble and lipid soluble drugs
- protein bound drugs is reduced = increases free drugs ( more active drugs )
3) increased clearance
4) Excretion = increased Renal plasma flow = doubles the elimination

Question 2

Drugs effects on the foetus

what factors effect whether the drug crosses the placenta or not ?

Answer 2

1) most drugs cross the placenta 
factors that effect this are :
- lipid solubility 
- molecular size
- protein binding 
-metabolism

Question 3

what drugs effect blastocyst formation ?

Answer 3

1) cytotoxic drugs
2)alcohol
day 1-16

Question 4

Drugs that effect organogenesis

Answer 4

days 17-60

most teratogens

Question 5

what effects cell and organ maturation

60 days terms

Answer 5

1) alcohol
2) nicotine
3) radio active iodine
4) iodine
5) Corticosteroids

Question 6

Tertatogenic drugs ( 7A+D)
(8)

Answer 6

1-ACE, ARB
2-Anticonvulsants 
3-Antibiotics 
4-Antipsychotics 
5-Antithyroid 
6-Anticoagulant 
7-Abuse (alcohol, cigs, opioids)
8-DMARDS (methotrexate)

Question 7

common drug issues in pregnancy ?

6

Answer 7

1-Nausea and vomitting 
2-Asthma 
3-HT
4-UTI
5-Anticoagulation 
6-Anticonvulsants

Question 8

absorption in the baby

Answer 8

1) skin ( body weight is greater so topical agents such as steroids are absorbed more )
- intramuscular =impiared

Question 9

how can synthetic female hormones influence the menstrual cycle ?

Answer 9

steroid hormones = lipid soluble = walk through walls , binds to cytosolic receptor –>nucleus –>hormone response element –>gene transcription

Question 10

what are the synthetic oestrogens?

synthetic progesterone?

Answer 10

synthetic oestrogen : makes it through the first pass metabolism => ethinyloestradiol (EE)

Synthetic progesterone : levongesterol , norethisterone

Question 11

Case study of the Oestrogen and progesterone pill ? (COCP)
complications ACHES
(2)

Answer 11

1) first line = oral contraceptive pill
21 days on 7 days OFF
oestrogen –> at higher doses inhibits FSH = so inhibit ovulation
- Progesterone = thicken cervical mucous to prevent entry of sperm
- bleeding is regular and lighter

Abdominal pain 
Chest pain 
Headache 
Eyes blurred 
Sharp leg pain

increases the risk of breast and cervical cancer

Question 12

Progesterone only pill (POP)

- mini pill

Answer 12

The traditional progestogen-only pill (POP) prevents pregnancy by thickening the mucus in the cervix to stop sperm reaching an egg

xx DONT TAKE 7 DAY BREAK xx

ACHES
- They cause irregular bleeding !

Question 13

What is the emergency pill ?

2

Answer 13

1)morning after pill is called Levonelle or EllaOne
( man made progesterone )
Stops or delays the release of an egg (ovulation). Levonelle has to be taken within 72 hours (3 days) of sex to prevent pregnancy.

Question 14

What is a copper coil ?

Answer 14

1)Normal cycle but with copper coil, heavier bleeding

• To fertilize an egg, sperm must first pass through cervical mucus before entering the uterus.
• Copper ions decrease the sperm’s ability to move and prevent the sperm from passing through the cervical mucus and going on to fertilize the egg.