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Bioscience for Midwifery > ULO 5- Principles of pharmacology, pharmacokinetics and common medication in childbirth > Flashcards

ULO 5- Principles of pharmacology, pharmacokinetics and common medication in childbirth Flashcards

1
Q

Define: Pharmacokinetics

A

describes the movement of drugs into and inside the body

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2
Q

Define: Pharmacodynamics

A

is the relationship between drug concentration at the site of action and the resulting effect

includes the mechanisms through which drugs exert their effects on the body

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3
Q

Explain: Precautions, Contraindications and Side-effects

A

Precautions- measures taken to ensure the woman is safe and minimise adverse outcomes

Contraindications- drug should not be used or recommended

Side-effects- undesirable effects of a drug

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4
Q

Why do some drugs cross the placenta barrier

A
  • it is not an effective barrier to the passage of drugs and
  • the blood-brain barrier is underdeveloped in the fetus
  • the placenta barrier thins towards the end of pregnancy
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5
Q

Explain: the 3 types of drug names and what they are

A

Chemical- the active ingredient abbreviated
Generic- simplified chemical name
Trade name- brand, marketed name

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6
Q

Explain: Pharmaceutics

A

describes the formulation and method of administration of drug

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7
Q

Pharmaceutics

Routes of administration depend on…

A

the type of formulation

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8
Q

List routes of administration

A
  • Oral
  • Nasogastric
  • Topical
  • Rectal
  • Vaginal
  • sublingual
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9
Q

Pharmaceutics

Define: Parenteral administration

A

any method avoiding the GIT

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10
Q

Define the different Parenteral Administration methods

A
  • Intradermal: into dermis
  • Subcutaneous: under skin
  • Intramuscular: into muscles (butt, thigh)
  • Intravenous: into vein
  • Epidural: into CFS above dura mater
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11
Q

What factors affect drug storage

A
  • exposure to light
  • moisture
  • temperature extremes
  • expiry dates
  • specific needs of sensitive drugs
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12
Q

Pharmacology

What are the 4 processes of Pharmacokinetics

A

Drug:

  • Absoprtion
  • Distribution
  • Metabolism
  • Excretion
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13
Q

Pharmacokinetics

What factors affect drug absorption

A
  • Type of membrane transport (active/passive)
  • Epithelial barriers
  • Chemical nature of drug (water/lipid based)
  • pH of the site of action
  • Surface area of drug
  • GI tract activities
  • Proximity to blood supply
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14
Q

Pharmacokinetics

Define: Dug Distribution

A

is the movement of the drug from the site of absorption through the body, via the blood stream

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15
Q

Pharmacokinetics

Define: Volume of distribution

A

the concentration of the drug in the plasma

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16
Q

Pharmacokinetics

Define: Drug Metabolism

A

the process of chemical alteration of drugs within cells to prepare for excretion

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17
Q

Pharmacokinetics

Define: Bioavailability

A

the amount of drug available to the body /receptor sites for therapeutic effect

  • high with IV, low with oral
18
Q

Pharmacokinetics

Define: Bioequivalence

A

describes the equal bioavailability of different formulations of the same drug

19
Q

Pharmacokinetics

Explain: Life of the Drug in relation to drug excretion

A

Half Life- time it takes for 1 half of the concentration of the drug to be eliminated from the body

Long half life- active in the body for longer, cannot repeat frequently

Loading/priming dose- for slow to accumulate drugs

20
Q

Pharmacodynamics

What type of effects do drugs have on the body

A
  • Chemical
  • Physical
  • Enzyme linked effects
  • Receptor effects
21
Q

Pharmacodynamics

Define: Chemical modes of action

A

are where the drug chemical reacts with a chemical in the body that is causing a problem

22
Q

Pharmacodynamics- Drug action at receptors

Describe: Receptors and 2 most important

A

are specific protein sites on cell membranes where chemicals lock

Agonists- stimulating/promote the natural pathways (Oxytocin/syntocin)
Antagonists- blocking/prevent attachment of natural chemicals (paracetamol)

23
Q

Pharmacodynamics

Explain: the 4 properties of a drug at a receptor

A

Affinity- extent of binding
Specificity- selectivity to receptor type
Efficacy- therapeutic effect caused at receptor
Potency- strength of drug required to cause an effect

24
Q

Pharmacodynamics- Drug Safety

Describe: Therapeutic Index

A

High TI- safer drug: bigger margin for error allowable

Low TI- more toxic: must be precise

25
Q

Pharmacodynamics- Drug Safety

Define: Margin of Safety

A

dose range between min. effective concentration (mec) and maximum safe concentration (msc)

26
Q

Pharmacology- Pregnancy and Lactation

What factors influence a drugs potential to cross the placenta from maternal to fetal circulation

A
  • Drug physiochemical properties
  • Transplacental transport system
  • Dosage
  • Placental drug metabolism
27
Q

Pharmacology- Pregnancy and Lactation

Define: Teratogens

A

drugs which cause morphological defects in utero

28
Q

Pharmacology- Pregnancy and Lactation

What are the 5 Drug Classes/Risks

A

Class A- no risk in controlled human studies (paracetamol, VitB6)

Class B- (B1-B3) no risk in controlled animal studies (amoxicillin, dopamine)

Class C- small risk in controlled animal studies (codeine, antipsychotics)

Class D- strong evidence of risk to the human fetus (Valium, anti clotting agents)

Class X- Never to be used in pregnancy, very high risk to the human fetus (Xanax, accutane)

29
Q

Pharmacology- Pregnancy and Lactation

Explain: analgesia use during pregnancy

A

NSAIDS- avoid before 3rd trimester, miscarriage risk 1st trimester
Tramadol- avoid especially in 3T, risk of fetal toxicity in 1T
Opioids- 1T associated with heart defects/spina bifida. some able to use for short periods
Paracetamol- Class A safe in pregnancy

30
Q

Pharmacology- Pregnancy and Lactation

Explain: Safe and unsafe analgesia during lactation

A

SAFE
- paracetamol, ibruprofen, tramadol (smal amount enters breast milk)

UNSAFE
- codeine, hydrocodone, oxycodone

31
Q

Prescribing for Midwives (once accredited)

List: schedule 4 medications midwives can prescribe

A

Analgesia- Nitrous oxide/oxygen, paracetamol, codeine
Antibiotics- amoxycillin, benzylpenicillin, flucloxicillin
Antivirals- Acyclovir

32
Q

Prescribing for Midwives (once accredited)

List: schedule 8 medications midwives can prescribe

A

Opiods

  • pethidine
  • morphine
  • fentanyl
33
Q

What are the 3 natural lines of defence

A

1st- barriers inc. saliva, skin, hairs
2nd- inflammation and phagocytosis by white blood cells
3rd- antibody production/action

34
Q

Define: Pharmacology

A

is the use, effect and modes of action drugs

35
Q

Explain: Schedule 4 drugs

A

these are prescription only drugs

36
Q

Give example: schedule 4 drugs and side-effects

A

Amoxicillin- antibiotic. S/E- GI upset, candidiasis, abdominal cramps

Panadeine Forte- analgesic. S/E- GI upset, constipation, drowziness, dizziness, euphoria

37
Q

Give example: Schedule 8 drugs and side-effects

A

Morphine- opioid analgesic. S/E- respiratory depression, GI upset, dizziness, urinary retention

Pethidine- synthetic opioid analgesic. S/E- respiratory depression, delayed gastric emptying, lightheadedness, dependence

38
Q

Therapeutic Range

Define: Minimum effective concentration (MEC)

A

Is the level a drug needs to be present in the general circulation in order to produce a clinical effect

39
Q

Therapeutic Range

Define: Maximum safe concentration

A

this is the level beyond which the drug will produce adverse effects

40
Q

Pharmacology

Define: Plasma concentration

A

is the measure of a specific amount of drug in a specific volume of plasma (e.g. mmol /L).

  • Measurement of plasma concentration is one of the ways that therapeutic levels of drugs can be monitored
41
Q

Define: Therapeutic range

A

is the range between the MEC and the MSC that is associated with drug efficacy

42
Q

Pharmacodynamics

What are the 4 main types of regulatory proteins

A
  • Carrier transport
  • Enzymes
  • Ions
  • Receptors

Bioscience for Midwifery (8 decks)

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