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Quiz

L7 Drugs in Pregnancy and Lactation

Gelöschter Nutzer 8 Fragen Aktualisiert am 2 Okt 2019

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Fragen in diesem Quiz (8)

  1. 1Teratogenesis - Pregnancy phases and risk"
    • Pre-embryonic (conception to 17 days) - All or nothing, i.e. if many cells damaged the pregnancy will spontaneously [blank_start]miscarry[blank_end]
    • Embryonic (Day 18-55) - Cells are differentiating and major organs forming, embryo is most [blank_start]vulnerable[blank_end] to teratogens
    • Foetal (day 56 to birth) - Some structures still developing (cerebral cortex, renal glomeruli) - prone to
    [blank_start]damage[blank_end]. Deafness can still occur in this period
    1. Amiscarry
    2. Bvulnerable
    3. Cdamage
  2. 2Non-teratogenic harm to the foetus:
    • Anything that causes [blank_start]vasoconstriction[blank_end] of the placental vasculature may harm the foetus
    • Spontaneous abortions (e.g. [blank_start]isotretinoin[blank_end])
    • Intra-uterine growth retardation
    • Prematurity and still-births ([blank_start]warfarin[blank_end])
    • Neonatal CNS depression or withdrawal
    1. Avasoconstriction
    2. Bisotretinoin
    3. Cwarfarin
  3. 3Physiologic changes during pregnancy can affect the pharmacokinetics/pharmacodynamics of drugs:
    • Changes in total body [blank_start]weight[blank_end] and body [blank_start]fat[blank_end] composition
    • Prolonged gastrointestinal transit time which can affect the [blank_start]bioavailability[blank_end] of drugs
    • Expanded plasma volume, more extracellular fluid & total body water which may increase the [blank_start]volume[blank_end] of distribution for [blank_start]hydrophilic[blank_end] drugs
    1. Aweight
    2. Bfat
    3. Cbioavailability
    4. Dvolume
    5. Ehydrophilic
  4. 4ADEC Pregnancy Categories (Australia) does not take into account [blank_start]rare idiosyncratic[blank_end] reactions in the neonate to a medicine that crosses the placenta, or in cases of [blank_start]overdose[blank_end], occupational exposure etc.
    1. Arare idiosyncratic
    2. Boverdose
  5. 5Folic acid should be started at least one month before conception occurs – and some conditions require higher doses, e.g. epilepsy
    1. ARichtig
    2. BFalsch
  6. 6Factors that determine transfer into breast milk:
    • Drug concentrations in the maternal plasma; some drugs are poorly absorbed into the maternal [blank_start]circulation[blank_end]
    • Drug [blank_start]lipophilicity[blank_end] (Note that fat is a small proportion of milk)
    • Drug protein binding
    • Milk pH (Milk pH = 7.0–7.2. More acidic than plasma (pH = 7.4) some ion trapping)
    • Molecular size – drugs that are <500 Da.

    • Most drugs transfer into milk(rare exceptions: [blank_start]insulin, heparin[blank_end].)
    • Most drugs transfer by [blank_start]passive[blank_end] diffusion (unionised, unbound drug)
    • Extent of transfer depends on properties of the drug, blood and breast milk
    1. Acirculation
    2. Blipophilicity
    3. Cinsulin, heparin
    4. Dpassive
  7. 7• Decreased milk production = dopamine [blank_start]agonists[blank_end] e.g. bromocriptine, [blank_start]oestrogen[blank_end]-containing contraception
    • Increased milk production = dopamine [blank_start]antagonists[blank_end] e.g. domperidone, SSRIs, opioids
    1. Aagonists
    2. Boestrogen
    3. Cantagonists
  8. 8If WAMD <10% the drug will be safe for the baby to ingest through breast milk.
    1. ARichtig
    2. BFalsch

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Beschreibung
Der Nutzer hat seine Fachbereichs-Information gelöscht. Quiz am L7 Drugs in Pregnancy and Lactation, erstellt von Gelöschter Nutzer am 02/10/2019.
Autor
Gelöschter Nutzer
Sprache
English
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143
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Erstellt am 2 Okt 2019 · aktualisiert am 2 Okt 2019
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