Quiz
L7 Drugs in Pregnancy and Lactation
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Questions in this quiz (8)
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- Amiscarry
- Bvulnerable
- Cdamage
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- Avasoconstriction
- Bisotretinoin
- Cwarfarin
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- Aweight
- Bfat
- Cbioavailability
- Dvolume
- Ehydrophilic
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.
- Arare idiosyncratic
- Boverdose
5Folic acid should be started at least one month before conception occurs – and some conditions require higher doses, e.g. epilepsy
- ATrue
- BFalse
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- Acirculation
- Blipophilicity
- Cinsulin, heparin
- Dpassive
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- Aagonists
- Boestrogen
- Cantagonists
8If WAMD <10% the drug will be safe for the baby to ingest through breast milk.
- ATrue
- BFalse
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- User has deleted their subject information Quiz on L7 Drugs in Pregnancy and Lactation, created by Deleted user on 02/10/2019.
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- Created on 2 Oct 2019 · updated on 2 Oct 2019
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