Quiz
L10 Reproductive Pharmacology
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Questions in this quiz (16)
1Choose ALL correct statements about pregnancy physiology.
- AIncrease in plasma volume thus volume of distribution, requires increase in dose in some medications to achieve therapeutic levels.
- BIncrease in cardiac output.
- CDecrease in glomerular filtration rate and renal clearance, can require lower doses and longer dosing intervals
- DInduction of hepatic enzymes reduces levels of medications with hepatic metabolism, can affect anti epileptic medication levels.
- EPlacenta decreases volume of distribution and adds an additional compartment in the distribution and elimination of medications
- FHypercoagulable state requires adjustment of anticoagulants and careful monitoring of coagulation parameters
- GDecreased thyroid function
2Placental transfer of medications
1. Factors promoting transfer:
- [blank_start]Lipophilic[blank_end]
- [blank_start]Low[blank_end] molecular weight (250-500)
2. Factors reducing transfer
- Highly [blank_start]ionized[blank_end]
- [blank_start]Protein[blank_end] binding
- [blank_start]High[blank_end] Molecular weight (>500-1000)- ALipophilic
- BLow
- Cionized
- DProtein
- EHigh
3Teratogenic medicines can have a direct effect (eg thalidomide, isotretinoin), or act through effects on oxygen transfer or nutrient supply to the developing fetus (eg methotrexate)
- ATrue
- BFalse
4Known specific teratogens - match to effect:
[blank_start]Thalidomide[blank_end] - first trimester phocomelia
[blank_start]Warfarin[blank_end] - late first trimester nasal hypoplasia, third trimester fetal anticoagulation and intracranial bleeding
[blank_start]ACE inhibitors[blank_end] - first trimester spontaneous abortion, second and third trimester renal hypoplasia
[blank_start]Valproic acid[blank_end] - first trimester-cardiac and NTD (neural tube defects)
[blank_start]Carbamazepine[blank_end] - NTDs and facial hypoplasia- AThalidomide
- BWarfarin
- CACE inhibitors
- DValproic acid
- ECarbamazepine
5Opiod dependence:
Cessation during pregnancy can result in fetal [blank_start]withdrawal[blank_end] and fetal death
Usual course of action is [blank_start]methadone[blank_end] maintenance
Detoxification by tapering can be performed in carefully selected patients with fetal [blank_start]monitoring[blank_end]- Awithdrawal
- Bmethadone
- Cmonitoring
6Select all antimicrobial classes that are generally safe in pregnancy.
- ABeta-lactams
- BNitrofurantoin
- CAminoglycosides
- DVancomycin
- EFluoroquinolones
- FTetracyclines
7Lamivudine and zidovudine for HIV in pregnancy reduces vertical transmission to the neonate from 15-30% to < 2%.
- ATrue
- BFalse
8Corticosteroids (betamethasone preferred, or dexamethasone) can be administered to reduce the incidence of intraventricular hemorrhage and reduce the risk of respiratory distress syndrome in preterm (<34 weeks) deliveries
- ATrue
- BFalse
9Group B streptococcus can cause neonatal sepsis, pneumonia, meningitis. With penicillin prophylaxis, risk is reduced to 1:600 in known carriers.
- ATrue
- BFalse
10_______ administered to patients delivering at <30 weeks gestation reduces the risk of cerebral palsy from 3.5% to 1.9% (RR 0.55).
- AMagnesium sulfate
- BPenicillin
- CValaciclovir
11Congenital Adrenal Hyperplasia is an [blank_start]autosomal recessive[blank_end] genetic condition causing increased androgen production in a female fetus. Maternal administration of [blank_start]dexamethasone[blank_end] suppresses the [blank_start]fetal[blank_end] adrenal glands. Must be initiated [blank_start]early[blank_end] in pregnancy.
- Aautosomal recessive
- Bdexamethasone
- Cfetal
- Dearly
12Uterine stimulants for labour induction, PPH:
[blank_start]Oxytocin[blank_end]
Ergot alkaloids (May cause hypertensive crisis in hypertensives or when administered by the [blank_start]IV[blank_end] route)
Prostaglandins (Categories [blank_start]E and F[blank_end] are potent uterine stimulants)- AIV
- BE and F
- COxytocin
13Uterine relaxants/Tocolytics:
Beta 2 agonists (ritodrine, terbutaline and salbutamol, no effect on delaying [blank_start]preterm labour[blank_end])
Calcium channel blockers (Nifedipine, [blank_start]effective[blank_end] for preterm)
Oxytocin receptor antagonists (Atosiban. Doesn't work though - [blank_start]placebo[blank_end] just as good)
Nitrates (Nitroglycerin and isosorbide dinitrate, [blank_start]cGMP[blank_end] mediated relaxation of smooth muscle. Good for twins or C section)
Prostaglandin synthetase inhibitors (blocks synthesis of prostaglandins via COX, limited use <[blank_start]48[blank_end]h)- Apreterm labour
- Beffective
- Cplacebo
- DcGMP
- E48
14Contraceptives:
- Estrogen component inhibits [blank_start]ovulation[blank_end] through suppression of [blank_start]FSH and LH[blank_end]
- Progesterone: Inhibits ovulation by suppressing the LH surge, thick cervical [blank_start]mucous[blank_end] barrier, ovum transport is altered, implantation is hampered by [blank_start]endometrial[blank_end] changes- AFSH and LH
- Bovulation
- Cmucous
- Dendometrial
15Metformin can be used as a fertility treatment to induce ovulation.
- ATrue
- BFalse
16Physiologic bladder contraction is mediated by acetlycholine at post-ganglionic [blank_start]muscarinic[blank_end] receptors (M3). Treatment of abnormal contraction ([blank_start]overactive[blank_end] bladder or detrusor overactivity) is therefor mainly [blank_start]anticholinergic[blank_end] agents like atropine, propanetheline, solifenacin. Common side effects: dry mouth and eyes, blurred vision, tachycardia, pruritis, sedation, headache, constipation. Contraindication in narrow angle [blank_start]glaucoma[blank_end] and urinary retention.
Incontinence due to reduced outlet resistance is usually treated surgically. [blank_start]Alpha-adrenergic[blank_end] receptors contract the urinary sphincter. Ephedrine and pseudoephedrine minimally effective (only [blank_start]mild[blank_end] cases). [blank_start]Duloxetine[blank_end] (SNRI) contracts the sphincter during filling with no effect on relaxation with voiding.- Amuscarinic
- Boveractive
- Canticholinergic
- Dglaucoma
- EAlpha-adrenergic
- Fmild
- GDuloxetine
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- User has deleted their subject information Quiz on L10 Reproductive Pharmacology, 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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