Pharmacology Chapter 9 - Drug Therapy During Pregnancy and Breastfeeding. Flashcards
___ to __ of pregnant women take at least one prescription drug and most take more, like for nausea or pre-eclampsia, or for chronic conditions.
1/3 to 1/2
Physiological changes in pregnancy that impact drug dosing are in the …
kidney, liver, and GI tract.
Teratogenic effects (congenital disorder) - affect…who more than who?
fetus more than mother.
By 3rd trimester, renal blood flow is …
doubled.
Bowel movements are increased/decreased during pregnancy?
decreased.
All drugs ___ the placenta.
cross.
Drug transfer is…easier for ? and difficult for ?
easier for lipid soluble drugs and difficult for ionized, highly polar or protein bound drugs.
Drugs can/cannot cause birth defects.
CAN. Like, nicotine and smaller babies or alcohol and dependence.
Teratogenesis - def
to produce a monster
Teratogen - def
drug induced birth defect.
Some birth defects -
cleft palate, clubfoot, , hydrocephalus, spina-bifida, etc.
3 stages of embryonic development…
Pre-implantation period - conception –> week 2).
Embryogenic Period (week 3 –> week 8.)
Fetal period - week 9 – term.
Teratogens act in all or none way - T/F
True - it will either do harm and baby could die, or baby recovers.
To prove a drug is a teratogen, drug must…
cause a characteristic set of malformations, must act only during a specific window of vulnerability, etc.
1983 - FDA made classifications for drugs and risk to fetus. What are they? And what do they mean?
A - remote risk of harm , B - slightly more than A, C - greater risk than B, D - proven risk of fetal harm but use may be acceptable, X - proven risk of fetal harm and cannot be used!
