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21 Cards in this Set
- Front
- Back
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What are some changes in absorption of pharmacokinetics resulting from physiological changes during pregnancy?
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1. Decreased motility can increase extend of absorption
2. Delayed gastric emptying can decrease rate of absorption 3. Comliance may decrease due to N/V 4. Decrease extent of absorption if vomiting (loss of drug) |
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What are some change in distribution of parmacokinetics resulting from physiological changes during pregnancy?
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1. Vd changes: increase in body water which lead to increase distribution of water soluble drugs
2. Changes in body fat which may decrease extent of absorption 3. Decrease in plasma PRO (albumin) which decreases PRO binding |
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When is the placental transport from mom to fetus established by?
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5th week of life
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How does drug transfer work across the placenta?
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1. Most drugs cross from mom to fetus
2. Drugs move primarily by passive diffusion 3. LMW drugs flow freely (ETOH, lithium, theophylline) 4. PRO-bound drugs do not cross membranes readily 5. Tissue layers thin as pregnancy progresses |
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What are the stages of fetal development?
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1. Fertilization and implantation
2. 1st trimester (greatest potential for teratogenicity) 3. 2nd trimester 4. 3rd trimester |
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What is the meaning of Category A?
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controlled studies fail to demonstrate risk in 1st trimester - possibility of harm seems remote.
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What is the meaning of Category B?
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Animal studies do not indicate risk but there are no controlled human studies
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What is the meaning of Category C?
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Studies have shown animal teratogenic effects but there are no controlled studies in women
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What is the meaning of Category D?
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Positive evidence of human fetal risk exists but benefits in certain situations may make risk acceptable
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What is the meaning of Category X?
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Positive evidence of fetal abnormalities and the risk clearly outweighs any possible benefits
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What are the factors that influence teratogenicity?
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1. embryonic stage at exposure.
2. dose of drug 3. specificity of drug 4. simultaneous exposure to any agent that may increase or decrease potential for abnormalities |
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What are some pregnancy induced diseases?
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1. N/V (generally begins 2-4 wks after conception and lasts 12-14 weeks)
2. heartburn (common in 2nd and 3rd trimesters) 3. constipation 4. hemorrhoids 5. anemias 6. pre-eclampsia |
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What pharmacological treatment can be used to treat N/V in pregnancy?
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Vitamin B-6 (Pyridoxine)
or Ondansetron |
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What pharmacological treatment can be used to treat heartburn in pregnancy?
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1. non-absorbent antacids (Al and Mag gel)
2. Sucralfate 3. H2 blockers |
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What pharmacological treatment should be avoided in the treatment of heartburn in pregnant patients?
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systemic antacids
and pepto-bismol (contains salicylates) |
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What are some pharmacological treatment options for constipation in pregnancy?
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1. Docusate sodium (DOC)
2. emollient or bulk laxative AVOID MINERAL OIL! - can decrease vit K to fetus and increase risk of fetal hemorrhagic complications |
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What are some pharmacological treatment options for hemorrhoids in pregnant patients?
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1. External astringent - witch hazel or tucks pads
watch ingredients in external anal analgesics, there is a risk of systemic absorption. also, avoid topical anesthetics, there is a risk of significant systemic absorption |
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What are the treatments for patients who are pregnant and are suffering from anemia?
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1. folic acid daily
2. ferrous sulfate |
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What are the s/s of pre-eclampia?
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1. edema (weight gain of greater than 6 lbs/week)
2. Increased BP (SBP increased by 30 or greater than 140. DBP increased by 15 or greater than 90) 3. proteinuria |
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What are some non-pharmacological treatments for pre-eclampsia?
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Normal fluid and salt intake
strict bedrest quiet dark room |
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What are some pharmacological treatment options for pre-eclampsia?
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hospitalization
IVE (D5LR) Magnesium Sulfate IV to prevent seizures IV hydralazine |
