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20 Cards in this Set

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  • Back
Differences between men and women with ALBUMIN
No gender differences
However albumin is decreased during pregnancy
Differences between men and women with ALPHA ACIDIC GLYCOPROTEIN
Lower in women
Elevated by stress
Differences between men and women with SEX HORMONE BINDING GLOBULIN
Higher in women
Differences between men and women with LIPOPROTEINS
Lower in premenopausal women
Differences between men and women with GASTRIC EMPTYING
Slower in women
Contributes to IBS
Changes during pregnancy with RENAL CLEARANCE
No gender difference
However renal clearance is increased during prenancy
It decreases with age (for men and women)
Adjust for body size rather than for gender
Changes during pregnancy with DRUG ABSORPTION
Decreased GI transit time (delayed absoption of oral meds)
Decreased acid secretion (more alkaline)
Changes during pregnancy with GALLBLADDER
Decreased motility
Increased volume
Changes during pregnancy with ALKALINE PHOSPHATASE
4x increase
Changes during pregnancy with CHOLESTEROL
Increased
List two conditions that are related to high estrogen levels and/or liver disfunction
Spider angiomata
Palmar erythema
What changes occur during phase 1 metabolism during pregnancy?
CYP1A2 decreases (metabs caffeine)
CYP2C9 increases
CYP2D6 increases
CYP3A4 increases
What changes occur during phase 2 metabolism during pregnancy?
UGT inc's
NAT2 inc's
COMT inc's
(overall inc in phase 2 metabolism)
What changes in acid/base equilibrium occur during pregnancy?
Mild respiratory alkalosis (7.40 - 7.46)
Dec'd PCO2 (26-32)
Dec'd HCO3 (18-21)
Left shift of O2 dissociation curve
List 6 renal changes that occur during pregnancy
GFR inc's by 50% (CrCl is 150-200)
Serum Cr is 0.5-0.6 (normal is 0.5-1.0)
Inc'd proteinuria
Inc'd glycosuria
Kindey enlargement (+1cm)
Right kidney and/or ureter is dilated
What changes occur during pregnancy that affect DRUG DISTRIBUTION?
Inc'd plasma volume
Inc'd Vd
Dec'd plasma protein binding (due to 20-30% dec in albumin during 2nd and 3rd trimester)
List the changes in GFR that occur during pregnancy
1st trimester: Inc's by 50%
2nd trimester: Inc's by 80%
3rd trimester: Dec's back to normal
What changes in hepatic blood flow occur during pregnancy?
Hepatic blood flow inc's during the 2nd trimester
What changes in peak drug conc occur during pregnancy?
Peak drug conc dec's due to:
inc'd plasma volume
inc'd Vd
some decrease due to less albumin and more free drug?
What factors contribute to the increased excretion of many drugs during pregnancy?
Inc'd hepatic metabolism
Inc'd hepatic blood flow
Inc'd renal blood flow
Inc'd renal GFR