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Chapter 9 pharmacolo
drug therapy during pregnancy and breast feeding
| Question | Answer |
|---|---|
| About 2/3 of pregnant women | take at least one medication |
| Medication Exposure in Pregnancy Risk Evaluation Program | 2009, FDA's new program to increase healthcare professionals' knowledge of drug risks during pregnancy |
| Pregnancy brings on the physiolgic changes in the | kidneys, liver and gastrointestinal tract(thus a compensatory change) |
| During pregnancy, the tone and motility of the bowel | decreases (allowing more drugs to be absorbed) |
| True of False: more time is available for reabsorption of drugs that undergo enterohepatic recirculation. Therefore the effects are prolonged | true |
| Essentially all drugs can | cross the placenta |
| The cliniciian should assume that | any drug taken will reach the fetus |
| lipid soluble drugs cross the placenta readily, while drugs that are _______ have more difficulty | ionized, polar, protein bound |
| teratogenesis | the development of birthdefects |
| Gross malformations | produced by exposure to teratogens during embryonic period |
| exposure during the fetal period usually | disrupts FUNCTION rater than gross anatomy |
| It is important to note that lack of proof of teratogenicity | does not mean that a drug is safe |
| in 1983, the FDA established a system for classifying drugs according to their probable risk categories: | ABCD and X (A is the least dangerous) |
| The new proposed system under FDA will have three sections: | 1.)Fetal risk summary, 2.) Clinical Considerations. 3.) Data |
| Fetal Risk Summary | will describe what is known about a drugs' effects on the fetus and will offer a conclusion on safety during pregancy |
| Clinical Considerations | describe the likely effects if a drug is taken before a woman knows that she is pregnant. |
| Data | will detail the evidence from human and animal studies that supports the information in the fetal risk summary |
| Any woman of reproductive age who takes a known teratogen must be | counseled about the risk and necessity of using at least one form of birth control |
| Drugs that are lipid soluble readily | enter breast milk |
| Drugs that do not enter breast milk are | ionized, polar, and protein bound |
| Although most drugs can de detected in milk | concentrations are usually too low to harm the nursing |
| Steps 1-3 taken to minimize the risk to the infant | 1.) dosing immediately AFTER feeding 2.) avoiding drugs that have a long half life 3.) avoiding sustained release formulations |
| Steps 4-7 taken to minimize the risk to infant | 4.) choosing drugs that tend to be excluded from milk 5.) choosing drugs that are least likely to effect infant 6.) avoiding hazardous 7.) using lowest EDfor shortest time |
Created by:
Hoopster
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