Prego and lactation

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Author:
mminnick
ID:
142378
Filename:
Prego and lactation
Updated:
2012-03-18 21:21:04
Tags:
Regis University
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Description:
IP8
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  1. First 2 weeks
    • "all or nothing"
    • general tratogenic agents
  2. 18-60 days
    (organogenesis)
    • Structural anomalies
    • Drugs:
    • - chemo
    • - diethylstillbestrol
    • - Li
    • - retnoids (isotretinoin)
    • - thalidomide
    • - anticonvulsants (carbamazepine, phenobarbital, phenytoin, valproic acid)
    • - warfarin
  3. 60 -end of prego
    • retardation of growth, CNS abnormalities, death, and functional abnormalities
    • Drugs:
    • - ACE & ARBs
    • - NSAIDs
    • - tertacycline derivatives
  4. Pharmacokinetic change: body fat increase
    increased Vd for fat soluble drugs
  5. Pharmacokinetic change: plasma albumin decrease
    increases Vd for highly protein bound drugs
  6. Pharmacokinetic change: Plasma volume, cardiac output and GFR increase (30-50%)
    drugs are cleared more quickly
  7. Pharmacokinetic change: Prego-induced pH increase
    effects gastric absorptin of drugs that are weak acids or bases
  8. Pharmacokinetic change: Estrogen and progesterone levels increase
    Liver enzyme activity is altered leading to changes in drug excretion
  9. Drug size and crossing the placenta
    • 500 Da-yes, cross
    • 500 -1000 Da- cross, but more slowly
    • >1000 - dont cross

    • MW - <200, free diffusion and transfer
    • MW - >200, minimal transfer

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