Therapeutics - Drugs in Pregnancy 2

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Author:
kyleannkelsey
ID:
293917
Filename:
Therapeutics - Drugs in Pregnancy 2
Updated:
2015-01-26 11:55:13
Tags:
Therapeutics Drugs Pregnancy
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Therapeutics - Drugs in Pregnancy
Description:
Therapeutics - Drugs in Pregnancy
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  1. What is Parity?
    Number of a woman’s pregnancies which exceed 20 weeks gestation
  2. What do the numbers after P represent, as in G4P2113?
    • Full term deliveries
    • Preterm deliveries
    • Abortions (spontaneous and elective)/Miscarriage
    • Living children
  3. What are the physiologic changes that occur in a pregnant woman?
    • ↑ Cardiac output
    • ↑ Renal perfusion and function
    • ↑ Blood volume
    • ↓ GI motility
    • ↑ Weight gain
  4. How many additional calories should a pregnant woman consume daily?
    Additional 300/day
  5. How much additional Protein should a pregnant woman consume daily?
    additional 10 gm/day
  6. How much Calcium should a pregnant woman consume daily?
    • 1200 mg/day
    • How much Folic acid should a pregnant woman consume daily?
    • 400 mcg/day (800-1000 mcg is more normally used)
    • Low risk 0.4 mg/day
    • High risk 4 mg/day
  7. How much Iron should a pregnant woman consume daily?
    Additional 30 mg/day from 2nd trimester on
  8. How do Pharmacokinetics/dynamics change in pregnancy?
    • Shorter t1/2 of renally eliminated drugs
    • Larger apparent Vd for lipophobic drugs
    • Potential ↓ rate or extent of absorption with oral administration
  9. What immunizations should mom’s receive before during or after pregnancy?
    • Rubella, Hep B and Influenza
    • Varicella before or after
    • Tdap during
  10. What portion of pregnancy represents the greatest risk is organogenesis?
    Second through eighth week
  11. During what time frame is the fetus not usually susceptible to teratogens?
    First 2 weeks
  12. What are the factors effecting placental transfer of medications?
    • Low protein binding
    • High lipophilicity
    • Low molecular weight (< 600)
    • Unionized state
  13. Retinoic acid (Accutaine) can cause what birth defects?
    Craniofacial, CNS and Cardiac effects
  14. What drugs are important fetal teratogens?
    • ACE inhibitors
    • Carbamazepine
    • Phenytoin
    • Valproic acid
    • Alcohol
    • Lithium
    • Misoprostol
    • Systemic Retinoids
    • Tetracyclines
    • Thalidomide
    • Warfarin
  15. What is the abnormality, estimated risk and critical period for teratogenicity of ACE inhibitors?
    • Renal failure/agenesis
    • Critical period: 2nd-3rd tri
    • % risk: 1-10
  16. What is the abnormality, estimated risk and critical period for teratogenicity of Carbamazepine?
    • Neural tube defects
    • c 3rd wk
    • % risk: 1
  17. What is the abnormality, estimated risk and critical period for teratogenicity of Phenytoin? Fetal hydantoin syndrome
    • Critical period: 1st tri
    • % risk: 5-10
  18. What is the abnormality, estimated risk and critical period for teratogenicity of Valproic acid?
    • Neural tube defects
    • Critical period: 3rd wk
    • % risk: 2
  19. What is the abnormality, estimated risk and critical period for teratogenicity of Alcohol?
    • Fetal alcohol syndrome
    • Critical Period:Throughout
    • % risk: 10-30
  20. What is the abnormality, estimated risk and critical period for teratogenicity of Lithium?
    • Ebstein's anomaly
    • Critical Period: 1st tri
    • % risk: < 1
  21. What is the abnormality, estimated risk and critical period for teratogenicity of Misoprostol?
    • Möbius syndrome
    • Critical Period: 1st tri
    • % risk: < 2
  22. What is the abnormality, estimated risk and critical period for teratogenicity of Systemic Retinoids?
    • Retinoid embryopathy
    • Critical Period: 1st tri
    • % risk: 30
  23. What is the abnormality, estimated risk and critical period for teratogenicity of Tetracyclines?
    • Discoloration of teeth
    • Critical Period: >2nd tri
    • % risk: Unknown

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