Pharm EXAM 3 > OB Considerations > Flashcards

OB Considerations Flashcards

(22 cards)

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1
Q

Basic considerations

A
  • benefits must outweigh the risk
  • lack of clinical trials
  • physiological changes
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2
Q

physiological changes of pregnancy

A
  • dose may need to increase in third trimester d/t doubled renal BF, and increased GFR
  • some drugs hepatic metabolism increase (phenytoin, carbamazapine, Valporic acid)
  • bowel motilty decreases: increase drug absorption; may need dose reduction
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3
Q

Placenta drug transer

3 answers

A
  • lipid soluble drugs cross placenta easily
  • ionized, highly polar, or protetin bound have difficulty crossing
  • ASSUME any drug will cross
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4
Q

ADR during pregnancy

A
  • same as non pregnant individuls but also unique effects
  • asprin near term supresses labor contractions
  • regular use of dependance drugs can result in infant drug dependance
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5
Q

teratogenesis occurs about ____-____%

A
  • 1-3%
  • difficult to identify
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6
Q

Causes of congenital abnormalities

A
  • genetics
  • enviromental chemicals
  • drugs
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7
Q

teratogenesis is dependent on ____

A
  • drug given
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8
Q

Three stages of development

A
  • preimplantation presomite period (conception- week 2)
  • embryonic period (week 3-8)
    * gross malformations can occur
  • fetal period (week 9- term)
    * functional impairement
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9
Q

Category A risk

A

remote risk

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10
Q

Category B risk

A

slightly more risk than A

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11
Q

Category D risk

A

PROVEN risk for fetal harm

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11
Q

Catgeory C risk

A

greater risk than B

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12
Q

Category X risk

A

PROVEN risk for fetal harm; CI section will have a statement in drug labeling

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13
Q

common drugs to avoid during preganancy

13

A
  1. SOME anticancer,immunosupressants, antiseizure
  2. sex hormones
  3. tetracycline
  4. trimethoprim- sulfamethoxazole
  5. alcohol/ nicotine
  6. 5-a reductase inhibitors
  7. ACE inhibitors
  8. SOME antithyroid hormones
  9. sotrtinoin/ other vitamin A
  10. lithium
  11. NSAIDS
  12. oral hypoglycemics
  13. warfarin
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14
Q

DOC for pain

A
  • acetaminophen
  • ibuprofen
  • ketorolac
  • morphine
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15
Q

DOC anticoagulants

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A
  • warfarin
  • heparin (unfractionated)
16
Q

DOC antidpressants

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A
  • sertraline
  • paroxetine
  • TCA
17
Q

DOC antiepileptic

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A
  • carbamazepine
  • phenytoin
  • valporic acid
18
Q

DOC antihistamine

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A
  • lordatadine
  • fexofenadine
19
Q

DOC beta blockers

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A
  • labetalol
  • metoprolol
  • propranolol
20
Q

DOC endocrine

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A
  • propylthiouracil
  • insulin
  • levothyroxine
21
Q

DOC glucocorticoids

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A
  • prednisolone
  • presnisone
Pharm EXAM 3
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