G3 (ADME IN PREGNANCY) EXAM
QUESTIONS AND ANSWERS
Why is it hard to decide whether a medication is safe in pregnancy? - Correct Answers -
Because pregnant women aren't allowed to participate in clinical trials, so unsure if drug
affects pregnant women adversely, but history based evidence is used (e.g. has drug
been seen to cause any issues for pregnant women/unborn baby?)
What are the 2 contributing factors for ADME changes during pregnancy? - Correct
Answers -~Maternal physiological changes
~Effects of the placental-foetal compartment
Does the foetus and mother exchange blood? - Correct Answers -~No, the mother's and
fetus's blood do not directly mix during pregnancy
~The placenta acts as a barrier between the two bloodstreams, allowing for the
exchange of oxygen, nutrients, and waste products
What is the placenta? - Correct Answers -A temporary organ that develops in the uterus
during pregnancy, connecting the developing fetus to the mother
What is meant by Vd (volume of distribution)? - Correct Answers -Volume that would
contain the total body content of the drug (Q) at a concentration equal to that present in
the plasma
What is Cmax? - Correct Answers -Maximum plasma drug concentration.
What is tmax? - Correct Answers -Time it takes to reach Cmax.
What is progesterone? - Correct Answers -A steroid hormone the uterus to prepare for
pregnancy.
Identify 3 ways pregnancy affects absorption via the oral route? - Correct Answers -
~Reduces intestinal mobility
~Increase in nausea and vomiting
~Increase in gastric pH
Identify one sex hormone that increases during pregnancy? - Correct Answers -
Progesterone.
What does the increase in plasma progesterone levels during pregnancy lead to a
reduction in? - Correct Answers -Intestinal mobility.
, What does reduction in intestinal mobility lead to an increase in? - Correct Answers -
Leads to a 30-50% increase in gastric and intestinal emptying time
How are Cmax and tmax affected by a reduction in intestinal mobility? - Correct
Answers -tmax increases and Cmax decreases.
How does the occurrence of nausea and vomiting (during the first trimester) affect
absorption via the oral route? - Correct Answers -Potential for partial or complete
ejection of the dosage form
How do pregnancy lead to an increase in gastric pH? - Correct Answers -Because
during pregnancy, there is a decrease in gastric acid secretions and an increase in
mucus secretions, leading the gastric pH to increase.
Which molecules are most likely to cross the lactocyte barrier? - Correct Answers -Lipid
bilayer - small and non-polar molecules are most likely to cross
Do drugs which are highly bound to albumin or other transport proteins readily cross the
lactocyte barrier? - Correct Answers -No - they behave similar to large molecular weight
drugs.
How is the absorption of weak acids affected by an increase in gastric pH? - Correct
Answers -Reduced absorption, as weak acids (like analgesics, antiemetics) are best
absorbed in acidic environments (as it's unionised)
What is the pH partition hypothesis? - Correct Answers -Only unionized nonpolar drugs
penetrate the cell membrane
(not always true!!)
What 2 things does the pH partition hypothesis assume? - Correct Answers -~GI tract
acts as a lipid barrier towards weak electrolyte drugs which are absorbed by passive
diffusion
~GI/blood barrier is impermeable to ionised forms of drugs - only lipid soluble unionised
species will cross
How does pregnancy affect absorption via the inhalation route? - Correct Answers -
Alveolar uptake is increased.
What is alveolar uptake? - Correct Answers -The process of inhaling a gas or vapor into
the lungs and having it absorbed into the bloodstream from the air sacs (alveoli)
Why is alveolar uptake increased during pregnancy? - Correct Answers -Maternal
cardiovascular and respiratory system undergoes changes to maintain perfusion of the
QUESTIONS AND ANSWERS
Why is it hard to decide whether a medication is safe in pregnancy? - Correct Answers -
Because pregnant women aren't allowed to participate in clinical trials, so unsure if drug
affects pregnant women adversely, but history based evidence is used (e.g. has drug
been seen to cause any issues for pregnant women/unborn baby?)
What are the 2 contributing factors for ADME changes during pregnancy? - Correct
Answers -~Maternal physiological changes
~Effects of the placental-foetal compartment
Does the foetus and mother exchange blood? - Correct Answers -~No, the mother's and
fetus's blood do not directly mix during pregnancy
~The placenta acts as a barrier between the two bloodstreams, allowing for the
exchange of oxygen, nutrients, and waste products
What is the placenta? - Correct Answers -A temporary organ that develops in the uterus
during pregnancy, connecting the developing fetus to the mother
What is meant by Vd (volume of distribution)? - Correct Answers -Volume that would
contain the total body content of the drug (Q) at a concentration equal to that present in
the plasma
What is Cmax? - Correct Answers -Maximum plasma drug concentration.
What is tmax? - Correct Answers -Time it takes to reach Cmax.
What is progesterone? - Correct Answers -A steroid hormone the uterus to prepare for
pregnancy.
Identify 3 ways pregnancy affects absorption via the oral route? - Correct Answers -
~Reduces intestinal mobility
~Increase in nausea and vomiting
~Increase in gastric pH
Identify one sex hormone that increases during pregnancy? - Correct Answers -
Progesterone.
What does the increase in plasma progesterone levels during pregnancy lead to a
reduction in? - Correct Answers -Intestinal mobility.
, What does reduction in intestinal mobility lead to an increase in? - Correct Answers -
Leads to a 30-50% increase in gastric and intestinal emptying time
How are Cmax and tmax affected by a reduction in intestinal mobility? - Correct
Answers -tmax increases and Cmax decreases.
How does the occurrence of nausea and vomiting (during the first trimester) affect
absorption via the oral route? - Correct Answers -Potential for partial or complete
ejection of the dosage form
How do pregnancy lead to an increase in gastric pH? - Correct Answers -Because
during pregnancy, there is a decrease in gastric acid secretions and an increase in
mucus secretions, leading the gastric pH to increase.
Which molecules are most likely to cross the lactocyte barrier? - Correct Answers -Lipid
bilayer - small and non-polar molecules are most likely to cross
Do drugs which are highly bound to albumin or other transport proteins readily cross the
lactocyte barrier? - Correct Answers -No - they behave similar to large molecular weight
drugs.
How is the absorption of weak acids affected by an increase in gastric pH? - Correct
Answers -Reduced absorption, as weak acids (like analgesics, antiemetics) are best
absorbed in acidic environments (as it's unionised)
What is the pH partition hypothesis? - Correct Answers -Only unionized nonpolar drugs
penetrate the cell membrane
(not always true!!)
What 2 things does the pH partition hypothesis assume? - Correct Answers -~GI tract
acts as a lipid barrier towards weak electrolyte drugs which are absorbed by passive
diffusion
~GI/blood barrier is impermeable to ionised forms of drugs - only lipid soluble unionised
species will cross
How does pregnancy affect absorption via the inhalation route? - Correct Answers -
Alveolar uptake is increased.
What is alveolar uptake? - Correct Answers -The process of inhaling a gas or vapor into
the lungs and having it absorbed into the bloodstream from the air sacs (alveoli)
Why is alveolar uptake increased during pregnancy? - Correct Answers -Maternal
cardiovascular and respiratory system undergoes changes to maintain perfusion of the
