NURS 5334 Advanced Pharmacology
Module 2 Questions And Complete
100% Correct Answers
\.physiologic changes during pregnancy & drug impact - Answer-- 3rd trimester = renal blood
doubles, renal excretion accelerated
- tone and mobility of bowel decreases -> prolongation of drug effects
\.placental drug transfer - Answer-all drugs can cross the placenta, some cross more easily than
others
\.adverse reactions during pregnancy - Answer-can adversely affect both pregnant pt and fetus
- heparin -> osteoporosis
- prostaglandins -> stimulate uterine contraction
- some pain relievers can be used during delivery can cause respiratory depression in baby
\.teratogenesis birth defects - Answer-gross malformations = cleft palate, clubfoot,
hydrocephalus
neurobehavioral & metabolic anomalies
\.3 stages of teratogenesis development - Answer-1. conception through week 2
2. embryonic period week 3-8 = gross malformations
3. fetal period week 9-delivery = functions disrupted w/ teratogen exposure
,\.identification of teratogens - Answer-difficult to identify, 3 criteria must be met:
1. The agent must be present during the critical stage of development
2. The agent produces a particular pattern of birth defects in animal studies.
3. The agent crosses the placenta and there is a dose-response relationship.
\.responding to teratogen exposure - Answer-Determine when the drug was taken
Determine when the pregnancy began
-Weeks 3-8 (organogenesis) is most crucial time
Determine type of malformation expected
Conduct 2 US and consult FDA to determine severity
\.how to decrease risk of drug effects during breastfeeding - Answer-- take drugs immediately
after breastfeeding
- avoid drugs w/ long half-lives
- choose drugs that tend to be excluded from milk, least likely to affect infant
- avoid hazardous drugs
\.pediatric response to drugs - Answer-- more sensitive to drugs
- greater individual variation
- sensitivity d/t organ system immaturity
- increased risk for adverse rxns
, \.determining the intensity of duration of drug response in neonates & infants - Answer--
elevated drug levels = more intense response
- delayed elimination = prolonged response
- immaturity of organs = risk for both^
\.increased sensitivity in infants caused by immature state of... - Answer-absorption, protein
binding of drugs, BBB, hepatic metabolism, renal drug excretion
\.infant absorption: oral administration - Answer-prolonged and irregular gastric
adult function at 6-8 months
\.infant absorption: gastric acidity - Answer-- very low 24 hours after birth
- does not reach adult values for 2 years
- low acidity = absorption of acid-labile drugs is increased
\.infant absorption: intramuscular admin - Answer-slow, erratic, delayed absorption as results of
low blood flow in 1st few days of life
in early infancy, absorption of IM drugs more rapid than neonates & adults
\.infant absorption: transdermal - Answer-more rapid & complete for infants than older children
& adults
- stratum corneum of infant's skin is thin
- blood flow to skin is greater in infants than older patients
- infants increased risk for toxicity from topical drugs
\.infant distribution: BBB - Answer-- not fully developed at birth
Module 2 Questions And Complete
100% Correct Answers
\.physiologic changes during pregnancy & drug impact - Answer-- 3rd trimester = renal blood
doubles, renal excretion accelerated
- tone and mobility of bowel decreases -> prolongation of drug effects
\.placental drug transfer - Answer-all drugs can cross the placenta, some cross more easily than
others
\.adverse reactions during pregnancy - Answer-can adversely affect both pregnant pt and fetus
- heparin -> osteoporosis
- prostaglandins -> stimulate uterine contraction
- some pain relievers can be used during delivery can cause respiratory depression in baby
\.teratogenesis birth defects - Answer-gross malformations = cleft palate, clubfoot,
hydrocephalus
neurobehavioral & metabolic anomalies
\.3 stages of teratogenesis development - Answer-1. conception through week 2
2. embryonic period week 3-8 = gross malformations
3. fetal period week 9-delivery = functions disrupted w/ teratogen exposure
,\.identification of teratogens - Answer-difficult to identify, 3 criteria must be met:
1. The agent must be present during the critical stage of development
2. The agent produces a particular pattern of birth defects in animal studies.
3. The agent crosses the placenta and there is a dose-response relationship.
\.responding to teratogen exposure - Answer-Determine when the drug was taken
Determine when the pregnancy began
-Weeks 3-8 (organogenesis) is most crucial time
Determine type of malformation expected
Conduct 2 US and consult FDA to determine severity
\.how to decrease risk of drug effects during breastfeeding - Answer-- take drugs immediately
after breastfeeding
- avoid drugs w/ long half-lives
- choose drugs that tend to be excluded from milk, least likely to affect infant
- avoid hazardous drugs
\.pediatric response to drugs - Answer-- more sensitive to drugs
- greater individual variation
- sensitivity d/t organ system immaturity
- increased risk for adverse rxns
, \.determining the intensity of duration of drug response in neonates & infants - Answer--
elevated drug levels = more intense response
- delayed elimination = prolonged response
- immaturity of organs = risk for both^
\.increased sensitivity in infants caused by immature state of... - Answer-absorption, protein
binding of drugs, BBB, hepatic metabolism, renal drug excretion
\.infant absorption: oral administration - Answer-prolonged and irregular gastric
adult function at 6-8 months
\.infant absorption: gastric acidity - Answer-- very low 24 hours after birth
- does not reach adult values for 2 years
- low acidity = absorption of acid-labile drugs is increased
\.infant absorption: intramuscular admin - Answer-slow, erratic, delayed absorption as results of
low blood flow in 1st few days of life
in early infancy, absorption of IM drugs more rapid than neonates & adults
\.infant absorption: transdermal - Answer-more rapid & complete for infants than older children
& adults
- stratum corneum of infant's skin is thin
- blood flow to skin is greater in infants than older patients
- infants increased risk for toxicity from topical drugs
\.infant distribution: BBB - Answer-- not fully developed at birth
