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- author "Tyler"
- tags "Drug Therapy Pregnant, Breast Feeding, Peds, & Immunizations"
- description ""
- fileName "Pharm II - Test 1"
- What physiologic changes take place during the 3rd trimester? How does is affect dosing?
- Renal blood flow is doubled and renal excretion is accelerated. Therefore you have increased excretion so you need to increase your dose!
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What happens during pregnancy to the bowels?
The tone and mobility of bowel decreases, therefore it increases absorption. Decrease dose!!
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Third trimester dosing vs. mobility of bowel decrease results in what?
They both cancel each other out, therefore you would leave the dosage of a drug the same.
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How can Heparin affect the fetus?
Causes Osteoporosis
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What can prostaglandins do to the fetus?
Stimulate uterine contraction
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How can pain relievers affect fetus?
May depress respiration in the new born
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When is the most dangerous time to take a drug during pregnancy?
1st trimester (weeks 3-18)
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What should you teach women of child bearing age?
Treat their bodies as if they were pregnant. -take Folic Acid
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Classic teratogenic exposure?
- Day 31-81 from LMP
- (based on 28 day cycle)
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If a pregnant woman was having constipation what would you advise her to do?
- Drink warm juice
- Increase fiber
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If a pregnant woman has nausea what would you inform her to do?
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If a pregnant woman was having muscle pain what would you instruct her to do?
Hot & Cold Therapies
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Category A drugs in pregnancy?
Nothing falls under this category
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Category B drugs during pregnancy?
the Best ?
no risk in animals/humans according to studies
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Category C drugs in pregnancy?
use Caution ⚠
- 2/3 of all meds
- animal studies show risk
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Category D drugs in pregnancy?
Dangerous!!
evidence of human risk
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Category X drugs during pregnancy?
❌ these off your list!
fetal abnormalities likely
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What are some ways that you can decrease passing a drug to an infant?
- -Take drug immediately after breast feeding
- -avoid drugs with long half-life
- -choose drugs that tend to be excluded from milk
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Age requirements for Peds patient?
16 and younger
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Peds Patients and drugs?
- More sensitive to drugs
- Show greater individual variation
- Sensitive due to immature organ system
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Oral administration in infants?
Gastric motility doesn't mature until age 2
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What type of administration should you not use on an infant?
Per cutaneous
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Distribution in infants?
Blood-brain barrier isn't developed therefor you have CNS side effects
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What type of cream should you not use on an infant?
Cortisone Cream
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Immaturity of organs puts infants at risk for what response(s)?
More intense response or a prolonged response
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Children metabolize drugs faster until what age?
2
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Dosing in infants?
- Under 1 = Lower
- Over 1 = Higher
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Glucocorticoids could cause what adverse effect in children?
Growth Suppression
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Tetracyclines could cause what adverse effect in children?
Discolored Teeth
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Sulfonamides could cause what adverse effect in children?
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Aspirin could cause what adverse effect in children?
Reye's Syndrome
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Fluroquinolones could cause what adverse effects in children?
Tendon Rupture
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Dosing in children is best based on what?
Body Surface Area (BSA)
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When should a fever cease after the first administration of an antibiotic?
72 hours
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When would you expect to see an adverse reaction to an immunization?
A few days afterwards
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Symptom of whooping cough (pertussis)?
- Gasping Cough
- (infants are vulnerable)
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Symptoms of Measles?
- Koplik spots (bright red spots in throat)
- URI professing to serious disease
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Where is H. Flu prominent in? And why is it such a concern?
Prominent in bacterial ear ? infections
Meningitis is a great concern because it could develop into it.
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Symptoms of Rotovirus?
Gastroenteritis with profound diarrhea and vomiting that causes severe dehydration
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Symptoms of Influenza?
A respiratory illness with a rapid onset, fever, general malaise - muscle aches
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Before giving a patient a flu vaccination what should you make sure they aren't allergic to?
Eggs
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What is the most effective way to treat?
Immunity!! Therefor staying up to date on vaccines.
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Symptoms of small pox?
- Pustules all in the same phase
- Mild Respiratoy Illness
- Fever
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Who would get the inactivated flu vaccine?
- Pregnant women
- Chemo Patients
- Inmunocompromised pts
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Adverse Effects of Immunizations: Mild
- (expected) >25%
- -Low grade fever
- -Injection site irritation
- -Fussiness
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Adverse Effects of Immunizations: Moderate
High Grade Temp
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Adverse Effects of Immunizations: Severe
- Allergic Reaction
- Guillane Barre
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