Chapter 8: Drug Administration Throughout the Life Spam

Drug therapy in pregnant women is discontinued unless a serious condition is present.

Select the drugs that are less likely to cross the placenta in pregnant women..

Which of the following is NOT a bodily change in pregnant women that can affect the success of drug therapy?

Fat soluble drugs are distributed into breast milk, so it may be passed to the lactating infant,

Some drugs, such as thalidomide, are absolute teratogens.

The following are stages of pregnancy, as they relate to pharmacology. Note that these are out of order. [blank_start]Preimplantation phase[blank_end]: This occurs during weeks [blank_start]1-2[blank_end] of the [blank_start]first trimester[blank_end]. The embryo has not yet established a physical connection to the mother. This is also called the [blank_start]all or none[blank_end] period because exposure to a teratogen either causes death or has no effect. Drugs are much [blank_start]less likely[blank_end] to cause malformations because the baby's organ systems have not yet begun to form, but certain drugs (such as [blank_start]nicotine[blank_end]) can cause growth delays. [blank_start]Fetal period[blank_end]: Occurs in weeks [blank_start]9-40[blank_end] post-conception. During this time, the fetus' organs systems are growing and developing. Blood flow to the placenta [blank_start]increases[blank_end] and placental vascular membranes become [blank_start]thinner[blank_end]. This maximizes the transfer of substances from mother to child. The fetus may receive [blank_start]larger[blank_end] doses of medications and other substances from the mother, which has a prolonged duration of action in the unborn child due to a lack of mature metabolic enzymes and efficient excretion mechanisms.. Exposure to teratogens is [blank_start]more likely[blank_end] to produce slowed growth or impaired organ function rather than gross structural malformations. [blank_start]Embryonic period[blank_end]: This occurs in weeks [blank_start]3-8[blank_end] postconception. There is rapid development of internal structures. This is the period of [blank_start]maximum sensitivity[blank_end] to teratogens. Teratogenic agents can lead to structural abnormalities and spontaneous abortion. The abnormality depends on which organ is forming.

The following is the current FDA pregnancy category ratings with examples. I made them out of order to make sure that we know the answers. [blank_start]A[blank_end]- Adequate, well -controlled studies in pregnant women have shown no increased risk of fetal abnormalities in any trimester of pregnancy. [blank_start]C[blank_end]- Animal studies have shown an adverse effect and there are no adequate and well-controlled studies in women. OR no animal studies have been conducted and there are no adequate and well controlled studies on women (basically, we don't know what this will do to your baby.) [blank_start]X[blank_end]- Adequate, well controlled observational studies in animals or pregnant women have demonstrated evidence of fetal abnormalities or risks. [blank_start]D[blank_end]- Adequate, well controlled or observational studies in pregnant women have demonstrated a risk to the fetus. [blank_start]B[blank_end]- Animal studies have revealed no evidence of harm to the fetus, but there aren't any adequate and well-controlled studies in pregnant women. OR animal studies have shown an averse effect, but adequate and well-controlled studies in pregnant women have failed to yield a similar response.

Select the drugs that are a FDA pregnancy risk category A. (Here's a hint: 4 of these are correct)

Select the drugs that are an FDA pregnancy risk category B. (Here's a hint: 5 of these are correct)

Select the drugs that are a FDA pregnancy risk category C. (Hint: 6 of these are right).

There were too many things that were pregnancy category D and X, so rather than making a "select all that apply" question, I made a "drag and drop" one. Match the drugs to their pregnancy category. To make things easier to place, I put the drugs in alphabetical order. D: [blank_start]Alcohol[blank_end], [blank_start]ACE inhibitors[blank_end], [blank_start]angiotensin receptor blockers[blank_end], [blank_start]carbamazepine[blank_end], [blank_start]cyclophosphamide[blank_end], [blank_start]gentamicin[blank_end], [blank_start]lithium carbonate[blank_end], [blank_start]methimazole[blank_end], [blank_start]mitomycin[blank_end], [blank_start]nicotine[blank_end], [blank_start]NSAIDs[blank_end], [blank_start]phenytoin[blank_end], [blank_start]propylthiouracil[blank_end], [blank_start]streptomycin[blank_end], [blank_start]tetracyclines[blank_end], [blank_start]valproic acid[blank_end]. X: [blank_start]Clomiphene[blank_end], [blank_start]flurouracil[blank_end], [blank_start]isotretinoin[blank_end], [blank_start]leuprolide[blank_end], [blank_start]menotropins[blank_end], [blank_start]methotrexate[blank_end], [blank_start]misoprostol[blank_end], [blank_start]nafarelin[blank_end], [blank_start]oral contraceptives[blank_end], [blank_start]raloxifene[blank_end], [blank_start]ribavirin[blank_end], [blank_start]statins[blank_end], [blank_start]temazepam[blank_end], [blank_start]testosterone[blank_end], [blank_start]thalidomide[blank_end], and [blank_start]warfarin[blank_end],

A lot of the drugs secreted into breast milk cause injury to infants.

Which of the following is FALSE about drug administration in breast feeding women?

Which of the following is NOT a factor to consider when giving medications to pediatric patients?

If a child is given a medication and vomits immediately after, you should NEVER reorder the medication,

Select the appropriate interventions when administering medication to infants.

You are teaching a parenting class to a group of young, new mothers. You are instructing them about how to take care of their children when their children are sick Select the accurate educational statements about handing medication administration to toddlers that could be made by the nurse.

Which of the following should you tell parents to do when administering medications to their toddler?

IM and IV medication administration in a toddler is similar to IM and IV medication administration in an infant.

Select the options that may be helpful and/or necessary when giving medications in toddlers?

Select the similarities and differences between medication administration in preschool children and medication administration in toddlers.

Play-acting troubling experiences with dolls may be beneficial in preschool children before and after medication procedures.

Because they are able to comprehend the difference between health and illness and recognize that medications are administered to make them feel better, school age children have a large concept of illness and the risks involved with ingesting a harmful substance.

School age children are unlikely to resist injections

Which of the following is important when administering medications to a school age child?

Select the appropriate interventions when approaching medication administration in adolescents.

Select the differences between pharmacotherapy of young adults (18-40 years old) versus pharmacotherapy of middle adults (40-65 years old).

Select the information that is FALSE about the normal physiological changes that affect medication administration in older adults.