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Pregnancy and Lactation

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NAPLEX Pharmacy (Endo) Quiz on Pregnancy and Lactation, created by Mark W. on 14/12/2016.
Mark W.
Quiz by Mark W., updated more than 1 year ago
Mark W.
Created by Mark W. over 7 years ago
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Resource summary

Question 1

Question
How many weeks constitute a term pregnancy?
Answer
  • 24-30 weeks
  • 30-35 weeks
  • 37-42 weeks
  • 44-46 weeks

Question 2

Question
Fill the table below with the appropriate Physiologic/Pharmacokinetic changes
Image:
080fa2c6-31ed-40ce-b475-aaf6aa9ce348 (image/png)
Answer
  • increase in hepatic metabolism
  • decrease in hepatic metabolism
  • thinning of barrier
  • thickening of barrier
  • increased renal blood flow
  • decreased renal blood flow
  • increased blood volume
  • decreased blood volume
  • increased albumin concentration
  • decreased albumin concentration
  • decrease motility
  • increased motility
  • increased intestinal blood flow
  • decreased intestinal blood flow
  • increased gastric pH
  • decreased gastric pH
  • increase metabolism
  • decreased metabolism
  • increased distribution
  • decreased distribution
  • increased GFR
  • decreased GFR
  • increased elimination
  • decreased elimination
  • increased distribution
  • decreased distribution
  • increased protein binding
  • decreased protein binding
  • increased absorption
  • decreased absorption
  • increased concentration
  • decreased concentration
  • increased maternal concentration
  • decreased maternal concentration
  • increased fetal concentration
  • decreased fetal concentration
  • increased concentration
  • decreased concentration
  • increase concentration
  • decrease concentration
  • increased free drug concentration
  • decreased free drug concentration
  • increased concentration
  • decreased concentration

Question 3

Question
Which of the following are true in regards to medication use in pregnancy? (select all that apply)
Answer
  • eliminate nonessential drugs
  • discourage self-medication
  • minimize exposure to harmful medications
  • adjust doses for use during pregnancy

Question 4

Question
What vaccinations should be administered during pregnancy?
Answer
  • Inactivated influenza vaccine
  • Tdap ( @ 27-36 weeks)
  • Hepatitis B
  • Hepatitis A
  • Meningitis

Question 5

Question
Why are multivitamins used during pregnancy?
Answer
  • fetal bone development
  • maternal and fetal erythropoiesis
  • prevent neural tube defect

Question 6

Question
Why is calcium used during pregnancy?
Answer
  • maternal and fetal erythropoiesis
  • fetal bone development
  • prevent neural tube defect
  • prevention of HTN

Question 7

Question
[blank_start]Folic acid[blank_end] is used during pregnancy to prevent neural tube defects
Answer
  • Folic acid

Question 8

Question
Drugs with a molecular weight of less than [blank_start]600[blank_end] daltons readily cross the placenta barrier.
Answer
  • 600

Question 9

Question
Lipophilic drugs will cross the placental barrier more than hydrophilic drugs
Answer
  • True
  • False

Question 10

Question
Which albumin levels are higher, fetal or maternal?
Answer
  • fetal
  • maternal

Question 11

Question
Fetal blood pH < maternal, therefore weak bases more easily cross, ionize, and less likely to diffuse back across the placental barrier
Answer
  • True
  • False

Question 12

Question
Only [blank_start]unbound[blank_end] drugs can cross placental membranes
Answer
  • unbound

Question 13

Question
Blood flow to [blank_start]uterus[blank_end] impacts drug transfer to fetus
Answer
  • uterus

Question 14

Question
What is the drug of choice for the treatment of hyperemesis gravidarum?
Answer
  • ondansetron
  • pyridoxine
  • doxylamine
  • phosphoric acid

Question 15

Question
The treatment of choice for nausea and vomiting during pregnancy is [blank_start]nonpharmacological treatment[blank_end]
Answer
  • nonpharmacological treatment
  • pyridoximine and doxylamine
  • emetrol

Question 16

Question
What is the first line or drug of choice for nausea and vomiting during pregnancy?
Answer
  • pyridoxine
  • doxylamine
  • phosphoric acid
  • metoclopramide

Question 17

Question
For nausea and vomiting during pregnancy, [blank_start]phosphoric acid[blank_end] should not be used if the patient is a diabetic
Answer
  • phosphoric acid
  • metoclopramide
  • dopamine
  • diclegis

Question 18

Question
Nausea and Vomiting 2nd line therapy is [blank_start]metoclopramide[blank_end] 3rd line therapy is [blank_start]dopamine antagonist[blank_end]
Answer
  • metoclopramide
  • ondansetron
  • doxylamine
  • promethazine
  • dopamine antagonist
  • dicelgis
  • ondansetron
  • methylprednisone

Question 19

Question
First line line treatment for constipation during pregnancy is incerase [blank_start]fiber[blank_end] and [blank_start]fluid[blank_end] intake
Answer
  • fiber
  • fluid

Question 20

Question
What drugs should not be used to treat constipation during pregnancy?
Answer
  • osmotic laxatives
  • docusate
  • castor oil
  • mineral oil
  • senna
  • bsicodyl

Question 21

Question
GERD/Heartburn 1st line: [blank_start]Lifestyle Modifications[blank_end] 2nd line: [blank_start]antacids or sucralfate[blank_end]
Answer
  • Lifestyle Modifications
  • antacids or sucralfate
  • metoclopramide
  • PPIs
  • antacids or sucralfate
  • sodium bicarbonate
  • Ranitidine
  • PPIs

Question 22

Question
Which of the following treatment can be used to treat Hemorrhoids during a pregnancy?
Answer
  • Higher fiber intake
  • increase oral fluid intake
  • use sitz baths
  • Topical anesthetics, protectants, and astringents
  • tylenol

Question 23

Question
Bulk forming agents should be utilized to treat diarrhea during pregnancy, what drugs should be avoided?
Answer
  • Diphenoxylate/atropine
  • paregoric
  • bismuth subsalicylate
  • psyllium/fiber

Question 24

Question
Saline nasal spray/drops are safe to use during pregnancy in the treatment of cough, colds, and allergies
Answer
  • True
  • False

Question 25

Question
What is the drug of choice to treat cold , cough, and allergies during pregnancy?
Answer
  • chlorpheniramine
  • diphenhydramine
  • loratidine
  • budesonide

Question 26

Question
What drugs are recommended during the 2nd and 3rd trimesters in the treatment of cough, cold, and allergies during pregnancy?
Answer
  • diphenhydramine
  • loratidine
  • cetirizine
  • beclomethasone

Question 27

Question
What nasal steroids are recommended for chronic allergies during pregnancy?
Answer
  • Budesonide (Rhinocort)
  • Beclomethasone (Beconase AQ)
  • Advair

Question 28

Question
[blank_start]Acetaminophen[blank_end] is the drug of choice for acute pain managment during pregnancy
Answer
  • Acetaminophen
  • opioids
  • NSAIDs
  • aspirin

Question 29

Question
What is the drug of choice in the treatment of HTN and severe eclampsia?
Answer
  • labetalol
  • hydralazine
  • IV magnesium

Question 30

Question
IV [blank_start]Magnesium[blank_end] is used for seizure protection and treatment
Answer
  • Magnesium

Question 31

Question
Pharmacological treatment for gestational HTN should be started if the systolic BP is greater than [blank_start]150-160[blank_end] OR the diastolic is greater than [blank_start]100-110[blank_end]
Answer
  • 150-160
  • 100-110

Question 32

Question
Essential/Gestational HTN 1st line (DOC): [blank_start]Methyldopa[blank_end] 2nd line: [blank_start]Labetolol[blank_end]
Answer
  • Methyldopa
  • Labetalol

Question 33

Question
Coagulation Disorders You need to continue treatment for women with history of Deep Vein Thrombosis/Pulmonary Embolism, Mitral Valve Replacement, clotting factor deficiencies, antiphospholipid antibodies
Answer
  • True
  • False

Question 34

Question
Coagulation Disorders 1st line: [blank_start]LMWH[blank_end] 2nd line: [blank_start]UFH[blank_end] Treatment is to be contiuned through pregnancy and [blank_start]6[blank_end] weeks after delivery (including breastfeeding)
Answer
  • LMWH
  • UFH
  • 6

Question 35

Question
Which of the following drugs are contraindicated in the treatment of UTIs during pregnancy?
Answer
  • Cephalexin
  • Ampicillin
  • SMX-TMP
  • Fluoroquinolines
  • Tetracyclines

Question 36

Question
What are the top drug choices in the treatment of UTIs during pregnancy?
Answer
  • Cephalexin
  • Ampicillin
  • Nitrofurantoin
  • Tetracyclines

Question 37

Question
What drugs are utilized in the treatment of pyelonephritis?
Answer
  • Ceftriaxone
  • Ampicillin plus gentamicin
  • Ampicillin-sulbactam
  • nitrofurantoin
  • cephalexin

Question 38

Question
STI's Drug of choice syphillis: [blank_start]penicillin G[blank_end] Drug of choice for gonorrhea: [blank_start]cetriaxone[blank_end] Durg of choice for chlamydia: [blank_start]amoxicillin[blank_end] ; 2nd line: [blank_start]ertthromycin[blank_end]
Answer
  • penicillin G
  • ceftriaxone
  • amoxicillin
  • erythromycin
  • ceftriaxone
  • penicillin G
  • amoxicillin
  • erythromycin
  • amoxicillin
  • ceftriaxone
  • penicillin G
  • erythromycin
  • erythromycin
  • amoxicillin
  • ceftriaxone
  • penicillin G

Question 39

Question
Acyclovir/valacyclovir is used in the treatment of genital herpes during pregnancy
Answer
  • True
  • False

Question 40

Question
[blank_start]Metronidazole[blank_end] is the treatment of choice for bacterial vaginosis, and the alternative treatment is clindaymcin
Answer
  • Metronidazole

Question 41

Question
Asthma [blank_start]Albuterol[blank_end] is the short acting beta agonist of choice and [blank_start]budesonide[blank_end] is the inhaled corticosteriod of choice during preganancy
Answer
  • Albuterol
  • budesonide

Question 42

Question
During pregnancy, changing agents to minimize risk is NOT recommended for the treatment of epilepsy
Answer
  • True
  • False

Question 43

Question
What drugs are the safest to use to treat epilepsy during pregnancy?
Answer
  • lamotrigine
  • levetiracetam
  • valproic acid
  • carbamazepine

Question 44

Question
HIV during pregnancy New diagnosed: [blank_start]HAART[blank_end] [blank_start]Zidovudine[blank_end] is the mainstay of antiretroviral therapy Avoid [blank_start]efavirenz[blank_end]
Answer
  • HAART
  • Zidovudine
  • efavirenz
  • clindamycin
  • Zidovudine
  • HAART
  • efavirenz
  • clindamycin
  • efavirenz
  • Zidovudine
  • HAART
  • clindamycin

Question 45

Question
Treatment of schizophrenia, bipolar disorder, depression usually needs to be continued during pregnancy and breastfeeding; high relapse rates if discontinued
Answer
  • True
  • False

Question 46

Question
What are the most preferred agents in the treatment of mental health issues in pregnant women?
Answer
  • fluoxetine
  • citalopram
  • escitalopram
  • levetiracetam

Question 47

Question
Nortriptyline and desipramine are TCAs of choice in the treatment of mental health issues during pregnancy
Answer
  • True
  • False

Question 48

Question
Treatment of choice for HYPOthryoridism: [blank_start]levothyroxine[blank_end] Treatment of choice for HYPERthryroidism: [blank_start]propylthiouracil[blank_end] or [blank_start]methimazole[blank_end]
Answer
  • levothyroxine
  • propylthiouracil
  • methimazole

Question 49

Question
[blank_start]Tocolysis[blank_end] is the prcoess of stopping contractions
Answer
  • Tocolysis

Question 50

Question
What drugs are utilized in pre-term labor and tocolysis?
Answer
  • IV magnesium
  • terbutaline
  • nifedipine
  • promethazine

Question 51

Question
What drugs are needed for cervical ripening? Cervical ripening: in order to dilate, collagen must loosen and separate; moisture necessary; occurs naturally in women who spontaneously enter labor
Answer
  • misoprostol
  • dinoprostone
  • oxytocin
  • methylergonovine

Question 52

Question
Labor induction 1st line: [blank_start]oxytocin[blank_end] 2nd line: [blank_start]methylergonovine[blank_end]
Answer
  • oxytocin
  • Methylergonovine
  • misoprostol
  • dinoprostone
  • methylergonovine
  • dinoprostone
  • misoprostol
  • Oxytocin

Question 53

Question
If mother colonized with Group B Streptococcus: [blank_start]Penicillin G[blank_end]
Answer
  • Penicillin G

Question 54

Question
Analgesia can prolong the 1st and 2nd stages of labor
Answer
  • True
  • False

Question 55

Question
[blank_start]Epidural[blank_end] analgesia has better profile than parenteral opioids (poor maternal pain relief and less vigorous neonates)
Answer
  • Epidural

Question 56

Question
Drug Factors General Guidelines Most drugs appear in breast milk to some degree. Most common mechanism of transfer is passive diffusion. Levels of most drugs in breast milk do not usually exceed 1% to 2% of ingested maternal dosage If the milk/plasma ratio of drug and active metabolites is less than [blank_start]1:1[blank_end], it is usually safe to breastfeed RID: If infant dose is less than [blank_start]10[blank_end]% of maternal dose (weight adjusted), it is usually safe to breastfeed
Answer
  • 1:1
  • 10

Question 57

Question
Depression Sertraline and paroxetine are most frequently prescribed with few reported adverse effects,
Answer
  • True
  • False

Question 58

Question
breast milk is more acidic; weak bases are more likely to stay trapped in breast milk “ion trapping:
Answer
  • True
  • False
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