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protein binding, and blood flow to the placenta.
• Essentially all drugs can cross the placenta and the nurse
should assume that any drug taken during pregnancy will
reach the fetus. (nicotine, pot, narcotics) 7 Pharmacodynamics Physical changes occur: 1) by 32 weeks gestation cardiac
output is increased by 50% and 2) from the second
trimester on arterial blood pressure is decreased. The above changes necessitate careful assessment of the
drug’s pharmacodynamics. 8 Pharmacodynamics
Teratogen---any compound capable of interfering with
embryonic and/or fetal development.
1. Must cause a characteristic set of malformations.
2. Act only during a specific period of time during
3. Incidence of malformations should increase with
increasing dosage and duration of exposure.
4. Incidence and causes of congenital anomalies.
• Less than 1% of all birth defects caused by
1. Identification of teratogens very difficult.
2. Greatest risk is 15-60 days after conception. (2
weeks to a month after female gets pregnant)
weeks 9 Teratogenesis and
Stage of Development
Stage Development occurs in three stages:
• Conception through week 2
• Embryonic period – weeks 3 to 8
Embryonic Gross malformations produced by teratogens • Fetal period – week 9 to term
Fetal Functions disrupted with teratogen exposure 10 Fig. 9-1. Effects of teratogens at various stages of development of the fetus. 11 FDA 12 Drugs Associated with Neonatal
Opiates 13 Drugs and Breast Feeding
• Majority of drugs are secreted into breast
milk---but very few instances in which the drug
needs to be discontinued.
• If drug concentrations in the breast milk rise
enough a pharmacological effect can occur in
• Difficult to accurately predict the amount of
maternal drug transfer but range is
• Drugs present in breast milk may cause
adverse effects i...
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- Spring '14