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Pharmacology

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General Pharmacology

Question
50 out of 91
 

Which of the following drugs can be safely prescribed in pregnancy? (AIIMS Nov 2009)



A Warfarin
B ACE inhibitors

C Heparin
D beta- blockers

Ans. C Heparin

Drugs safe during pregnancy

  1. Anticoagulation
  2. Antimalarial
  3. Antithyroid
  4. Antihypertensive





  1. Muscle relaxant
  2. Vertical transmission
  • HIV
  • Toxoplasmosis

- Heparin
- Chloroquine
- Propyl thiouracil
- Hydralazine
- Methyl Dopa
-Dihydropyridine/CCBs.
-Discontinue before labour as they weaken uterine contraction.
-blocker
- Cardioselective
- Prazosin and clonidine
- d-tubocurarine

- Zidovudine; Nevirapine
- Spiramycin

Placental drug transport depends upon

Lipid solubility:

  1. Unionized drug transportation> Ionized drug like thiopentone > Highly ionized drugs (SCh, d-tubocurarine).
  2. Exception - Salicylates are almost completely ionized at physiological pH, even then fetus level is high because the small amount of salicylate which is not ionized is highly lipid soluble.

Molecular Size:

Molecular size:

- 250 - 500 - Cross placenta easily, depending upon their lipid solubility and degree of ionization

- 500 -1000 - Cross placenta more difficulty

- > 1000 - Cross very poorly

Heparin is a very large polar molecule, so unable to cross the placenta. Though, an acidic drug by nature it should remain unionized in the low pH of placenta. But the drug is a bulky molecule with polar character. Therefore, it fails to enter the blood placenta barrier.

Placental Transporters:

  1. P- glycoprotein transporter pumps back into the maternal circulation a variety of drugs, including cancer drugs (vinblastine, doxorubicin) and other agent (digoxin). Inhibition of this transporter may cause drug accumulation in the fetus.

General Pharmacology Flashcard List

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