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Section 11: Gynecologic and Obsetric Disorders

Which of the following drug properties limits the ability of a drug to readily transfer across the placenta?

A. Low protein binding

B. Molecular weight above 1,000 Da

C. Lipophilicity

D. Weak base

The answer is B. Drugs with a high molecular weight do not substantially cross the placenta. Drugs with low protein binding, lipophilicity, and those that are weak bases all contribute to passage of drug to the placenta.

Which of the following types of data is least likely to be available when evaluating drug safety during pregnancy?

A. Case study or case series

B. Case–control study

C. Retrospective cohort study

D. Controlled clinical trial

The answer is D. Controlled clinical trials of exposure to medications during pregnancy are limited because of the unknown risk of exposure to the drug on the fetus and the potential risk for teratogenicity. Observational studies (eg, case–control, cohort) are more common since there is no direct intervention.

A 36-year-old otherwise healthy woman is contemplating pregnancy. Your recommendation to her for preconception planning is:

A. Continue smoking and ethanol consumption, but work toward decreasing use.

B. Take folic acid 4 mg daily during the first trimester.

C. Take folic acid 0.4 mg daily before conception followed by 4 mg daily during at least the first trimester.

D. Take folic acid 0.4 mg daily.

The answer is D. Folic acid 0.4 to 0.8 mg daily is recommended for all women of childbearing age to reduce the incidence of neural tube defects, since many pregnancies are unplanned and may not be recognized until after the first month.

A 29-year-old pregnant woman who is at week 37 is complaining of constipation for the past 3 days despite increasing her dietary fiber and water intake. Which of the following recommendations is not appropriate?

A. Polyethylene glycol

B. Castor oil

C. Bisacodyl

D. Senna

E. None of the above is appropriate.

The answer is B. Castor oil is not ...

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