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Medication Safety: A Focus on Pregnancy and Lactation

1. Which of the following is a physiological change that happens as a result of pregnancy?

A. Decreased gastric pH B. Decreased gastric emptying time C. Increased body volume D. Increased serum protein

2. If a pregnant woman was given a highly lipid soluble drug which of the following would be expected?

A. Decreased concentration B. Increased concentration C. The drug would be more highly protein bound D. No change as compared to a non-pregnant state

3. Which of the following is the mechanism by which drugs predominantly enter the placenta and breast milk?

A. Active transport B. Passive diffusion C. Carrier proteins D. Ion channels

4. Which of the following drugs will easily cross the placenta?

A. High molecular weight drug B. Polarized drug C. Unbound drug – please see comments in manuscript D. Weakly acidic drug

5. Which of the following is true about factors that influence the exposure of a drug on a breastfeeding infant?

A. The pH of the milk changes throughout the day causing changes in the permeability of drugs B. The fat composition of milk changes throughout the day causing changes in the solubility of fat-soluble drug C. Passage of drugs between breast milk and plasma is unidirectional D. Both A and B are correct

6. Which of the following infant related factors may lead to accumulation of a drug that was ingested by the mother?

A. Lower gastric pH B. Slower gastric emptying time C. Increased bile salts D. Decreased intestinal permeability

7. If a breastfeeding mother were to have two alcoholic drinks which of the following would be recommended in relation to breastfeeding?

A. She must wait 2 hours after the last drink before breastfeeding B. She must wait 4 hours after the last drink before breastfeeding C. She can breastfeed immediately if she pumps-and-dumps before she breastfeeds D. The CDC recommends two drinks per day is safe and there are no precautions to follow

8. Which of the following medications should a clinician choose for a breastfeeding mother to reduce the amount of drug exposure to an infant?

A. Lowest degree of protein binding B. High degree of lipid solubility C. Extended release dosage form D. Poor oral absorption

9. If a breastfeeding mother presents with allergic rhinitis which of the following recommendations would be appropriate?

A. Diphenhydramine B. Fluticasone C. Fexofenadine D. Promethazine

10. As a result of the Pregnancy and Lactation Labeling Rule which of the following is a labeling requirement in the pregnancy category?

A. Information about adverse effects reported to pregnancy registries B. Risk statements based on animal and human data C. Background risk information in the general population D. All the above

Evaluation Questions

11. To what extent did the program meet objective #1?

A. Excellent B. Very Good C. Good D. Fair E. Poor

12. To what extent did the program meet objective #2?

A. Excellent B. Very Good C. Good D. Fair E. Poor

13. To what extent did the program meet objective #3?

A. Excellent B. Very Good C. Good D. Fair E. Poor

14. To what extent did the program meet objective #4?

A. Excellent B. Very Good C. Good D. Fair E. Poor

15. Rate the effectiveness of how well the program related to your educational needs:

A. Excellent B. Very Good C. Good D. Fair E. Poor

16. Rate how well the active learning strategies (questions, cases, discussions) were appropriate and effective learning tools:

A. Excellent B. Very Good C. Good D. Fair E. Poor

17. Rate the quality of the faculty:

A. Excellent B. Very Good C. Good D. Fair E. Poor

18. Rate the effectiveness and the overall usefulness of the material presented:

A. Excellent B. Very Good C. Good D. Fair E. Poor

19. Rate the appropriateness of the examination for this activity:

A. Excellent B. Very Good C. Good D. Fair E. Poor

20. Rate the effectiveness of how well the activity related to your practice needs:

A. Excellent B. Very Good C. Good D. Fair E. Poor

21. Rate the effectiveness of how well the activity will help you improve patient care:

A. Excellent B. Very Good C. Good D. Fair E. Poor

22. Will the information presented cause you to change your practice?

A. Yes B. No

23. Are you committed to making these changes?

A. Yes B. No

24. As a result of this activity, did you learn something new?

A. Yes B. No

25. What is your practice setting or area of practice?

A. Community Pharmacy/Independent B. Community Pharmacy/Chain C. Hospital/Health Systems D. Administrative/Pharmacy Director E. Critical Care Pharmacy F. Long-term Care G. Managed Care/PBM H. Oncology I. Specialty Pharmacy J. Industry/Manufacturing

26. How many years have you been in practice?

A. <5 B. 5 – 10 C. 11 – 20 D. >20

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