安徽医科大学：《临床药理学 Clinical Pharmacology》课程教学资源（授课教案，英文版）Charpter 22 Drug therapy in pregant and nursing women

安徽医科大学国际教育学院教案与讲稿 Teaching Plan for International Students,AHMU Title of the course:Drug therapy in pregant and nursing women Chapter:22 Teacher's name: Chang Yan Grade:2013 Department:Clinical Medicine,School of International Education Time:14:30-16:50 Date(D/M/Y):3/30/2016 To master: (1)Pharmacokinetic features of pregnant and nursing women Teaching Objectives; (2)Principle of clinical drug use of pregnant and nursing women Familiar with: Teaching (1)Physiological changes of pregnant and nursing women Requirements (2)Pharmacodynamic features of common drugs (3)General principles of teratology (1)Pregnancy physiological and its effects on pharmacokinetics Teaching (2)Pharmacokinetic studies during pregancy Content (3)Teratogenesis (4)Drug therapy in nursing mothers Teaching Focus: Teaching (1)The changes in physiology and its effects on pharmacokinetics Focus; (2)Principle of clinical drug use of pregnant and nursing women Difficult Difficult problems and their Solutions: Problems (1)Apply the knowledge to rational use of drugs in pregnant and nursing and their women Solutions (2)Take various teaching models and give some exmples (1)Physiological features of pregnancy 8 min (2)Pharmacokinetic features of pregnant women 10 min Time (3)Drug therapy in pregnant women 6 min Allotment (4)General principles of teratology 5 min (5)Drug therapy in nursing mothers 5 min (6)Principle of clinical drug use of pregnant and nursing women 3 min (1)The physiologial changes in pregnancy Assignment (2)The pharmacokinetic and pharmacodynamic features (3)Principle of clinical drug use in pregnancy (1)Principle of Clinical Pharmacology(Second Edition);ArthurJ.Atkinson (2)Basic Clinical Pharmacology;Bertram G Katzung Reference (3)Oxford Textbook of Clinical Pharmacology and Drug Therapy;David Text Grahame-Smith,Jeffrey Aronson (4)《临床药理学》（第四版）人民卫生出版社；李俊主编 Memo

安徽医科大学国际教育学院教案与讲稿 1 Teaching Plan for International Students, AHMU Title of the course: Drug therapy in pregant and nursing women Chapter: 22 Teacher’s name: Chang Yan Grade: 2013 Department: Clinical Medicine, School of International Education Time: 14:30—16:50 Date (D/M/Y): 3/30/2016 Teaching Objectives; Teaching Requirements To master: (1) Pharmacokinetic features of pregnant and nursing women (2) Principle of clinical drug use of pregnant and nursing women Familiar with: (1) Physiological changes of pregnant and nursing women (2) Pharmacodynamic features of common drugs (3) General principles of teratology Teaching Content (1) Pregnancy physiological and its effects on pharmacokinetics (2) Pharmacokinetic studies during pregancy (3) Teratogenesis (4) Drug therapy in nursing mothers Teaching Focus; Difficult Problems and their Solutions Teaching Focus: (1) The changes in physiology and its effects on pharmacokinetics (2) Principle of clinical drug use of pregnant and nursing women Difficult problems and their Solutions: (1) Apply the knowledge to rational use of drugs in pregnant and nursing women (2) Take various teaching models and give some exmples Time Allotment (1) Physiological features of pregnancy 8 min (2) Pharmacokinetic features of pregnant women 10 min (3) Drug therapy in pregnant women 6 min (4) General principles of teratology 5 min (5) Drug therapy in nursing mothers 5 min (6) Principle of clinical drug use of pregnant and nursing women 3 min Assignment (1) The physiologial changes in pregnancy (2) The pharmacokinetic and pharmacodynamic features (3) Principle of clinical drug use in pregnancy Reference Text (1) Principle of Clinical Pharmacology (Second Edition); ArthurJ. Atkinson (2) Basic & Clinical Pharmacology; Bertram G. Katzung (3) Oxford Textbook of Clinical Pharmacology and Drug Therapy; David Grahame-Smith, Jeffrey Aronson (4)《临床药理学》（第四版）人民卫生出版社；李俊 主编 Memo

安徽医科大学国际教育学院教案与讲稿 Teaching Plan for International Students,AHMU Title of the course:Drug therapy in pregant and nursing women Chapter:22 Teacher's name: Chang Yan Grade:2013 Department:Clinical Medicine,School of International Education Time:14:30-16:50 Date(D/M/Y):3/30/2016 Lecture Notes: 【Raise a question】 1min What are special populations? 【Show date】 1min WHO survey showed that 89%of women take prescription drugs during pregnancy (avg=3 prescription each)not including OTC preparation and alternative therapies 【Physiologial Changes in Pregnancy】 8min Gastrointestinal changes Cardiovascular system changes Decrease in albumin concentration Enzymatic activity changes Increase in glomerular filtration rate(GFR) Give examples:Phenytoin Maternal Physiologic Changes Altering PK of Drugs 10 min ●Volume Expansion Protein binding-increase in free fraction of drugs bound to albumin ●Clearance changes Gastrointestinal changes Give examples:Caffeine;Theophylline;Methadone;Ampicllin 【Drug Studies for Pregnancy】 6min Pregnancy Specific Drugs ●Tocolytic agents ●Oxytocic agents 2

安徽医科大学国际教育学院教案与讲稿 2 Teaching Plan for International Students, AHMU Title of the course: Drug therapy in pregant and nursing women Chapter: 22 Teacher’s name: Chang Yan Grade: 2013 Department: Clinical Medicine, School of International Education Time: 14:30—16:50 Date (D/M/Y): 3/30/2016 Lecture Notes: 【Raise a question】 1 min What are special populations? 【Show date】 1 min WHO survey showed that 89% of women take prescription drugs during pregnancy (avg = 3 prescription each) not including OTC preparation and alternative therapies 【Physiologial Changes in Pregnancy】 8 min
Gastrointestinal changes
Cardiovascular system changes
Decrease in albumin concentration
Enzymatic activity changes
Increase in glomerular filtration rate (GFR) Give examples: Phenytoin 【Maternal Physiologic Changes Altering PK of Drugs】 10 min
Volume Expansion
Protein binding-increase in free fraction of drugs bound to albumin
Clearance changes
Gastrointestinal changes Give examples: Caffeine; Theophylline; Methadone; Ampicllin 【Drug Studies for Pregnancy】 6 min Pregnancy Specific Drugs
Tocolytic agents
Oxytocic agents

安徽医科大学国际教育学院教案与讲稿 ●Eclampsia agents Drugs commonly used by women of childbearing potential ●Antidepressants ●Asthma drugs 【Teratogenesis】 5min General Principles of Teratology Teratogens act with specificity ● Teratogens demonstrate a dose-response relationship Teratogens must reach the conceptus Effects depend on the development stage when exposed Genotype of mother and fetus effect susceptibility Placental Transfer of Drugs 【Drug Therapy in Nursing Mother】 5min ●Drugs in breast milk Evaluation of drugs in breast milk Factors Effecting the Milk /Plasma Concentration Ratio 【General Recommendations】 3 min Drugs considered safe for pregnancy are usually safe during lactation ● Decrease the drug dose to the infant by feeding just prior to drug administration Infant blood levels can be monitored and should be less than therapeutic dosage 3

安徽医科大学国际教育学院教案与讲稿 3
Eclampsia agents Drugs commonly used by women of childbearing potential
Antidepressants
Asthma drugs 【Teratogenesis】 5 min General Principles of Teratology
Teratogens act with specificity
Teratogens demonstrate a dose-response relationship
Teratogens must reach the conceptus
Effects depend on the development stage when exposed
Genotype of mother and fetus effect susceptibility Placental Transfer of Drugs 【Drug Therapy in Nursing Mother】 5 min
Drugs in breast milk
Evaluation of drugs in breast milk
Factors Effecting the Milk / Plasma Concentration Ratio 【General Recommendations】 3 min
Drugs considered safe for pregnancy are usually safe during lactation
Decrease the drug dose to the infant by feeding just prior to drug administration
Infant blood levels can be monitored and should be less than therapeutic dosage