A pregnant patient asks the nurse about the safe use of medications during the third trimester. What will the nurse tell her about drugs taken at this stage?
a. They may need to be given in higher doses if they undergo renal clearance.
b. They require lower doses if they are me-tabolized by the liver.
c. They are less likely to cross the placenta and affect the fetus.
d. They are more likely to cause anatomical defects if they are teratogenic.
A
In the third trimester, drugs excreted by the kidneys may have to be increased, because renal blood flow is doubled, the glomerular filtration rate is increased, and drug clearance is accele-rated. Hepatic metabolism increases, meaning that drugs metabolized by the liver must be in-creased. All drugs can cross the placenta. Anatomic defects are more likely to occur in the em-bryonic period, which is in weeks 3 through 8 in the first trimester.
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