Which are physiologic changes during pregnancy that affect drug absorption, metabolism, distribution, and excretion? (Select all that apply.)
a. Circulating steroid hormones
b. Decreased gastrointestinal motility
c. Decreased renal perfusion
d. Increased maternal circulatory blood volume
e. Poor sleep and fatigue
f. Rapid respiratory rate
ANS: A, B, D
Steroid hormones, decreased GI motility, and increased blood volume all affect maternal drug effectiveness. Renal perfusion is increased during pregnancy. Poor sleep does not alter drug effectiveness. Rapid respiratory rate does not necessarily occur.
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