A pregnant patient is taking a medication that may produce toxicity if it is prolonged in her body. Which physiological change in the pregnant woman would be the most likely cause of an in-creased risk of toxicity?
a. Increased glomerular filtration rate (GFR)
b. Decreased renal blood flow
c. Prolonged transit through the gut
d. Increased hepatic metabolism
C
Prolonged transit means more time for drugs to be absorbed, and this could increase the levels of drugs for which absorption is normally poor; therefore, prolonged transit increases the possibility of toxicity.
An increased GFR would expedite the passage of drugs through the system and therefore would be least likely to produce toxicity.
Decreased renal blood flow does not occur in the third trimester of pregnancy, therefore it is not relevant to this situation.
Increased hepatic metabolism would not affect toxicity.
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