Pharmacology and Toxicology Flashcards
6 cards from real IBCLC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Pharmacology and Toxicology flashcards as text
A mother is taking metformin for type 2 diabetes and wants to breastfeed. What does the evidence show?
Answer: Metformin has very low transfer into breast milk (RID approximately 0.3-0.7%) and is considered compatible with breastfeeding
Metformin has a very low RID of approximately 0.3-0.7% and is considered compatible with breastfeeding.
A breastfeeding mother needs general anesthesia for emergency surgery. When can she resume breastfeeding?
Answer: Once she is awake, alert, and able to safely hold and feed her infant
Modern anesthetic agents are short-acting and cleared rapidly. Breastfeeding can resume once the mother is awake and alert.
Which herbal galactagogue has the most evidence for increasing milk supply, and what are the safety considerations?
Answer: Fenugreek has the most published evidence but can cause GI effects, hypoglycemia, and has cross-reactivity with peanut/chickpea allergies
Fenugreek is the most studied herbal galactagogue but has important safety considerations.
A mother is prescribed ibuprofen for postpartum pain. What makes this a preferred analgesic during breastfeeding?
Answer: It has very low transfer (RID approximately 0.1-0.7%), is highly protein-bound, and is well-studied with no reported adverse effects
Ibuprofen is highly protein-bound (>99%), has minimal transfer into breast milk, and has extensive safety data.
What is the primary concern regarding codeine use in breastfeeding mothers?
Answer: Some mothers are ultra-rapid CYP2D6 metabolizers who convert codeine to morphine at dangerously high rates, leading to infant sedation and potentially fatal respiratory depression
Ultra-rapid CYP2D6 metabolizers convert codeine to morphine at higher rates, resulting in elevated morphine levels in breast milk.
A mother who is a heavy coffee drinker (6+ cups daily) notices her breastfed newborn is unusually irritable and has difficulty sleeping. What is the likely connection?
Answer: Caffeine accumulates in neonates due to their immature metabolism, with a half-life of approximately 97 hours in newborns versus 5 hours in adults
Neonates have extremely limited ability to metabolize caffeine, with a half-life of approximately 97 hours.