Providing medication advice for pregnant and lactating patients is a high-stakes responsibility that demands the use of specialized, evidence-based resources. A pharmacist cannot rely on general knowledge alone and must be proficient in navigating key references, a skill central to the principles of evidence-based practice taught throughout the PharmD curriculum “. This quiz will test your knowledge on the essential drug information resources for pregnancy and lactation, from the “gold standard” textbooks to freely available government databases.
1. Which of the following is widely considered the “gold standard” tertiary reference text for detailed information on drug use in pregnancy and lactation?
- a. The Physician’s Desk Reference (PDR)
- b. The Orange Book
- c. Briggs’ Drugs in Pregnancy and Lactation
- d. The Merck Manual
Answer: c. Briggs’ Drugs in Pregnancy and Lactation
2. LactMed® is a free online database maintained by which government organization?
- a. The Food and Drug Administration (FDA)
- b. The Centers for Disease Control and Prevention (CDC)
- c. The National Institutes of Health (NIH) / National Library of Medicine (NLM)
- d. The Drug Enforcement Administration (DEA)
Answer: c. The National Institutes of Health (NIH) / National Library of Medicine (NLM)
3. The primary focus of the LactMed® database is to provide information on:
- a. Drugs and their effects on breastfeeding infants.
- b. Teratogenic effects of drugs during the first trimester.
- c. The management of infertility.
- d. Contraceptive efficacy.
Answer: a. Drugs and their effects on breastfeeding infants.
4. The new FDA Pregnancy and Lactation Labeling Rule (PLLR) replaced the old A, B, C, D, X categories with:
- a. A simple “safe” or “unsafe” designation.
- b. A numerical risk score from 1-10.
- c. A narrative summary of risks and clinical considerations.
- d. A color-coded warning system.
Answer: c. A narrative summary of risks and clinical considerations.
5. The PLLR includes a specific subsection (8.3) that is new compared to the old labeling, which addresses:
- a. Dosing in renal impairment.
- b. Females and Males of Reproductive Potential.
- c. Geriatric use.
- d. Drug-drug interactions.
Answer: b. Females and Males of Reproductive Potential.
6. The course “Principles of Evidence-Based Practice” covers the different types of drug information resources.
- a. True
- b. False
Answer: a. True
7. A patient asks if it is safe to take a specific herbal supplement while breastfeeding. Which type of resource would be most appropriate to consult first?
- a. The product’s marketing website.
- b. A social media parenting group.
- c. An evidence-based database specializing in natural medicines and lactation, like LactMed® or Natural Medicines database.
- d. A general medical textbook.
Answer: c. An evidence-based database specializing in natural medicines and lactation, like LactMed® or Natural Medicines database.
8. The old FDA Pregnancy Category X meant that:
- a. The drug was safe to use.
- b. There was no available data.
- c. The risk of use in a pregnant woman clearly outweighed any possible benefit.
- d. The drug was safe, but only in the third trimester.
Answer: c. The risk of use in a pregnant woman clearly outweighed any possible benefit.
9. A pharmacist looking for the most recent, original research on a new drug’s use in pregnancy would consult which type of literature?
- a. Tertiary Literature (e.g., a textbook)
- b. Secondary Literature (e.g., PubMed) to find Primary Literature
- c. The product’s package insert only
- d. An online patient forum
Answer: b. Secondary Literature (e.g., PubMed) to find Primary Literature
10. What is a major limitation of the old FDA pregnancy letter categories?
- a. They were too detailed.
- b. They were often misinterpreted as a simple grading system (e.g., ‘B’ is safer than ‘C’) without considering the clinical context.
- c. They were only for healthcare professionals and not available to the public.
- d. They were updated daily.
Answer: b. They were often misinterpreted as a simple grading system (e.g., ‘B’ is safer than ‘C’) without considering the clinical context.
11. The management of women’s health is a topic within the Patient Care 5 curriculum.
- a. True
- b. False
Answer: a. True
12. The Relative Infant Dose (RID) is used to assess infant exposure to a drug through breast milk. An RID of less than what percentage is generally considered safe?
- a. 1%
- b. 10%
- c. 25%
- d. 50%
Answer: b. 10%
13. A drug’s package insert is considered what type of drug information resource?
- a. Primary literature
- b. Secondary literature
- c. Tertiary literature
- d. It is not considered a drug information resource.
Answer: c. Tertiary literature
14. A pharmacist receives a question about a rare exposure in pregnancy. After checking tertiary resources, they find only a few case reports. These case reports are examples of:
- a. Primary literature
- b. Secondary literature
- c. Tertiary literature
- d. Clinical practice guidelines
Answer: a. Primary literature
15. Evaluating relevant primary literature to answer drug information questions is a key objective for student pharmacists.
- a. True
- b. False
Answer: a. True
16. Which property would make a drug MORE likely to pass into breast milk?
- a. High molecular weight
- b. High protein binding
- c. Low lipid solubility
- d. Low protein binding
Answer: d. Low protein binding
17. The “Lactation” subsection of the new PLLR provides information on:
- a. The amount of drug in breast milk and potential effects on the infant.
- b. How to increase milk supply.
- c. The best type of formula to use.
- d. How to manage contraception while breastfeeding.
Answer: a. The amount of drug in breast milk and potential effects on the infant.
18. General drug information databases like Micromedex and Lexicomp contain specific sections on pregnancy and lactation.
- a. True
- b. False
Answer: a. True
19. Why is it often difficult to find high-quality, randomized controlled trial data on medication use in pregnant women?
- a. Because drug effects are not different in pregnancy.
- b. Due to ethical concerns with enrolling pregnant women in clinical trials.
- c. Because pregnant women do not take medications.
- d. Because the FDA prohibits such studies.
Answer: b. Due to ethical concerns with enrolling pregnant women in clinical trials.
20. An active learning session on women’s health, where these resources would be applied, is part of the Patient Care 5 course.
- a. True
- b. False
Answer: a. True
21. A drug that is a weak base is more likely to become trapped and concentrate in breast milk because:
- a. Breast milk is slightly more acidic than plasma.
- b. Breast milk is more alkaline than plasma.
- c. All weak bases are highly protein-bound.
- d. Breast milk has a neutral pH.
Answer: a. Breast milk is slightly more acidic than plasma.
22. A key role of the pharmacist is to communicate a risk/benefit assessment to the patient and provider, rather than giving a simple “safe” or “unsafe” answer.
- a. True
- b. False
Answer: a. True
23. The “Female Reproduction and Pregnancy” lecture is a topic within the Patient Care 5 curriculum.
- a. True
- b. False
Answer: a. True
24. An active learning session on women’s health is part of which course?
- a. PHA5787C Patient Care 5
- b. PHA5163L Professional Skills Lab 3
- c. PHA5781 Patient Care I
- d. PHA5782C Patient Care 2
Answer: a. PHA5787C Patient Care 5
25. A pharmacist is looking for information on a specific drug exposure during pregnancy. The best search strategy in a database like PubMed would involve using keywords for the drug name and:
- a. “Side effects”
- b. “Pregnancy” or “teratogenicity”
- c. “Pharmacokinetics”
- d. “Cost”
Answer: b. “Pregnancy” or “teratogenicity”
26. The information in a tertiary resource like a textbook or database can sometimes be less current than the primary literature.
- a. True
- b. False
Answer: a. True
27. MotherToBaby is an information service that provides resources for:
- a. Only healthcare professionals.
- b. Only patients.
- c. Both patients and healthcare professionals.
- d. Only drug manufacturers.
Answer: c. Both patients and healthcare professionals.
28. An active learning session on women’s health is part of which course module?
- a. Module 3: Women’s Health
- b. Module 1: Diabetes Mellitus
- c. Module 4: Medication Safety
- d. Module 8: Men’s Health
Answer: a. Module 3: Women’s Health
29. The old pregnancy category “A” indicated that:
- a. There was positive evidence of human fetal risk.
- b. Animal studies showed risk, but human studies did not.
- c. Controlled studies in women failed to demonstrate a risk to the fetus in the first trimester.
- d. The drug was contraindicated.
Answer: c. Controlled studies in women failed to demonstrate a risk to the fetus in the first trimester.
30. The “Special Patient Populations” lecture is part of the Drug Therapy Individualization course.
- a. True
- b. False
Answer: a. True
31. When counseling a lactating mother about a medication, it is important to advise her to:
- a. Monitor the infant for any potential side effects, such as drowsiness or irritability.
- b. Increase the dose of her medication.
- c. Stop breastfeeding immediately.
- d. Not worry about any potential effects on the infant.
Answer: a. Monitor the infant for any potential side effects, such as drowsiness or irritability.
32. The term “teratogen” refers to any agent that can:
- a. Cure a disease.
- b. Cause a birth defect.
- c. Prevent pregnancy.
- d. Treat nausea in pregnancy.
Answer: b. Cause a birth defect.
33. Which of the following drug characteristics makes placental transfer LEAST likely?
- a. Low molecular weight
- b. High molecular weight (e.g., insulin, heparin)
- c. Lipophilic
- d. Low protein binding
Answer: b. High molecular weight (e.g., insulin, heparin)
34. The new PLLR requires the drug label to be updated when new information becomes available.
- a. True
- b. False
Answer: a. True
35. A pharmacist is helping a provider choose an antidepressant for a pregnant patient. The best approach is to:
- a. Recommend against all antidepressants.
- b. Consult evidence-based resources to compare the relative risks and benefits of different agents.
- c. Choose the newest drug on the market.
- d. Choose the cheapest drug available.
Answer: b. Consult evidence-based resources to compare the relative risks and benefits of different agents.
36. A drug’s half-life is an important consideration for lactating mothers because drugs with a shorter half-life:
- a. Are cleared more quickly from the mother’s system, potentially leading to lower infant exposure.
- b. Are more likely to concentrate in breast milk.
- c. Have a higher Relative Infant Dose.
- d. Are more toxic to the infant.
Answer: a. Are cleared more quickly from the mother’s system, potentially leading to lower infant exposure.
37. The “Reproductive Self-Care” module in Patient Care I would likely cover patient use of what resource?
- a. Primary literature databases
- b. The product labeling on an OTC prenatal vitamin
- c. A surgical textbook
- d. A compounding manual
Answer: b. The product labeling on an OTC prenatal vitamin
38. The lecture “Female Reproduction and Pregnancy” is part of which course?
- a. PHA5787C Patient Care 5
- b. PHA5163L Professional Skills Lab 3
- c. PHA5781 Patient Care I
- d. PHA5782C Patient Care 2
Answer: a. PHA5787C Patient Care 5
39. When using any drug information resource, it is important for the pharmacist to:
- a. Accept the information at face value without question.
- b. Critically evaluate the quality of the evidence presented.
- c. Only use one resource.
- d. Only use resources that are free.
Answer: b. Critically evaluate the quality of the evidence presented.
40. An active learning session covering women’s health is part of which course?
- a. PHA5787C Patient Care 5
- b. PHA5163L Professional Skills Lab 3
- c. PHA5781 Patient Care I
- d. PHA5782C Patient Care 2
Answer: a. PHA5787C Patient Care 5
41. The absence of data on a drug’s use in pregnancy means the drug is safe.
- a. True
- b. False
Answer: b. False
42. Which of the following is an example of tertiary literature?
- a. A randomized controlled trial published in a journal.
- b. A case report.
- c. The Micromedex database.
- d. A PubMed search result list.
Answer: c. The Micromedex database.
43. A pharmacist’s ability to answer medication-related questions using scientific literature is a defined Entrustable Professional Activity (EPA).
- a. True
- b. False
Answer: a. True
44. The most important factor in deciding whether a lactating mother should take a medication is:
- a. The cost of the drug.
- b. A risk-benefit assessment for both the mother and the infant.
- c. The convenience of the dosing schedule.
- d. The taste of the medication.
Answer: b. A risk-benefit assessment for both the mother and the infant.
45. Which of the following is NOT a subsection of the new Pregnancy and Lactation Labeling Rule (PLLR)?
- a. 8.1 Pregnancy
- b. 8.2 Lactation
- c. 8.3 Females and Males of Reproductive Potential
- d. 8.4 Geriatric Use
Answer: d. 8.4 Geriatric Use
46. A pharmacist should always document the resources they used to answer a drug information question about pregnancy or lactation.
- a. True
- b. False
Answer: a. True
47. If different resources provide conflicting information, the pharmacist should:
- a. Choose the information that is easiest to explain.
- b. Evaluate the strength and date of the evidence in each resource to make a clinical judgment.
- c. Assume the drug is unsafe and recommend against its use.
- d. Tell the patient to choose which advice to follow.
Answer: b. Evaluate the strength and date of the evidence in each resource to make a clinical judgment.
48. An active learning session on women’s health is part of which course module?
- a. Module 3: Women’s Health
- b. Module 1: Diabetes Mellitus
- c. Module 4: Medication Safety
- d. Module 8: Men’s Health
Answer: a. Module 3: Women’s Health
49. The overall goal of using drug information resources for this population is to:
- a. Find a definitive “yes” or “no” answer.
- b. Gather sufficient, high-quality evidence to support a safe and effective therapeutic plan.
- c. Fulfill an academic requirement.
- d. Bill for clinical services.
Answer: b. Gather sufficient, high-quality evidence to support a safe and effective therapeutic plan.
50. The ultimate reason to be proficient with these resources is to:
- a. Answer questions quickly.
- b. Protect patients—both mother and infant—from preventable harm while ensuring the mother receives necessary medical treatment.
- c. Pass the final exam.
- d. Appear knowledgeable in front of other healthcare professionals.
Answer: b. Protect patients—both mother and infant—from preventable harm while ensuring the mother receives necessary medical treatment.