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Semin Perinatol. 2014 Dec;38(8):475-86. doi: 10.1053/j.semperi.2014.08.011. Epub 2014 Oct 1.

Basic obstetric pharmacology.

Author information

1
Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, 718 Salk Hall, 3501 Terrace St, Pittsburgh, PA 15261.
2
Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA; Department of Obstetrics and Gynecology, School of Medicine University of Washington, Seattle, WA.
3
Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, 718 Salk Hall, 3501 Terrace St, Pittsburgh, PA 15261; Department of Pathology, School of Medicine, University of Pittsburgh, Pittsburgh, PA; Thomas Starzl Transplantation Institute, Pittsburgh, PA; McGovern Institute for Regenerative Medicine, Pittsburgh, PA; Magee Womens Research Institute, Pittsburgh, PA. Electronic address: rv@pitt.edu.

Abstract

Pregnancy is associated with a variety of physiological changes that can alter the pharmacokinetics and pharmacodynamics of several drugs. However, limited data exists on the pharmacokinetics and pharmacodynamics of the majority of the medications used in pregnancy. In this article, we first describe basic concepts (drug absorption, bioavailability, distribution, metabolism, elimination, and transport) in pharmacokinetics. Then, we discuss several physiological changes that occur during pregnancy that theoretically affect absorption, distribution, metabolism, and elimination. Further, we provide a brief review of the literature on the clinical pharmacokinetic studies performed in pregnant women in recent years. In general, pregnancy increases the clearance of several drugs and correspondingly decreases drug exposure during pregnancy. Based on current drug exposure measurements during pregnancy, alterations in the dose or dosing regimen of certain drugs are essential during pregnancy. More pharmacological studies in pregnant women are needed to optimize drug therapy in pregnancy.

KEYWORDS:

Pharmacokinetics; Pharmacology; Pregnancy; clinical pharmacology; placental transfer

PMID:
25281357
PMCID:
PMC5771662
DOI:
10.1053/j.semperi.2014.08.011
[Indexed for MEDLINE]
Free PMC Article

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