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Therapie. 2014 May-Jun;69(3):223-34. doi: 10.2515/therapie/2014026. Epub 2014 Jul 14.

[Pharmacokinetic alterations in pregnancy and use of therapeutic drug monitoring].

[Article in French]

Author information

1
Centre suisse de Teratovigilance et Division de Pharmacologie cliniqueCentre hospitalier universitaire Vaudois et Université de Lausanne, Lausanne, Suisse - École de Pharmacie Genève-Lausanne, Universités de Genève et Lausanne, Genève, Suisse.
2
École de Pharmacie Genève-Lausanne, Universités de Genève et Lausanne, Genève, Suisse.
3
Centre suisse de Teratovigilance et Division de Pharmacologie cliniqueCentre hospitalier universitaire Vaudois et Université de Lausanne, Lausanne, Suisse.
4
Médecine materno-fœtale, Département de Gynécologie obstétrique et Génétique médicale, Centre hospitalier universitaire Vaudois et Université de Lausanne, Lausanne, Suisse.
5
Centre suisse de Teratovigilance et Division de Pharmacologie cliniqueCentre hospitalier universitaire Vaudois et Université de Lausanne, Lausanne, Suisse - Pharmacie des Hôpitaux de l'Est Lémanique, Vevey, Suisse.

Abstract

Following the thalidomide tragedy, pharmacological research in pregnant women focused primarily on drug safety for the unborn child and remains only limited regarding the efficacy and safety of treatment for the mother. Significant physiological changes during pregnancy may yet affect the pharmacokinetics of drugs and thus compromise its efficacy and/or safety. Therapeutic drug monitoring (TDM) would maximize the potential effectiveness of treatments, while minimizing the potential risk of toxicity for the mother and the fetus. At present, because of the lack of concentration-response relationship studies in pregnant women, TDM can rely only on individual assessment (based on an effective concentration before pregnancy) and remains reserved only to unexpected situations such as signs of toxicity or unexplained inefficiency.

PMID:
25011648
DOI:
10.2515/therapie/2014026
[Indexed for MEDLINE]

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