Clinical Pharmacology During Pregnancy
- 1st Edition - December 5, 2012
- Language: English
Clinical Pharmacology During Pregnancy is written for clinicians, physicians, midwives, nurses, pharmacists and other medical professionals directly involved in the care of women… Read more
Clinical Pharmacology During Pregnancy is written for clinicians, physicians, midwives, nurses, pharmacists and other medical professionals directly involved in the care of women during pregnancy. This book focuses on the impact of pregnancy on drug disposition and also includes coverage of treatments for diseases of specific body systems as well as essential content on dosing and efficacy.
The broad range of this book encompasses analgesics, antiasthmatics, antidepressants, heart and circulatory drugs, vitamins and herbal supplements, and more. Topics in chemotherapy and substance abuse are covered, as are research issues, including clinical trial design and ethical considerations.
- Uses an evidence-based approach for therapeutics during pregnancy
- Includes a summary of specific medications by indication with up-to-date information on dosing and efficacy in pregnancy for the given indication
This book will be of value to anyone who is actively involved in the care of pregnant women, including obstetricians, residents in obstetrics, fellows in fetal maternal medicine, internists, general and family practitioners who provide care for women of reproductive age, pharmacists, midwives, nurse practitioners and physician assistants.
Contributors
1. Introduction
References
2. Physiologic Changes During Pregnancy
2.1 Physiologic changes during pregnancy
2.2 Cardiovascular system
2.3 Respiratory system
2.4 Renal system
2.5 Gastrointestinal system
2.6 Hematologic and coagulation systems
2.7 Endocrine system
2.8 Summary
References
3. Impact of Pregnancy on Maternal Pharmacokinetics of Medications
3.1 Introduction
3.2 Effects of pregnancy on pharmacokinetic parameters
3.3 Summary
References
4. Medications and the Breastfeeding Mother
4.1 Medication use by the breastfeeding mother
4.2 Clinical pharmacology of drug transfer into breast milk
4.3 During delivery
4.4 General anesthesia
4.5 Epidural anesthesia
4.6 Galactogogues
4.7 Immediate postpartum period
4.8 Pain
4.9 Methadone
4.10 Resumption of pre-pregnancy medications
4.11 Psycho- and neurotropic drugs
4.12 Drugs not to give to the nursing mother postpartum
4.13 Oral contraceptives (OCPs)
4.14 Summary
4.15 Where to find information
References
5. Fetal Drug Therapy
5.1 Introduction
5.2 Indications for fetal therapy
5.3 Strategies to achieve fetal drug therapy
5.4 Special considerations
Acknowledgments
References
6. Treating the Placenta: an Evolving Therapeutic Concept
6.1 Introduction
6.2 The placenta as the therapeutic target: the past
6.3 The placenta: therapeutic targets
6.4 The placenta as a therapeutic target today
6.5 The placenta as a therapeutic target in the future
Conclusions
References
7. What is Sufficient Evidence to Justify a Multicenter Phase 3 Randomized Controlled Trial in Obstetrics?
7.1 Introduction
7.2 Evidence, equipoise, and the ethical considerations in deciding whether to conduct a trial
7.3 Why are failure rates so high for pregnancy drug trials compared to other therapeutic areas?
7.4 Role of phase 2 trials
7.5 How to improve success rates
7.6 Learning from experience – the example of antioxidants and preeclampsia
Conclusions and recommendations
References
8. Ethics of Clinical Pharmacology Research in Pregnancy
References
Questions for further discussion
9. Pharmacogenomics in Pregnancy
9.1 Pharmacogenomics
9.2 Genetics and polymorphisms
9.3 Genes that influence pharmacokinetic variability
9.4 The current state of pharmacogenetic testing
9.5 Potential therapeutic areas for pharmacogenomics in pregnancy
9.6 Study designs and approaches to pharmacogenetics trials
References
10. Analgesics and Anti-Inflammatory, General and Local Anesthetics and Muscle Relaxants
10.1 Introduction
10.2 General anesthesia
10.3 Inhalational anesthetics
10.4 Intravenous anesthetics
10.5 Neuromuscular blocking agents
10.6 Regional anesthesia
10.7 Summary
References
11. The Management of Asthma During Pregnancy
11.1 Introduction
11.2 Effect of pregnancy on the course of asthma
11.3 Effect of asthma on pregnancy
11.4 Asthma management
11.5 Pharmacologic therapy
Conclusion
References
12. Updated Guidelines for the Management of Nausea and Vomiting of Pregnancy and Hyperemesis Gravidarum
12.1 Introduction
12.2 Hyperemesis gravidarum
12.3 Etiology and risk factors
12.4 Differential diagnosis
12.5 Management of NVP and HG
Conclusion
References
13. Clinical Pharmacology of Anti-Infectives During Pregnancy
13.1 Antibacterial therapy
13.2 Antifungal therapy
13.3 Malaria
13.4 Tuberculosis
13.5 HIV
13.6 Antivirals
13.7 Parasitic infections
References
14. Chemotherapy in Pregnancy
14.1 Introduction
14.2 Overview of chemotherapeutic agents
14.3 Alkylating agents
14.4 Anthracyclines
14.5 Plant alkaloids
14.6 Targeted therapies
14.7 Other agents
14.8 Treatment of specific cancers
14.9 Breast cancer
14.10 Lymphoma
14.11 Leukemia
14.12 Ovarian cancer
14.13 Future fertility
14.14 Pharmacokinetics in pregnancy
References
15. Substance Use Disorders
15.1 Introduction
15.2 Substance use disorders defined
15.3 Addiction defined as a disease of the brain
15.4 The good news: the brain can recover
15.5 Pregnancy enhances recovery
15.6 Addiction in women and pregnancy
15.7 Psychiatric co-morbidity
15.8 Substances used
15.9 Screening and detection
15.10 The role of urine and meconium testing
15.11 Brief office screening strategies
15.12 Brief office interventions
15.13 Long-term care and maintenance
Conclusion
References
16. Diabetes in Pregnancy
16.1 Introduction
16.2 Epidemiology
16.3 Classification
16.4 Gestational diabetes
16.5 Diabetes management in pregnancy
Conclusion
References
17. Cardiovascular Medications in Pregnancy
17.1 Introduction
17.2 Cardiovascular changes in pregnancy
17.3 Cardiovascular diseases in pregnancy
17.4 Pharmacodynamics of hemodynamically active drugs in pregnancy
17.5 Fetal pharmacodynamic response to hemodynamically active drugs
17.6 Direct fetal effects of hemodynamically active drugs
17.7 Pharmacokinetic changes in hemodynamically active drugs in pregnancy
Key points
References
18. Antidepressants in Pregnancy
18.1 Introduction
18.2 Effects of untreated perinatal depression on women and children
18.3 Approach to treatment
18.4 Potential risks of selective serotonin reuptake inhibitor (SSRI) use during pregnancy
18.5 Potential risks of non-SSRI antidepressant use during pregnancy
18.6 Potential risks of older antidepressant use during pregnancy
18.7 Anxiety
18.8 Summary
References
19. Uterine Contraction Agents and Tocolytics
19.1 Introduction
19.2 Uterine contraction agents (uterotonics)
19.3 Uterine relaxation agents (tocolytics)
References
20. Antenatal Thyroid Disease and Pharmacotherapy in Pregnancy
20.1 Thyroid function and physiology in pregnancy
20.2 Hyperthyroidism in pregnancy
20.3 Pharmacotherapy with thionamides in pregnancy
20.4 Hypothyroidism in pregnancy
20.5 Pharmacotherapy with levothyroxine in pregnancy
20.6 Summary
References
21. Dermatological Medications and Local Therapeutics
21.1 Introduction
21.2 Acne
21.3 Psoriasis
21.4 Bacterial infections
21.5 Viral infections
21.6 Fungal infections
21.7 Parasitic infections
21.8 Antipruritics
21.9 Glucocorticosteroids
21.10 Immunomodulators/immunosuppressive therapy
21.11 Analgesics
21.12 Antiseptics (disinfectants)
References
22. Vitamins, Minerals, Trace Elements, and Dietary Supplements
22.1 Introduction
22.2 First trimester
22.3 Second trimester
22.4 Third trimester
References
23. Herbs and Alternative Remedies
23.1 Herbal teas frequently used during pregnancy
23.2 Essential oils used as aromatherapy during pregnancy
23.3 Herbs used as capsules or dried extracts
23.4 Herbal topical preparations used in pregnancy
23.5 Non-herbal supplements used in pregnancy
23.6 Herbs used to induce labor
23.7 Acupuncture and acupressure therapy in pregnancy
23.8 Meditation and hypnosis in pregnancy
References
24. Envenomations and Antivenoms During Pregnancy
24.1 General principles about envenomation
24.2 Snake bites
24.3 Spider bites
24.4 Scorpion stings
24.5 Hymenoptera
24.6 Jellyfish
24.7 Antivenom use during pregnancy
Conclusions
References
25. Gastrointestinal Disorders
25.1 Gastroesophageal reflux disease
25.2 Peptic ulcer disease
25.3 Constipation
25.4 Diarrhea
25.5 Abdominal pain
25.6 Gastrointestinal infections
25.7 Inflammatory bowel disease
Liver diseases in pregnancy
25.9 Hepatitis C
25.10 Wilson’s disease
25.11 Autoimmune hepatitis
25.12 Intrahepatic cholestasis of pregnancy
25.13 Primary biliary cirrhosis and primary sclerosing cholangitis
References
Index
- Edition: 1
- Published: December 5, 2012
- Language: English
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