Fundamentals of Clinical Pharmacology With Application for Pregnant Women

Journal of Midwifery & Women's Health
Avinash S PatilRebecca C Pierson

Abstract

Medication use is common in pregnancy, yet for most medications the optimal formulation and dosage have not been described specifically for pregnant women. Often, adverse effects are only discovered anecdotally or after extensive off-label use occurs. Since pharmacologic research that includes pregnant women is sparse and animal studies are often not applicable to the human fetus, providers must use knowledge of drug behavior and normal physiologic changes of pregnancy to personalize treatment for pregnant women. In this review, we present an overview of the basic concepts of clinical pharmacology: pharmacokinetics, pharmacodynamics, and pharmacogenomics. The normal physiologic changes of pregnancy are presented as a framework to understand alterations in drug behavior. A clinical vignette that addresses 4 pregnancy scenarios involving medications-preterm birth, vaccination, herpes simplex virus infection, and codeine toxicity-is provided to illustrate application of core clinical pharmacologic concepts. Discussion of relevant literature illustrates the challenges of offering individualized pharmacologic therapy in pregnancy.

References

Oct 2, 1975·The New England Journal of Medicine·J W JohnsonT M King
Aug 1, 1990·British Journal of Obstetrics and Gynaecology·S C RobsonK W Woodhouse
Sep 1, 1983·The Journal of Antimicrobial Chemotherapy·P de Miranda, M R Blum
Oct 28, 1998·American Journal of Obstetrics and Gynecology·D F KimberlinG Miller
Nov 23, 2000·Lancet·U A Meyer
Aug 3, 2001·Pediatrics·D W KimberlinUNKNOWN National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Group
Aug 2, 2002·Clinical Pharmacology and Therapeutics·Andrea GaedigkJ Steven Leeder
Jun 13, 2003·The New England Journal of Medicine·Paul J MeisUNKNOWN National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network
Apr 27, 2004·Sexually Transmitted Diseases·Peter LeoneScott Justus
Apr 27, 2004·Birth Defects Research. Part A, Clinical and Molecular Teratology·Katherine M StoneElizabeth B Andrews
Dec 31, 2004·The New England Journal of Medicine·Yvan GascheJules Desmeules
Jul 4, 2006·Obstetrics and Gynecology·Jeanne S SheffieldGeorge D Wendel
Jan 24, 2007·American Journal of Obstetrics and Gynecology·Fujie XuStuart M Berman
Feb 8, 2007·Emerging Infectious Diseases·Denise J JamiesonSonja A Rasmussen
Sep 28, 2007·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·J M O'BrienG W Creasy
Dec 7, 2007·Chemical Research in Toxicology·F Peter Guengerich
Jul 19, 2008·The New England Journal of Medicine·Dag MosterTrond Markestad
Sep 19, 2008·The New England Journal of Medicine·K ZamanMark C Steinhoff
Oct 22, 2008·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Pushpanjali RaiSumita Mehta
Oct 6, 2010·Archives of Pediatrics & Adolescent Medicine·Angelia A EickKatherine L O'Brien
Nov 10, 2010·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Isaac BenowitzMarietta Vázquez
Mar 8, 2011·American Journal of Perinatology·Melanie M GloverJiri D Sonek
Apr 26, 2011·American Journal of Obstetrics and Gynecology·Allen A MitchellUNKNOWN National Birth Defects Prevention Study
May 24, 2011·American Journal of Obstetrics and Gynecology·Tracy A ManuckSusan M Ramin
Sep 9, 2011·Clinical Pharmacology and Therapeutics·J A JohnsonUNKNOWN Clinical Pharmacogenetics Implementation Consortium
May 1, 2012·American Journal of Obstetrics and Gynecology·UNKNOWN Society for Maternal-Fetal Medicine Publications Committee, with assistance of Vincenzo Berghella
Jul 31, 2012·Neurologic Clinics·Justine Chang, David Streitman
Sep 13, 2012·American Journal of Obstetrics and Gynecology·Steve N CaritisUNKNOWN Eunice Kennedy Shriver National Institute of Child Health and Human Development Obstetrical-Fetal Pharmacology Research Unit
Mar 20, 2013·Current Opinion in Infectious Diseases·Benjamin LindseyChristine Jones
Jan 25, 2014·Clinical Pharmacology and Therapeutics·K R CrewsUNKNOWN Clinical Pharmacogenetics Implementation Consortium
Sep 14, 2014·Journal of the American Pharmacists Association : JAPhA·Avinash S PatilAmy P Murtha
Dec 3, 2014·Obstetrics and Gynecology Clinics of North America·Geeta K Swamy, Rebecca Garcia-Putnam
Dec 3, 2014·Obstetrics and Gynecology Clinics of North America·Alyssa Stephenson-Famy, Carolyn Gardella
Jan 7, 2015·Obstetrics and Gynecology·Geeta K Swamy, R Phillips Heine
May 15, 2015·Clinical Pharmacology and Therapeutics·J K HicksUNKNOWN Clinical Pharmacogenetics Implementation Consortium
Jul 15, 2015·Infectious Disease Clinics of North America·Scott H James, David W Kimberlin
Aug 16, 2015·American Journal of Obstetrics and Gynecology·Kent D HeyborneJ Christopher Carey
Sep 20, 2015·Vaccine·Geeta K Swamy, Richard H Beigi
Oct 11, 2015·Seminars in Perinatology·Maisa FeghaliSteve Caritis
Oct 11, 2015·The Journal of Allergy and Clinical Immunology·Michael M McNeilFrank DeStefano
Dec 23, 2015·American Journal of Obstetrics and Gynecology·Tracy A ManuckUNKNOWN Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Genomics and Proteomics Network for

❮ Previous
Next ❯

Citations

Jun 21, 2017·Journal of Midwifery & Women's Health·Frances E Likis
Jan 11, 2020·Frontiers in Immunology·Chunlei MeiDonghui Huang
Dec 16, 2021·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Carolina Frandsen Pereira da CostaLuis Antonio Violin Dias Pereira

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

The Annals of Pharmacotherapy
Brian M Sadler, Daniel S Stein
Seminars in Perinatology
Yang ZhaoRaman Venkataramanan
© 2022 Meta ULC. All rights reserved