Drug Therapy During Pregnancy (eBook)

Tom K. A. B. Eskes, Mieczyslaw Finster (Herausgeber)

eBook Download: PDF

2013 | 1. Auflage
240 Seiten
Elsevier Science (Verlag)
978-1-4831-6298-0 (ISBN)

Infos

Drug Therapy During Pregnancy is a collection of papers dealing with the risks and benefits of drug treatment for both mother and fetus. One paper notes that the total use of medication during pregnancy in the Netherlands has decreased from 82.7 % to 71.7 %. The paper also points out the lack of a relationship between the number or type of congenital anomalies and the use of medication. Another paper assesses fetal drug exposure in two ways: firstly, through the physicochemical characteristics of the drug and the way it is handled by the mother in order to estimate placental passage and fetal exposure. Secondly, through the utilization of pharmacokinetic models estimating the probable time course of drug concentrations in the feto-maternal unit. One paper investigates the effects of hypertension during pregnancy, in which the etiology of hypertension, a group of disorders with one common abnormality, remains unsolved with a clinical diagnosis that is not always accurate. Treatment differs widely depending on the type: chronic hypertension, albuminuric hypertension, and hypertensive crises during pregnancy. One paper suggests that to prove any environmental exposure to a particular substance affecting pregnancy, the exact timing of exposure must be established, large samples are necessary, possibly on a national or international scale. The paper cites as example the four-year documentation period of the 50% to 80% incidence of malformations due to thalidomide. General medicine practitioners, obstetricians, gynecologists, and researchers dealing with pharmacology, pharmocokinetics, toxicology, or embryology will find the collection valuable.

Inhalt

Front Cover 1
Drug Therapy During Pregnancy 4
Copyright Page 5
Table of Contents 10
Preface 6
Contributors 8
Chapter 1. Prospective study of the use of medication during pregnancy in the Netherlands 12
INTRODUCTION 12
MATERIAL AND METHODS 13
RESULTS 13
DISCUSSION 16
CONCLUSION 18
Acknowledgements 19
References 19
Chapter 2. Pharmacotherapy during pregnancy: emphasis on pharmacokinetics 20
INTRODUCTION 20
THE INFLUENCE OF PHYSIOLOGICAL CHANGES IN PREGNANCY ON PHARMACOKINETIC PARAMETERS 21
KINETIC CONSIDERATIONS FOR DOSAGE ADJUSTMENT IN PREGNANCY 28
ASPECTS OF FETAL DRUG EXPOSURE 32
CONCLUSION 38
References 39
Chapter 3. Drugs and environmental agents in the pathogenesis of congenital malformations 43
ENVIRONMENTAL AGENTS 49
CONCLUSION 56
Acknowledgements 56
References 56
Chapter 4. Hypertension and pregnancy 64
INTRODUCTION 64
NORMAL AND ABNORMAL BLOOD PRESSURE DURING PREGNANCY 65
TYPES OF HYPERTENSIVE DISORDERS 67
CARDIOVASCULAR DYNAMICS OF HYPERTENSION DURING PREGNANCY 68
PHARMACOLOGIC TREATMENT OF HYPERTENSION DURING PREGNANCY 69
EFFECT OF ANTIHYPERTENSIVE THERAPY ON THE MATERNAL PROGNOSIS 81
EFFECT OF ANTIHYPERTENSIVE TREATMENT ON UTERINE BLOOD FLOW 83
EFFECT OF ANTIHYPERTENSIVE THERAPY ON THE FETUS AND NEONATE 85
RECOMMENDATIONS FOR CURRENT TREATMENT 87
References 89
Chapter 5. Non-steroidal anti-inflammatory agents 96
PHARMACOLOGY 96
PLACENTAL TRANSFER AND KINETICS 97
ADMINISTRATION AND INGESTION DURING PREGNANCY 98
GENERAL FETAL EFFECTS 99
FETAL EFFECTS THROUGH INHIBITION OF PHYSIOLOGIC FUNCTION 100
CONCLUSION 106
Acknowledgements 106
References 106
Chapter 6. Antiepileptics 111
DIPHENYLHYDANTOIN 112
VALPROIC ACID 113
DIAZEPAM 114
CARBAMAZEPINE 114
BARBITURATES 115
MAGNESIUM SULFATE 116
TERATOGENICITY 117
CONCLUSION 118
References 119
Chapter 7. Hormonal therapy during pregnancy 121
THYROID AND ANTITHYROID DRUGS 121
SEX HORMONES 131
Summary 139
CORTICOSTEROIDS 140
INSULIN 152
References 159
Chapter 8. Anesthesia during pregnancy and parturition 172
PERINATAL PHARMACOLOGY 172
SURGICAL ANESTHESIA DURING PREGNANCY 180
PRACTICAL CONSIDERATIONS 187
References 189
Chapter 9. Stimulation of uterine activity 194
INTRODUCTION 194
OXYTOCIN 194
PROSTAGLANDINS 198
CONCLUSION 203
Acknowledgement 203
References 203
Chapter 10. The use of beta-adrenergic drugs in obstetrics 206
INTRODUCTION 206
CLINICAL APPLICATION OF BETA-ADRENERGIC DRUGS IN PRETERM LABOR 206
MATERNAL EFFECTS 208
FETAL EFFECTS 210
NEONATAL EFFECTS 211
CONCLUSION 212
References 212
Chapter 11. Drugs and fetal heart rate patterns 215
INTRODUCTION 215
DRUGS THAT REDUCE FETAL HEART RATE VARIABILITY 216
DRUGS THAT ENHANCE FETAL HEART RATE VARIABILITY 221
COMMENTS 222
References 224
Chapter 12. Reproductive and developmentaltoxicology 226
INTRODUCTION 226
REPRODUCTIVE TOXICITY IN THE FEMALE 227
PREIMPLANTATION TOXICITY 228
PLACENTAL TOXICITY 228
FETAL TOXICITY/TRANSPLACENTAL CARCINOGENICITY 230
CONCLUSIONS 231
Acknowledgements 232
References 232
Index 236

Produkt-Details

• Erscheint lt. Verlag: 22.10.2013
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Gesundheitsfachberufe
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Gynäkologie / Geburtshilfe
• Themenwelt: Studium ► 2. Studienabschnitt (Klinik) ► Pharmakologie / Toxikologie
• ISBN-10: 1-4831-6298-2 / 1483162982
• ISBN-13: 978-1-4831-6298-0 / 9781483162980