Abstract
The effects of the many biochemical and physiologic changes of pregnancy on the dose-response relationship of drugs administered to pregnant women are poorly understood. The dose-response relationship is affected by pharmacokinetics, or what the body does to a drug, and pharmacodynamics, or what a drug does to the body. Insights into the potential effects of the changes of pregnancy on one aspect of the dose-response relationship of a drug can be obtained by studying the pharmacokinetics of the drug in the various stages of pregnancy and the postpartum period. There are several available approaches to studying pharmacokinetic changes in pregnancy. Single trough screening studies can provide qualitative estimates of elimination clearance, which with the dosing rate determines the steady-state drug concentration, throughout pregnancy and into the postpartum period. Population pharmacokinetic studies such as two stage pharmacokinetic studies and studies using a nonlinear mixed effects pharmacokinetic modeling approach can characterize pharmacokinetic changes more rigorously.
| Original language | English (US) |
|---|---|
| Article number | 151227 |
| Journal | Seminars in Perinatology |
| Volume | 44 |
| Issue number | 3 |
| DOIs | |
| State | Published - Apr 2020 |
Funding
Michael J. Avram, Ph.D. is the Assistant Editor-in-Chief of Anesthesiology and on the Editorial Board of Clinical Pharmacology & Therapeutics. He is a co-investigator on several NIH grants, including NICHD U54 HD085601 “Optimizing Medication Management for Mothers with Depression during Pregnancy (OPTI-MOM)” CoPIs: Katherine Wisner, M.D. M.S. Catherine Stika, M.D. Alfred George, M.D.
Keywords
- dose-response
- longitudinal studies
- pharmacodynamics
- pharmacokinetics
- pregnancy
ASJC Scopus subject areas
- Obstetrics and Gynecology
- Pediatrics, Perinatology, and Child Health