TY - CHAP M1 - Book, Section TI - Obstetrical Pharmacology A1 - Stika, Catherine S. A2 - Butler, Jennifer R. A2 - Amin, Alpesh N. A2 - Fitzmaurice, Laura E. A2 - Kim, Christine M. PY - 2019 T2 - OB/GYN Hospital Medicine: Principles and Practice AB - Almost half of all women report using four or more medications (other than prenatal vitamins) during their pregnancy.1 In one study of eight US health maintenance organizations, 64% of the 152,531 pregnancies analyzed showed documentation of at least one prescription medication during pregnancy, with an average of two prescriptions.2 Once women are hospitalized for delivery, medications including analgesics/anesthetics, oxytocics, antibiotics, and antihypertensives form the basis of many of our interventions. Most of the time, these medications are used off-label, without supporting studies in pregnancy. Because of ethical, medicolegal, and fetal safety concerns regarding pregnant women, few pharmacokinetic, pharmacodynamic or clinical trials were conducted during pregnancy until the past decade. Toxicologists focused on fetal exposure, but, in the absence of evidence, few pharmacologists or obstetricians recognized that pregnancy itself was a “special population.” Pregnant women have a unique drug response to the classical formulation of ADME (which stands for “absorption, distribution, metabolism and excretion”), which differs significantly from the average adult male or nonpregnant female. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - obgyn.mhmedical.com/content.aspx?aid=1159982027 ER -