RT Book, Section
A1 Stika, Catherine S.
A2 Butler, Jennifer R.
A2 Amin, Alpesh N.
A2 Fitzmaurice, Laura E.
A2 Kim, Christine M.
SR Print(0)
ID 1159982027
T1 Obstetrical Pharmacology
T2 OB/GYN Hospital Medicine: Principles and Practice
YR 2019
FD 2019
PB McGraw-Hill Education
PP New York, NY
SN 9781259861697
LK obgyn.mhmedical.com/content.aspx?aid=1159982027
RD 2024/04/25
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.