[Placental transfer of drugs]

Elisabeth Elefant1, Delphine Beghin

  • 1Centre de Référence sur les Agents Tératogènes, Hôpital Armand Trousseau, 26 avenue du Dr Arnold Netter, 75571 Paris Cedex 12. elisabeth.elefant@trs.ap-hp.fr

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Physiological Barriers01:25

Physiological Barriers

Physiological barriers are semi-permeable cellular structures restricting drug diffusion into intracellular compartments and tissues. There are six types of physiological barriers: blood endothelial, cell membrane, blood-brain, blood-cerebrospinal fluid (CSF), blood-placenta, and blood-testis barriers.
The blood endothelial barrier is the most porous of these. It allows all small ionized, un-ionized, and lipophilic molecules to pass through the endothelial lining into the interstitial space...
Factors Affecting Drug Distribution: Physiological Barriers01:23

Factors Affecting Drug Distribution: Physiological Barriers

Drug distribution in the body is intricately regulated by various physiological barriers that control the passage of substances. These include the capillary endothelial barrier, the blood-brain, blood-cerebrospinal fluid, blood-placental, and blood-testis barriers.
The capillary endothelial barrier allows only smaller molecules below 600 Da (Daltons) to pass through. It also restricts drugs like heparin that are bound to blood components, limiting their movement within the bloodstream.
The...
Drug Excretion: Pulmonary and Glandular Routes01:22

Drug Excretion: Pulmonary and Glandular Routes

Gaseous substances like general anesthetics are absorbed and excreted through the lungs via simple diffusion. This process depends on factors such as pulmonary blood flow, respiration rate, and the substance's solubility. Gaseous anesthetics like nitrous oxide with low blood solubility are excreted rapidly, while compounds like alcohol, with high blood and tissue solubility, are excreted slowly.
Drugs can also be excreted in breast milk, which is crucial for breastfeeding infants. The process...
Drug Elimination: Non-Renal Routes01:23

Drug Elimination: Non-Renal Routes

The liver plays a pivotal role in eliminating drugs and their metabolites, primarily through a process known as biliary excretion. This process involves the hepatocytes, the primary cells in the liver that generate bile. A range of transporters actively expels polar drugs or hydrophilic drug metabolites into the bile, which transports the drugs and metabolites into the small intestine. From here, they are eventually expelled from the body through feces. In some instances, the original drug or a...
Drug Excretion: Miscellaneous Routes01:10

Drug Excretion: Miscellaneous Routes

Drug excretion involves various organs, including the liver, intestines, skin, and eyes. In the case of drugs or toxins, they can be actively secreted into bile by transporters in the hepatocyte's canalicular membrane. These substances enter the GI tract during digestion and may be reabsorbed into the body from the intestine. This process, known as enterohepatic recycling, can significantly prolong the presence and effects of a substance in the body. To interrupt this cycle, specific substances...
Transcytosis of IgG01:15

Transcytosis of IgG

Transcytosis is the process in which molecules are internalized by endocytosis, transported across the cell, and released through exocytosis from the opposite end of the cell. Molecules such as insulin, immunoglobulins, and certain nutrients are transferred through the recycling endosomes by recycling and transcytosis.
IgG molecules from a mother undergo transcytosis starting around 13 weeks of gestation. The amount of IgG transferred and entering the fetal blood circulation increases with...