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Drug disposition during pregnancy
International Journal of Biological Research in Pregnancy
|January 1, 1982
Summary
Pregnancy alters drug disposition, increasing clearance for renally excreted drugs but not significantly affecting those cleared by the liver with high extraction. More research is needed for drugs with intermediate hepatic extraction.
Area of Science:
- Pharmacology
- Obstetrics
- Drug Metabolism
Background:
- Understanding drug disposition in pregnant individuals is crucial for safe and effective pharmacotherapy.
- Physiological changes during pregnancy can significantly alter drug pharmacokinetics.
Purpose of the Study:
- To review and synthesize existing literature on how pregnancy affects drug disposition.
- To categorize drugs based on their elimination pathways and hepatic extraction to predict pharmacokinetic changes.
Main Methods:
- Literature review of studies on drug disposition in human pregnancy.
- Analysis of drugs based on renal excretion and hepatic extraction ratio.
- Assessment of changes in drug clearance during pregnancy.
Main Results:
- Pregnancy increases the clearance of drugs primarily excreted by the kidneys, correlating with creatinine clearance.
- Clearance of parenterally administered drugs extensively metabolized by the liver with a high hepatic extraction ratio remains unchanged.
- Data are inconclusive regarding the impact of pregnancy on drugs extensively metabolized by the liver with low to intermediate hepatic extraction ratios.
Conclusions:
- Drug disposition is significantly altered by pregnancy, with predictable changes for certain drug elimination pathways.
- The impact of pregnancy on drug metabolism by the liver, particularly for drugs with low to intermediate hepatic extraction, requires further investigation.
- This review highlights the need for tailored approaches to pharmacotherapy in pregnant individuals based on drug-specific pharmacokinetic profiles.