Opioid receptor approaches for the development of medications for pregnant women

It is proposed that receptor selectivity may be used as a rational approach in the design and development of new opioid agents for use in pregnant women. While minimizing placental drug transfer will only reduce the direct effects of opioid drugs on the fetus, the use of selective opioid drugs may, in addition, reduce the indirect effects of opioids secondary to alterations in maternal and placental physiology. By taking advantage of the differential ontogeny of the different receptor subtypes, it may even be able to prevent significant drug effects on the fetus despite considerable placental transfer. The combined use of maternal-fetal pharmacokinetics and receptor selectivity may lead to the development of superior opioid drugs with minimal adverse effects on the mother and fetus. Finally, the approaches proposed here may be suitable for the development of other agents that may be useful in the treatment of pregnant addicts and their infants.