常见的原药物暴露 - - 一项基于美国人口的怀孕研究
Yanning Wang1, Nicole E Smolinski2, Thuy Nhu Thai3
1Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL (Ms Wang and Drs Smolinski, Thai, Sarayani, Ewig, and Winterstein); Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL (Ms Wang).
American journal of obstetrics & gynecology MFM
|December 7, 2023
概括
产前暴露于产性药物仍然是常见的. 这项研究确定了硫甲醇/trimethoprim和fluconazole等高暴露药物,突出了怀孕期间更新风险减轻策略的必要性.
科学领域:
- 药物监督 药物监督 药物监督
- 生殖毒理学 生殖毒理学
- 公共卫生 公共卫生
背景情况:
- 尽管有风险沟通努力,孕前暴露于具有致病性潜力的药物是一个重大问题.
- 了解常见的暴露和相关的风险因素对于开发有效的干预措施至关重要.
研究的目的:
- 在私人保险人员中,在怀孕期间识别已知或潜在的致病性风险的常用药物.
- 为旨在减少对有害药物的产前暴露的战略提供信息.
主要方法:
- 利用MerativeTM MarketScan®商业数据库 (2011-2018) 来分析怀孕和药物暴露情况.
- 使用TERIS (Teratogen Information System) 和药物专著,确定了致病性药物.
- 基于药房声明和医疗遭遇的产前暴露定义,不包括某些药物类别,如阿片类药物和性激素.
主要成果:
- 硫甲醇/三甲和高剂量可纳是怀孕期间最常用的致病药物之一.
- 产前暴露率有所不同,硫甲醇/trimethoprim的减少和vedolizumab的增加.
- 与活产妇相比,非活产妇怀孕的第一季度暴露率高于华法林,氨酸和托皮拉等药物的活产妇.
结论:
- 继续使用一些有毒药物与更安全的替代品需要重新评估风险减轻策略.
- 对暴露率的观察到的波动强调了对安全协议的持续评估的必要性.
- 对药物使用的临床背景进行进一步的研究对于在怀孕期间有效减少暴露至关重要.
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