怀孕相关的荷尔蒙和生理变化对抗发作药物的影响:专家观点
Denise Li1, Susannah Franco2, Page B Pennell1
1Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
由于生理变化,抗发作药物 (ASM) 剂量通常需要在怀孕期间大幅增加,需要仔细监测才能有效管理. 在产后,剂量通常会减少以防止毒性.
科学领域:
- 药理学 药理学是指药理学的学科.
- 神经学 神经学
- 产科 产科 产科 产科 产科
背景情况:
- 影响全球数百万有生育潜力的个体,需要使用抗发作药物 (ASM).
- 此外,ASM还用于各种神经精神疾病,导致显著的产前暴露.
- 怀孕涉及实质性的生理变化,影响药物的药理动力学.
研究的目的:
- 在怀孕期间审查ASM的药理动力学变化.
- 突出剂量调整和治疗药物监测的需要.
- 讨论在怀孕期间ASM管理的未来方向.
主要方法:
- 在怀孕期间ASM的药理动力学变化的文献综述.
- 对影响ASM代谢和清除的生理变化的分析.
- 对ASM剂量的临床影响的讨论.
主要成果:
- 怀孕引起的和肝血流增加,蛋白质结合的改变和酶活性显著影响ASM度.
- 某些ASM,如拉莫特里金,莱维他拉塞坦和牛炭胺,需要增加剂量,有时高达三倍,以保持治疗水平.
- 产后,ASM清除率下降,需要减少剂量以避免毒性.
结论:
- 密切的治疗药物监测和剂量调整对于在怀孕期间治疗至关重要.
- 基于生理学的药理动力学模型可能为实证的ASM剂量调整提供未来的解决方案.
- 在怀孕期间优化ASM治疗对于母亲和胎儿的健康至关重要.
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