产前暴露于瓦尔酸在各种使用指示
Nicole E Smolinski1,2, Amir Sarayani1,2,3, Thuy N Thai1,2,4
1Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville.
JAMA network open
|May 22, 2024
概括
酸使用期间的怀孕率保持不变,避孕措施的使用率较低,特别是在情绪和偏头痛障碍方面. 加强安全通讯并没有减少怀孕期间的酸暴露.
科学领域:
- 药物监督 药物监督 药物监督
- 生殖健康 生殖健康
- 神经学 神经学
背景情况:
- 在生育年龄的妇女中使用瓦尔酸会带来原性风险.
- 监管机构已发布警告和风险最小化计划,以减少子宫内的暴露.
研究的目的:
- 为了评估使用瓦尔酸的妇女的怀孕率.
- 为了评估同时使用的避孕药在不同的治疗用瓦尔酸治疗的适应症.
主要方法:
- 使用美国商业索赔数据 (2005-2020) 的回顾性队列研究.
- 已确定女性患者 (12-44岁) 开始使用酸.
- 分析了怀孕发生率和避孕药使用情况 (,偏头痛,情绪障碍).
主要成果:
- 分析了165,772个酸治疗情节.
- 从2005年到2019年,怀孕率保持稳定 (每100人年为1.74-1.90人)
- 与相比,在情绪障碍 (IRR 2.16) 和偏头痛 (IRR 2.01) 中观察到更高的怀孕率.
- 避孕措施的使用率很低 (22.3%),口服形式最常见.
结论:
- 尽管有安全警告,但酸怀孕率并没有下降.
- 在使用瓦尔酸的女性中,避孕措施的使用率仍然很低.
- 情绪障碍和偏头痛患者的怀孕率较高,需要针对性的干预措施.
相关概念视频
Antiepileptic Drugs: Modulators of Neurotransmitter Release Mediated by SV2A Protein
286
Antiepileptic drugs, such as levetiracetam (Keppra) and brivaracetam (Briviact), have emerged as crucial tools in managing epilepsy. These medications exert their therapeutic effects by targeting the synaptic vesicle protein SV2A, a transmembrane glycoprotein primarily found in the brain.
SV2A is a transmembrane glycoprotein located predominantly in the brain, modulating the release of neurotransmitters for neuronal communication. Both levetiracetam and brivaracetam exhibit a high affinity for...
SV2A is a transmembrane glycoprotein located predominantly in the brain, modulating the release of neurotransmitters for neuronal communication. Both levetiracetam and brivaracetam exhibit a high affinity for...
286
Teratogenicity
2.4K
The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...
2.4K
Factors Affecting Drug Response: Overview
2.0K
When it comes to infants and young children, they are typically administered smaller doses of medication in comparison to adults. This is primarily because their organ functions still need to fully develop, meaning their bodies are not as efficient at metabolizing or eliminating drugs. Additionally, their blood-brain barrier is more permeable than in adults. As a result, high concentrations of drugs can easily penetrate the central nervous system (CNS), potentially leading to neurological...
2.0K
Nonlinear Pharmacokinetics: Dependence of Elimination Half-Life and Dose Clearance
124
The elimination half-life and drug clearance of drugs following nonlinear kinetics can vary with dosage. The Michaelis-Menten parameters and drug concentration influence these factors. As the dose increases, the elimination half-life tends to lengthen, resulting in a reduction in clearance and a disproportionately larger area under the curve. The total clearance can be derived from the Michaelis-Menten equation for drugs following a one-compartment model.
A study on guinea pigs examined the...
A study on guinea pigs examined the...
124
Pharmacovigilance
825
Post-marketing surveillance is a critical component of pharmaceutical regulation, often uncovering unanticipated adverse drug reactions (ADRs) once a drug is widely used over an extended period.
This process, termed pharmacovigilance, aims to detect, evaluate, and minimize harmful effects related to medication use. The data collection for pharmacovigilance depends on spontaneous reporting systems, where healthcare professionals or patients voluntarily report suspected ADRs.
In some cases, there...
This process, termed pharmacovigilance, aims to detect, evaluate, and minimize harmful effects related to medication use. The data collection for pharmacovigilance depends on spontaneous reporting systems, where healthcare professionals or patients voluntarily report suspected ADRs.
In some cases, there...
825
Antiepileptic Drugs: GABAergic Pathway Potentiators
385
γ-aminobutyric acid or GABA, plays a pivotal role as an inhibitory neurotransmitter in the brain. GABA pathway potentiators, also known as GABAergic drugs, are a class of pharmaceutical agents designed to enhance the functioning of the GABAergic system. These medications primarily treat epilepsy, a neurological disorder characterized by recurrent seizures.
The key GABA pathway potentiators used in epilepsy management are as follows.
Benzodiazepines are a well-known class of drugs used for...
The key GABA pathway potentiators used in epilepsy management are as follows.
Benzodiazepines are a well-known class of drugs used for...
385


