دانلود کتاب Clinical Pharmacology During Pregnancy

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Cover Half Title Page Title Page Front Matter Clinical Pharmacology During PregnancySecond EditionEdited byDonald MattisonUniversity of South Carolina, Arnold School of ... Copyright Dedication Contents Contributors Acknowledgment 1. Introduction References 2. Physiologic changes during pregnancy 2.1 Physiologic changes during pregnancy 2.2 Cardiovascular system 2.3 Respiratory system 2.4 Renal system 2.5 Gastrointestinal system 2.6 Hematologic and coagulation systems 2.7 Endocrine system 2.8 Summary References 3. Impact of pregnancy on maternal pharmacokinetics of medications 3.1 Introduction 3.2 Effects of pregnancy on pharmacokinetic parameters 3.2.1 Extraction ratio 3.2.2 Area under the concentration-time curve 3.2.3 Bioavailability 3.2.4 Clearance 3.2.5 Protein binding 3.2.6 Organ blood flow 3.2.7 Intrinsic clearance 3.2.8 Metabolism 3.2.8.1 CYP3A 3.2.8.2 CYP2D6 3.2.8.3 CYP2C9 3.2.8.4 CYP1A2 3.2.8.5 CYP2C19 3.2.8.6 CYP2B6 3.2.8.7 CYP2E1 3.2.8.8 Uridine diphosphate glucuronyltransferase 3.2.8.9 Alcohol dehydrogenase 3.2.8.10 Carbonyl reductase 1 3.2.9 Renal 3.2.9.1 Filtration 3.2.9.2 Secretion/reabsorption 3.2.9.2.1 P-glycoprotein and organic anion transporter polypeptides 3.2.9.2.2 Organic anion transporter, oligopeptide transporters 3.2.9.2.3 Organic cation transporters, multidrug and extrusion transporters, and plasma monoamine transporter 3.2.9.2.4 pH-dependent changes in secretion and reabsorption 3.2.10 Volume of distribution 3.2.11 Half-life 3.3 Summary References 4. Medications and the breastfeeding mother 4.1 Medication use by the breastfeeding mother 4.2 Clinical pharmacology of drug transfer into breast milk 4.3 During delivery 4.4 General anesthesia 4.4.1 Volatile anesthetic agents 4.4.1.1 Halothane 4.4.1.2 Desflurane and sevoflurane 4.4.2 Intravenous anesthetic agents 4.4.2.1 Ketamine 4.4.2.2 Propofol 4.4.2.3 Etomidate 4.4.2.4 Thiopental 4.4.3 A general statement 4.5 Epidural anesthesia 4.6 Galactogogues including dietary supplements (including herbs) 4.7 Immediate postpartum period 4.8 Pain 4.8.1 Morphine 4.8.2 Codeine 4.8.3 Meperidine 4.8.4 Hydrocodone 4.9 Methadone 4.10 Resumption of prepregnancy medications 4.11 Psycho- and neurotropic drugs 4.11.1 Antidepressants, antipsychotics, anxiolytics, antiepileptics, and drugs for attention deficit hyperactivity disorder 4.12 Drugs not to give to the nursing mother postpartum 4.13 Oral contraceptives 4.13.1 Biologics and biopharmaceuticals (e.g., monoclonal antibodies) 4.13.2 Marijuana 4.14 Summary 4.15 Where to find information References 5. Fetal drug therapy 5.1 Introduction 5.2 Indications for fetal therapy 5.3 Strategies to achieve fetal drug therapy 5.3.1 Transplacental drug transfer 5.3.2 Direct fetal injection 5.3.3 Gene therapy 5.3.4 Stem cell transplantation 5.3.5 Nanoparticles 5.4 Special considerations 5.5 Ethical considerations References 6. Treating the placenta: an evolving therapeutic concept 6.1 Introduction 6.2 The placenta as the therapeutic target: the past 6.2.1 Placental function 6.2.2 Placental transport mechanisms 6.3 The placenta: therapeutic targets 6.4 The placenta as a therapeutic target today 6.4.1 Diabetes during pregnancy 6.4.2 Malaria in pregnancy 6.4.3 HIV-1 infection in pregnancy 6.5 The placenta as a therapeutic target in the future 6.6 Conclusions References 7. Conducting randomized controlled pharmaceutical trials in the pregnant population: challenges and solutions 7.1 Introduction 7.2 Ethical considerations 7.2.1 Maternal and fetal risks in pharmaceutical research 7.2.2 Equipoise 7.2.3 What is sufficient evidence to conduct a trial? 7.2.3.1 General considerations 7.2.3.2 Level of evidence to justify a trial during public health crises 7.2.4 Resource allocation in the context of limited research funding 7.3 Including pregnant women in pharmaceutical trials for nonobstetrical conditions 7.3.1 The dearth of evidence on the innocuity and efficiency of drugs in the pregnant population 7.3.2 Human pharmaceutical trials including pregnant women are required 7.3.3 Strategies to include pregnant women in pharmaceutical trials for nonobstetrical conditions 7.3.3.1 Public policies to promote pharmaceutical trials in the pregnant population 7.3.3.2 Innovative designs to determine the safety and efficiency of drugs in the pregnant population 7.4 Improving the success of drug trials for obstetrical conditions 7.4.1 Drug development failures in obstetrics 7.4.2 The importance of biological rationale 7.4.3 Using adequate design and outcomes in phase II trials 7.4.4 Calculating the sample size for phase III randomized controlled trials 7.4.5 Integrating precision medicine in obstetrics 7.4.6 The example of the antioxidant trials 7.5 Summary References 8. Pharmacogenomics in pregnancy∗ 8.1 Pharmacogenomics 8.2 Genetics and polymorphisms 8.3 Genes that influence pharmacokinetic variability 8.4 The current state of pharmacogenetic testing 8.5 Potential therapeutic areas for pharmacogenomics in pregnancy 8.6 Study designs and approaches to pharmacogenetics trials References 9. Anesthetic drugs 9.1 Introduction 9.2 General anesthesia 9.3 Inhalational anesthetics 9.4 Intravenous anesthetics 9.4.1 Thiopentone 9.4.2 Propofol 9.4.3 Ketamine 9.4.4 Etomidate 9.4.5 Benzodiazepines 9.4.6 Systemic opioids in pregnancy 9.5 Neuromuscular blocking agents 9.6 Regional anesthesia 9.6.1 Bupivacaine 9.6.2 Lidocaine 9.6.3 2-Chloroprocaine 9.6.4 Ropivacaine 9.6.5 Adjuvant opioids 9.6.6 Fetal effects of neuraxial opioids 9.7 Summary References 10. The management of asthma during pregnancy 10.1 Introduction 10.2 Effect of pregnancy on the course of asthma 10.3 Effect of asthma on pregnancy 10.4 Asthma management 10.5 Pharmacologic therapy 10.5.1 Inhaled corticosteroids 10.5.2 Inhaled beta-agonists 10.5.3 Leukotriene modifiers 10.5.4 Cromolyn and theophylline 10.5.5 Oral corticosteroids 10.5.5.1 Asthma biologics 10.6 Conclusion 10.6.1 The vaccine and medication surveillance study References 11. Nausea and vomiting of pregnancy 11.1 Nausea and vomiting of pregnancy 11.2 Prevalence 11.3 Etiologies and pathogenesis 11.3.1 Genetic influences 11.3.2 Hormonal influences 11.3.3 Helicobacter pylori 11.4 Burden of the disease 11.5 Cultural implications 11.6 Risk factors 11.7 Quantification 11.8 Effects on fetus 11.9 Late complications related to NVP 11.10 Approaches to treatment 11.11 Lifestyle alterations 11.12 Complementary and alternative medicine 11.12.1 Nonpharmacologic treatments 11.12.2 Vitamins 11.12.3 Herbal supplements 11.12.4 Ginger (Zingiber officinale) 11.12.5 Lemon 11.12.6 Pomegranate and spearmint 11.12.7 Quince (Cydonia oblonga) 11.13 Pharmacologic therapies 11.13.1 Fluid rehydration 11.13.2 Enteral versus parenteral nutrition 11.13.3 Diclegis 11.13.3.1 Bonjesta 11.13.3.2 Antacids 11.13.3.3 Diphenhydramine/dimenhydrinate/meclizine 11.13.3.4 Cimetidine/ranitidine 11.13.3.5 Omeprazole 11.13.3.6 Metoclopramide 11.13.3.7 Promethazine 11.13.3.8 Droperidol 11.13.3.9 Mirtazapine 11.13.3.10 Ondansetron/zofran 11.13.3.11 Glucocorticoids 11.13.3.12 Hospitalization considerations 11.13.3.13 Marijuana use 11.14 Differential diagnoses 11.15 Conclusion References 12. Clinical pharmacology of anti-infectives during pregnancy 12.1 Antibacterial therapy 12.2 Antifungal therapy 12.3 Malaria 12.4 Tuberculosis 12.5 HIV 12.6 Antivirals 12.7 Parasitic infections References 13. Chemotherapy in pregnancy 13.1 Introduction 13.1.1 Maternal outcomes 13.1.2 Obstetric outcomes 13.1.3 Fetal outcomes 13.2 Overview of chemotherapeutic agents 13.2.1 Antimetabolites 13.2.2 Alkylating agents 13.2.3 Anthracyclines 13.2.4 Plant alkaloids 13.2.5 Taxanes 13.2.6 Hormonal agents 13.2.7 Targeted therapies and immunotherapies 13.2.8 Other agents 13.3 Treatment of specific cancers 13.3.1 Breast cancer 13.3.2 Cervical cancer 13.3.3 Lymphoma 13.3.4 Leukemia 13.3.5 Ovarian cancer 13.3.6 Melanoma 13.3.7 Other malignancies 13.4 Pharmacokinetics in pregnancy References 14. Substance abuse in pregnancy 14.1 Introduction 14.2 Substance use disorders defined 14.3 Addiction defined as a disease of the brain 14.4 The good news: the brain can recover 14.5 Addiction in women and pregnancy 14.6 Psychiatric comorbidity 14.7 Substances used in pregnancy 14.7.1 Alcohol 14.7.1.1 Pharmacologic treatment of alcohol use in pregnancy 14.7.2 Tobacco; nicotine 14.7.3 Opiates and opioids 14.7.4 Neonatal abstinence syndrome 14.7.5 Marijuana and THC 14.7.6 Cocaine 14.7.7 Stimulants: amphetamine, methamphetamines; methylphenidate; ephedra; khat 14.7.7.1 Amphetamines and methamphetamines 14.7.7.2 Methylphenidate 14.7.7.3 Ephedra 14.7.7.4 Khat 14.7.7.5 Hallucinogens: lysergic acid diethylamide and phencyclidine 14.7.8 Club drugs: MDMA; gamma-hydroxybutyrate; flunitrazepam; ketamine 14.7.8.1 MDMA 14.7.8.2 Gamma-hydroxybutyrate 14.7.8.3 Flunitrazepam 14.7.8.4 Ketamine 14.8 Screening and detection 14.9 The role of urine and meconium testing 14.10 Brief office screening strategies 14.11 Brief office interventions 14.12 Long-term care and maintenance 14.13 Conclusion References 15. Diabetes in pregnancy 15.1 Introduction 15.2 Epidemiology 15.3 Classification 15.4 Gestational diabetes 15.5 Diabetes management in pregnancy 15.5.1 Nutritional goals and exercise 15.5.1.1 Physical activity 15.5.2 Glucose monitoring and glycemic control 15.5.3 Insulin therapy 15.5.4 Oral hypoglycemics 15.5.5 Risk for hypertensive disorders of pregnancy 15.5.6 Postpartum metabolic management and preconception care 15.6 Conclusion References 16. Cardiovascular medications in pregnancy 16.1 Introduction 16.2 Resources for guidance 16.3 Cardiovascular changes in pregnancy 16.3.1 Sedation for invasive procedures and timing of procedures 16.4 Cardiovascular disease in pregnancy 16.4.1 Hypertension 16.5 Mechanism of action for hypertensive medications 16.5.1 Medications affecting the renin angiotensin aldosterone system (the kidney–lung pathway) 16.5.2 Beta-Blockers 16.5.3 Calcium Channel Blockers 16.5.4 Diuretics 16.5.5 Direct vasodilators 16.5.6 Considerations for long-term therapy 16.5.7 Magnesium sulfate 16.6 Coronary artery disease and Spontaneous Coronary Artery Dissection 16.7 Coronary Microvascular Disease and angina 16.7.1 Cardiomyopathy/heart failure 16.8 Medications for cardiomyopathy 16.9 Electrophysiological 16.9.1 Antiarrhythmic medications 16.9.1.1 Rate control 16.9.1.2 Anticoagulation with atrial fibrillation 16.9.1.3 Anticoagulation and antiplatelet therapy 16.9.1.4 Long QT syndrome 16.9.1.5 Antiarrhythmic medications 16.9.1.6 Thromboembolic disorders 16.9.1.7 Hypotension 16.9.1.8 Pharmacology for Advanced Cardiac Life Support 16.9.1.9 Congenital heart disease in the adult 16.9.1.10 Cardiovascular effects of noncardiovascular medications References 17. Antidepressants in pregnancy 17.1 Introduction 17.2 Effects of untreated perinatal depression on women and children 17.3 Approach to treatment 17.4 Potential risks of selective serotonin reuptake inhibitor use during pregnancy 17.4.1 Obstetric outcomes 17.4.2 Congenital malformations 17.4.3 Persistent pulmonary hypertension of the newborn 17.4.4 Neonatal adaptation syndrome 17.4.5 Neurodevelopmental outcomes 17.5 Potential risks of non-SSRI antidepressant use during pregnancy 17.6 Potential risks of older antidepressant use during pregnancy 17.7 Anxiety 17.8 Summary References Further reading 18. Uterotonics and tocolytics 18.1 Introduction 18.2 Uterotonics 18.2.1 Oxytocin 18.2.2 Methylergonovine 18.2.3 Prostaglandins 18.2.3.1 PGE2—dinoprostone 18.2.3.2 PGE1—misoprostol 18.2.3.3 PGF2α—carboprost 18.2.4 Uterotonics summary 18.3 Tocolytics 18.3.1 Magnesium sulfate 18.3.2 β-Adrenergic receptor agonists 18.3.3 Calcium channel blockers 18.3.4 Cyclooxygenase inhibitors 18.3.5 Oxytocin receptor antagonists (atosiban) 18.3.6 Nitric oxide donors 18.3.7 Tocolytics summary References 19. Antenatal thyroid disease and pharmacotherapy in pregnancy 19.1 Thyroid function and physiology in pregnancy 19.2 Hyperthyroidism in pregnancy 19.3 Pharmacotherapy with thionamides in pregnancy 19.4 Hypothyroidism in pregnancy 19.5 Pharmacotherapy with levothyroxine in pregnancy 19.6 Summary References Further reading 20. Management of dermatological conditions in pregnancy 20.1 Introduction 20.2 Acne 20.2.1 Topical agents 20.2.2 Oral agents 20.3 Psoriasis 20.3.1 Topical agents 20.4 Oral agents 20.5 Dermatoses 20.5.1 Pemphigoid gestationis 20.5.2 Polymorphic eruption of pregnancy 20.5.3 Intrahepatic cholestasis of pregnancy 20.5.4 Atopic eruption of pregnancy 20.6 Bacterial infections 20.6.1 Topical agents 20.6.2 Oral agents 20.7 Viral infections 20.7.1 Topical agents 20.7.2 Oral agents 20.8 Fungal infections 20.8.1 Topical agents 20.8.2 Oral agents 20.9 Parasitic infections 20.9.1 Topical agents 20.9.2 Oral agents 20.10 Dermatological wounds References 21. Herbs and alternative remedies 21.1 Herbal teas frequently used during pregnancy 21.2 Essential oils used as aromatherapy during pregnancy 21.3 Herbs used as capsules or dried extracts 21.3.1 Ginger 21.3.2 Cranberry 21.3.3 Echinacea 21.3.4 St. John's wort 21.3.5 Valerian 21.3.6 Milk thistle/silymarin 21.3.7 Senna 21.3.8 Horse chestnut 21.4 Herbal topical preparations used in pregnancy 21.4.1 Aloe vera gel 21.4.2 Horse chestnut 21.4.3 Almond oil 21.5 Nonherbal supplements used in pregnancy 21.5.1 Fish oils 21.5.2 Probiotics 21.6 Herbs used to induce labor 21.7 Acupuncture and acupressure therapy in pregnancy 21.8 Meditation and hypnosis in pregnancy References Further reading 22. Envenomations and antivenom during pregnancy 22.1 General principles about envenomation 22.2 Snake bites 22.2.1 Management during pregnancy 22.2.2 Reports during pregnancy 22.3 Spider bites 22.3.1 Management during pregnancy 22.3.2 Reports during pregnancy 22.3.3 Scorpion stings 22.3.4 Management during pregnancy 22.3.5 Reports during pregnancy 22.3.6 Hymenoptera 22.3.7 Winged hymenoptera 22.3.8 Imported fire ants 22.3.9 Management during pregnancy 22.3.10 Reports during pregnancy 22.4 Jellyfish 22.4.1 Management during pregnancy 22.4.2 Reports during pregnancy 22.5 Antivenom use during pregnancy 22.6 Conclusions References 23. Gastrointestinal disorders 23.1 Gastroesophageal reflux disease 23.1.1 Treatment 23.1.1.1 Therapeutic lifestyle modifications 23.1.2 Antacids 23.1.3 Sucralfate 23.1.4 Promotility agents 23.1.5 H2-receptor antagonists 23.1.6 Proton pump inhibitors 23.2 Peptic ulcer disease 23.2.1 Treatment 23.2.1.1 Bismuth subsalicylate 23.2.1.2 Pancreatitis 23.2.1.3 Irritable bowel syndrome 23.3 Constipation 23.3.1 Treatment 23.3.1.1 Conservative treatment 23.3.1.2 Stool-bulking agents 23.3.1.3 Hyperosmotic agents 23.3.1.4 Stimulant laxatives 23.3.1.5 Emollient laxatives 23.3.1.6 Prokinetic agents 23.4 Diarrhea 23.4.1 Treatment 23.5 Abdominal pain 23.5.1 Tricyclic antidepressants 23.5.2 Selective serotonin reuptake inhibitors 23.5.3 Antispasmodics 23.6 Gastrointestinal infections 23.6.1 Amoxicillin 23.6.1.1 Clarithromycin 23.6.1.2 Tetracycline 23.6.1.3 Metronidazole 23.6.1.4 Fluoroquinolones 23.6.1.5 Rifaximin 23.6.1.6 Amphotericin and imipenem 23.6.1.7 Trimethoprim-sulfamethoxazole 23.6.1.8 Vancomycin 23.7 Inflammatory bowel disease 23.7.1 Treatment 23.7.1.1 Aminosalicylates 23.7.1.2 Antibiotics 23.7.1.3 Corticosteroids 23.7.1.4 Thiopurines 23.7.1.5 Methotrexate 23.7.1.6 Biologics 23.7.1.7 Tofacitinib Liver diseases in pregnancy 23.8 Hepatitis B 23.8.1 Treatment 23.8.1.1 Antiretrovirals 23.8.1.2 Interferon-α 23.9 Hepatitis C 23.9.1 Treatment 23.10 Wilson disease 23.10.1 Treatment 23.10.1.1 Penicillamine 23.10.1.2 Trientine 23.10.1.3 Zinc 23.11 Autoimmune hepatitis 23.12 Intrahepatic cholestasis of pregnancy 23.12.1 Ursodeoxycholic acid 23.12.1.1 Cholestyramine 23.12.1.2 Antihistamines 23.12.1.3 Other agents 23.13 Primary biliary cirrhosis and primary sclerosing cholangitis References Further reading 24. Challenges in predicting the pharmacokinetics of drugs in premature and mature newborns: example with piperacillin and tazo ... 24.1 Introduction 24.2 What is a PBPK model? 24.3 Neonates are not just “little adults” 24.4 PIP and TAZ PBPK model for preterm and term neonates [49–51] 24.4.1 Overview 24.4.2 Neonate physiology 24.4.3 Drug-specific model parameters 24.4.4 PBPK model sensitivity analyses 24.4.4.1 Renal GFR 24.4.4.2 Volume of kidney 24.4.4.3 Renal tubular secretion (active transport) 24.4.4.4 Body weight of term neonates 24.4.4.5 Partition coefficients for PIP and TAZ in the lumped compartment 24.5 Ability of the neonate PBPK model to predict plasma levels of PIP and TAZ 24.6 Conclusions References Index A B C D E F G H I J K L M N O P Q R S T U V W Y Z Back Cover