CSPT 2011- Pharmacokinetics in Pregnancy; Clinical Significance

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Gideon Koren


Pharmacokinetics, pharmacodynamics, bioequivalence, pregnancy, hair analysis


In pharmacokinetics drug absorption, distribution, clearance, and bioequivalence are usually considered, but during pregnancy the most important variable is adherence or compliance. Pharmacokinetic changes during pregnancy that may lead to changes in maternal drug use are described through presentation of cases highlighting the relevance of these changes. Non-invasive methods of pharmacokinetic analysis, such as determining concentrations of drug in hair, are now being tested and used.

Pharmacokinetics are important, but one needs to consider the entire pregnant state and its circumstances when treating women. One treats people, not a “volume of distribution” or a drug level. Therapy should be individualized as much as possible, addressing kinetic changes in the context of dynamic alterations and the effects of underlying medical conditions. To ensure that women are not orphaned from advances in drug therapy, much more research is needed into the determinants of pharmacokinetic and pharmacodynamic changes in pregnancy.

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1. Beigi RH, Han K, Venkataramanan R, Hankins GD, Clark S, Hebert MF, et al. Pharmacokinetics of oseltamivir among pregnant and nonpregnant women. Am J Obstet Gynecol 2011;6(suppl):S84- 8.
2. Greer LG, Leff RD, Laibl Rogers V, Robert SW, McCracken GH, Wendel GD Jr, et al. Pharmacokinetics of oseltamivir according to trimester of pregnancy. Am J Obstet Gynecol 2011;6(suppl): S89-93.
3. Klein J, Blanchette P, Koren G. Assessing nicotine metabolism in pregnancy--a novel approach using hair analysis. Forensic Sci Int 2004;145(2-3):191-4.
4. O'Brien L, Baumer C, Thieme D, Sachs H, Koren G. Changes in antidepressant metabolism in pregnancy evidenced by metabolic ratios in hair: a novel approach. Forensic Sci Int 2010;196(1- 3): 93-6.
5. Chen ML, Lee SC, Ng MJ, Schuirmann DJ, Lesko LJ, Williams RL. Pharmacokinetic analysis of bioequivalence trials: implications for sex-related issues in clinical pharmacology and biopharmaceutics. Clin Pharmacol Ther 2000;68(5):510-21.
6. Köken G, Yilmazer M, Cosar E, Sahin FK, Cevrioglu S, Gecici O. Nausea and vomiting in early pregnancy: relationship with anxiety and depression. J Psychosom Obstet Gynaecol 2008;29(2):91-5.

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