Document Detail


Effect of pregnancy on the pharmacokinetics of antihypertensive drugs.
MedLine Citation:
PMID:  19385709     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In the US, approximately 12% of women have hypertension during their pregnancy. Antihypertensive drugs are often given to lower maternal blood pressure in those with severe hypertension to prevent stroke and hypertensive crises. There is no conclusive evidence that antihypertensive treatment is beneficial to the mother in mild to moderate hypertension; however, approximately 3% of all pregnant women receive an antihypertensive drug at some time during their pregnancy. There are only limited data on the effects of pregnancy on the pharmacokinetics of antihypertensive drugs. However, knowledge of the pharmacokinetic properties of a drug in the nonpregnant adult and use of a mechanistic-based approach allow an estimation of the effect of pregnancy on the pharmacokinetics of drugs when data are limited or not available. In general, an increased plasma volume and decreased protein binding can alter the volume of distribution of the drug. Clearance can increase or decrease, depending on the pathway of elimination of the drug. Through changes in the volume of distribution and clearance, pregnancy can cause a change in the elimination half-life, resulting in the need for modification of the dosing frequency. The few studies in pregnant women with hypertension have included small numbers of women in the third trimester and postpartum, with little or no data in early pregnancy. In addition, many studies evaluating the efficacy of antihypertensive medications have been performed using dosing regimens of medications that have not been substantiated by pharmacological data in pregnant women. There is a need for well designed pharmacokinetic and pharmacodynamic studies of antihypertensive medications that include analysis during all three trimesters of pregnancy and postpartum. Higher doses and altered dosage intervals may be needed for antihypertensive drugs used in pregnant women.
Authors:
Gail D Anderson; Darcy B Carr
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Clinical pharmacokinetics     Volume:  48     ISSN:  0312-5963     ISO Abbreviation:  Clin Pharmacokinet     Publication Date:  2009  
Date Detail:
Created Date:  2009-04-23     Completed Date:  2009-07-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7606849     Medline TA:  Clin Pharmacokinet     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  159-68     Citation Subset:  IM    
Affiliation:
Department of Pharmacy, University of Washington, Seattle, Washington, USA. gaila@u.washington.edu
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MeSH Terms
Descriptor/Qualifier:
Antihypertensive Agents / administration & dosage,  pharmacokinetics*,  therapeutic use*
Drug Administration Schedule
Female
Half-Life
Humans
Hypertension / drug therapy*,  metabolism
Hypertension, Pregnancy-Induced / drug therapy*,  metabolism
Lactation / metabolism
Maternal-Fetal Exchange
Pregnancy
Pregnancy Complications, Cardiovascular / drug therapy*,  metabolism
Chemical
Reg. No./Substance:
0/Antihypertensive Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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