Download Clinical Pharmacology During Pregnancy by Donald Mattison PDF

By Donald Mattison

Clinical Pharmacology in the course of Pregnancy is written for clinicians, physicians, midwives, nurses, pharmacists and different doctors at once keen on the care of girls while pregnant. This publication specializes in the impression of being pregnant on drug disposition and in addition comprises insurance of remedies for illnesses of particular physique platforms in addition to crucial content material on dosing and efficacy.

The large variety of this publication encompasses analgesics, antiasthmatics, antidepressants, middle and circulatory medications, supplements and natural supplementations, and extra. issues in chemotherapy and substance abuse are coated, as are examine matters, together with medical trial layout and moral considerations.
* makes use of an evidence-based technique for therapeutics in the course of pregnancy
* incorporates a precis of particular drugs via indication with updated details on dosing and efficacy in being pregnant for the given indication
* encompasses a spouse web site containing aid fabrics for pro or carrying on with schooling classes in OB pharmacology

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Extra resources for Clinical Pharmacology During Pregnancy

Example text

They found that hepatic blood flow was decreased to 70% of the control value during labor. All of the studies were underpowered and in most cases did not have the pregnant women serve as their own control. At this point, it is unclear whether hepatic blood flow is increased or unchanged during pregnancy. In contrast, pregnancy is associated with increased renal filtration, creatinine clearance, and renal clearance of drugs [3, 10, 22, 23]. During normal pregnancy, effective renal plasma flow increases on average 50–85%, with a corresponding 50% increase in glomerular filtration rate [24, 25].

The AUC is dependent on the dose, clearance, and bioavailability of the drug. For some medications, AUC is the key determinant of medication efficacy and safety; while for other medications, either the maximum concentration and/or minimum concentration are better correlated with outcomes. For low extraction ratio drugs (both oral and intravenous administration), an increase in enzyme activity and/or a decrease in plasma protein binding will lead to a lower total drug AUC with changes in blood flow having no effect.

1A and B). Medications such as cyclosporine, tacrolimus, lithium, lamotrigine, ­gabapentin, levetiracetam, phenytoin, digoxin, vancomycin, and the aminoglycosides are examples of narrow therapeutic range drugs. These are medications for which the concentrations needed for therapeutic benefit are very close to those that result in toxicity. 1 A: Stereotypic oral concentration–time curve. The upper horizontal solid line represents the maximum tolerated concentration and the lower horizontal solid line represents the minimum effective concentration.

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