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Pharmakotherapie in der Schwangerschaft und Stillzeit

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Die geburtshilfliche Anästhesie

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Zusammenfassung

Die Arzneimittelbehandlung in Schwangerschaft und Stillzeit ist aufgrund der unbefriedigenden Datenlage mit erheblichen Unsicherheiten bezüglich möglicher teratogener oder fetotoxischer Wirkungen verbunden. Die Schwangerschaft und die begleitenden hormonellen Veränderungen betreffen sowohl die Pharmakodynamik (stärkere Wirkung von Narkotika) als auch die Pharmakokinetik (andere Dosierungen bedingt durch die Vergrößerung des wässrigen Kompartiments und eine verbesserte Elimination). Das Kind wird im Mutterleib durch die Blut-Plazenta-Schranke, nach der Entbindung beim Stillen durch die Blut-Milch-Schranke partiell vor Pharmaka geschützt. Basische Arzneistoffe, wie z. B. Morphin, können jedoch gut im Kind akkumulieren. Die maternale Plasmakonzentration, der Milch-Plasma-Verteilungsquotient (M/P-Quotient) und die (altersabhängige) Trinkmenge ergeben die zu erwartende Dosis, die der Säugling aufnimmt. Die relative Dosis, also das Verhältnis der durch den Säugling oral über die Muttermilch aufgenommenen Menge zur Dosierung der Mutter, eignet sich am besten, um die Belastung des Säuglings abschätzen und einordnen zu können.

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Authors and Affiliations

  1. Uni-Klinikum Schleswig-Holstein - Campus Kiel, Inst f. Experimentelle Klin Pharmakologie, Hospitalstr. 4, 24105, Kiel, Deutschland

    Dr. R. Böhm

  2. Universitätsklinikum Schleswig-Holstein, Klinik für Anästhesiologie, Arnold-Heller-Str. 3, 24105, Kiel, Deutschland

    Dr. H. Ohnesorge

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  1. Dr. R. Böhm
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  2. Dr. H. Ohnesorge
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Correspondence to R. Böhm or H. Ohnesorge .

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Editors and Affiliations

  1. Universitätsklinikum Würzburg, Würzburg, Deutschland

    Peter Kranke

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Böhm, R., Ohnesorge, H. (2017). Pharmakotherapie in der Schwangerschaft und Stillzeit. In: Kranke, P. (eds) Die geburtshilfliche Anästhesie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-54375-7_8

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  • DOI: https://doi.org/10.1007/978-3-662-54375-7_8

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-54374-0

  • Online ISBN: 978-3-662-54375-7

  • eBook Packages: Medicine (German Language)

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