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Metabolism and Drug–Drug Interaction in Pregnant Mother/Placenta/Fetus

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Developmental and Reproductive Toxicology

Part of the book series: Methods in Pharmacology and Toxicology ((MIPT))

Abstract

The pregnant woman and the presence of the fetus pose many challenges for proper and effective drug administration. The variety of physiological changes that takes place during pregnancy coupled together with the variety in the responses of the cytochrome P450 enzymes in terms of induction and inhibition as well as the presence of polymorphic forms which may be present and the influence of the drug transporters make predicting the pharmacokinetics and pharmacodynamics of any given drug difficult. Treatment and dosage during pregnancy and lactation with drugs such as antibiotics, antivirals, antiepileptic, anticancer, and antipsychotic medications all need to be evaluated carefully to minimize the occurrence of adverse effects due to possible excessive exposure or a lack of efficacy due to possible underexposure. In addition, as more literature data becomes available about the role of efflux transporters such as Pgp, BCRP, and MRP3 and uptake transporters OCT3 and OCTN1 in pregnancy and in the fetus with prescribed medications this information will need to be used in the evaluation. Therefore, for drugs with a narrow therapeutic window or those with marked pharmacologic or toxicological outcomes that are also cleared predominantly by a single CYP450 or handled by a single transporter, the need for systemic monitoring of plasma concentration to monitor exposure is warranted, at least during the initial days of starting a medication.

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Authors and Affiliations

  1. MPI Research, Mattawan, MI, 49071, USA

    Ali S. Faqi

  2. Alliance Pharma, Inc., Malvern, PA, USA

    Karsten A. Holm

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Correspondence to Ali S. Faqi .

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  1. MPI Research, Mattawan, Michigan, USA

    Ali S. Faqi

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Faqi, A.S., Holm, K.A. (2016). Metabolism and Drug–Drug Interaction in Pregnant Mother/Placenta/Fetus. In: Faqi, A. (eds) Developmental and Reproductive Toxicology. Methods in Pharmacology and Toxicology. Humana Press, New York, NY. https://doi.org/10.1007/7653_2016_64

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  • DOI: https://doi.org/10.1007/7653_2016_64

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  • Publisher Name: Humana Press, New York, NY

  • Print ISBN: 978-1-4939-7206-7

  • Online ISBN: 978-1-4939-7208-1

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