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Abstract

The past several decades have witnessed major advances in the practice of therapeutics. It is now recognized that the nature, duration, and intensity of drug action are dependent not only on the intrinsic properties of the drug but also on the interaction with the host to whom the drug is being administered. Although research has been proceeding at a rapid rate in adult medicine, developments in drug therapy during pregnancy, the perinatal period, and in the neonate are lagging far behind the other disciplines. This is because research in humans during pregnancy is limited by ethical and practical considerations. Therefore, present drug use in pregnancy is based on cautious empiricism, with therapeutic misadventures acting as warning signals.

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References

  1. Wood AJJ, Carr K, Vestal RE, et al: Direct measurement of the propranolol bioavailability during accumulation to steady-state. Br J Clin Pharmacol 6: 345–350, 1978

    PubMed  CAS  Google Scholar 

  2. Huet M, LeLorier J, Pomier G, et al: Bioavailability of lidocaine in normal volunteers and cirrhotics. Gastroenterology 75: 968A, 1978

    Google Scholar 

  3. Hill N, Antman EM, Green LH, et al: Intravenous nitroglycerin—a review of pharmacology, indications, therapeutic effects and complications. Chest 79: 69–76, 1981

    Article  PubMed  CAS  Google Scholar 

  4. Kostenbauder HB, Rapp RP, McGovern JP, et al: Bioavailability and single-dose pharmacokinetics of intramuscular phenytoin. Clin Pharmacol Ther 18: 449–456, 1975

    PubMed  CAS  Google Scholar 

  5. Wilder BJ, Serrano EE, Ramsey E, et al: A method of shifting from oral to intramuscular diphenylhydantoin administration. Clin Pharmacol Ther 16: 507–513, 1974

    PubMed  CAS  Google Scholar 

  6. Davison JS, Davison MC, Hay DM: Gastric emptying time in late pregnancy and labour. J Obstet Gynaecol Br Commonw 77: 37–41, 1970

    Article  PubMed  CAS  Google Scholar 

  7. Gryboski WA, Spiro HM: The effect of pregnancy on gastric secretion. N Engl J Med 255: 1131–1134, 1956

    Article  PubMed  CAS  Google Scholar 

  8. Krauer B, Krauer F: Drug kinetics in pregnancy. Clin Pharmacokinet 2: 167–181, 1977

    Article  PubMed  CAS  Google Scholar 

  9. Pirani BKK, Campbell DM, MacGillivray I: Plasma volume in normal pregnancy. J Obstet Gynaecol Br Commonw 80: 884–887, 1973

    Article  PubMed  CAS  Google Scholar 

  10. Katz R, Karliner JS, Resnik R: Effects of a natural volume overload state (pregnancy) on left ventricular performance in normal human subjects. Circulation 58: 434–441, 1978

    PubMed  CAS  Google Scholar 

  11. Munnell EW, Taylor HC: Liver blood flow in pregnancy hepatic vein catheterization. J Clin Invest 26: 952–956, 1947

    Article  Google Scholar 

  12. Krauer B, Krauer F, Hytten FE: Drug disposition and pharmacokinetics in the maternal-placental-fetal unit. Pharmacol Ther 10: 301–328, 1980

    Article  PubMed  CAS  Google Scholar 

  13. Appel GB, Neu HC: Gentamicin in 1978. Ann Intern Med 89: 528–538, 1978

    PubMed  CAS  Google Scholar 

  14. Aronson JK: Clinical pharmacokinetics of digoxin 1980. Clin Pharmacokinet 5: 137–149, 1980

    Article  PubMed  CAS  Google Scholar 

  15. Robertson EG: Physiologic adjustments in pregnancy: Water metabolism. Clin Obstet Gynecol 2: 431–440, 1975

    Google Scholar 

  16. Perucca E, Crema A: Plasma protein binding of drugs in pregnancy. Clin Pharmacokinet 7: 336–352, 1982

    Article  PubMed  CAS  Google Scholar 

  17. Reboud P, Groulade J, Groslambert P, et al: The influence of normal pregnancy and the postpartum state of plasma proteins and lipids. Am J Obstet Gynecol 86: 820–828, 1963

    PubMed  CAS  Google Scholar 

  18. Wood M, Wood AJJ: Changes in plasma drug binding and α1-acid glycoprotein in mother and newborn infant. Clin Pharmacol Ther 29: 522–526, 1981

    Article  PubMed  CAS  Google Scholar 

  19. Perucca E, Ruprah M, Richens A: Decreased serum protein binding of diazepam and valproic acid in pregnant women. Br J Clin Pharmacol 12: 276P, 1981

    Google Scholar 

  20. Chen SS, Perucca E, Lee JN, et al: Serum protein binding and free concentration of phenytoin and phenobarbitone in pregnancy. Br J Clin Pharmacol 13: 547–552, 1982

    PubMed  CAS  Google Scholar 

  21. Dean M, Stock B, Patterson RJ, et al: Serum protein binding of drugs during and after pregnancy in humans. Clin Pharmacol Ther 28: 253–261, 1980

    Article  PubMed  CAS  Google Scholar 

  22. Dvorchik BH: Drug disposition during pregnancy. Biol Res Preg 3: 129–137, 1982

    CAS  Google Scholar 

  23. Davis M, Simmons GJ, Dordoni B, et al: Induction of hepatic enzymes during normal human pregnancy. J Obstet Gynaecol Br Commonw 81: 690–695, 1973

    Article  Google Scholar 

  24. Davison JM, Hytten FE: Glomerular filtration during and after pregnancy. J Obstet Gynaecol Br Commonw 81: 588–595, 1974

    Article  PubMed  CAS  Google Scholar 

  25. Zaske DE, Cipolle RJ, Strate RG, et al: Rapid gentamicin elimination in obstetric patients. Obstet Gynecol 56: 559–564, 1980

    PubMed  CAS  Google Scholar 

  26. Kubacka RT, Johnstone HE, Tan HSI, et al: Intravenous ampicillin pharmacokinetics in the third trimester of pregnancy. Ther Drug Monit 5: 55–60, 1983

    Article  PubMed  CAS  Google Scholar 

  27. Nau H, Kunz W, Egger HJ, et al: Anticonvulsants during pregnancy and lactation—transplacental, maternal and neonatal pharmacokinetics. Clin Pharmacokinet 7: 508–43, 1982

    Article  PubMed  CAS  Google Scholar 

  28. Lander CM, Edwards VE, Eadie MJ, et al: Plasma anticonvulsant concentrations during pregnancy. Neurology (Minneap) 27: 128–131, 1977

    CAS  Google Scholar 

  29. Eadie MJ, Lander CM, Tyrer JH: Plasma drug level monitoring in pregnancy. Clin Pharmacokinet 2: 427–436, 1977

    Article  PubMed  CAS  Google Scholar 

  30. Peabody JL: Transcutaneous oxygen measurement to evaluate drug effects. Clin Perinato16: 109–121, 1979

    Google Scholar 

  31. Juchau MR, Chao ST, Omiecinski CJ: Drug metabolism by the human fetus. Clin Pharmacokinet 5: 320–339, 1980

    Article  PubMed  CAS  Google Scholar 

  32. National Foundation-“March of Dimes”: Facts. White Plains, New York, 1979

    Google Scholar 

  33. Wilson JG: Embryotoxicity of drugs in man, in Wilson JG, Fraser FC (eds): Handbook of Teratology, vol 1. New York, Plenum Press, 1977, p 309

    Google Scholar 

  34. Bleyer WA, Au WYW, Lang WA, et al: Studies on the detection of adverse drug reactions in the newborn. I. Fetal exposure to maternal medication. JAMA 213: 2046–2050, 1970

    Article  PubMed  CAS  Google Scholar 

  35. Yager JW: Congenital malformations and environmental influence: The occupational environment of the laboratory worker. J Occup Med 15: 724–728, 1973

    PubMed  CAS  Google Scholar 

  36. Stern L: In vivo assessment of the teratogenic potential of drugs in humans. Obstet Gynecol 58: 3S–8S, 1981

    PubMed  CAS  Google Scholar 

  37. Ballard PL, Ballard RA: Corticosteroids and respiratory distress syndrome: Status 1979, Pediatrics 63: 163–165, 1979

    PubMed  CAS  Google Scholar 

  38. Petersen MC, Nation RL, Ashley JJ, et al: The placental transfer of betamethasone. Eur J Clin Pharmacol 18: 245–254, 1980

    Article  PubMed  CAS  Google Scholar 

  39. Harrigan JT, Kangos JJ, Sikka A, et al: Successful treatment of fetal congestive heart failure secondary to tachycardia. N Engl J Med 304: 1527–1529, 1981

    Article  PubMed  CAS  Google Scholar 

  40. Newburger JW, Keane JF: Intrauterine supraventricular tachycardia. J Pediatr 95: 780–786, 1979

    Article  PubMed  CAS  Google Scholar 

  41. Kerenyi TD, Gleicher N, Meller J, et al: Transplacental cardioversion in intrauterine supraventricular tachycardia and digitalis. Lancet 2: 393–395, 1980

    Article  PubMed  CAS  Google Scholar 

  42. Klein AM, Holzman IA, Austin EM: Fetal tachycardia prior to the development of hydrops. Attempted pharmacologic cardioversion: case report. Am J Obstet Gynecol 134: 347–348, 1979

    PubMed  CAS  Google Scholar 

  43. Dumesic DA, Silverman NH, Tobias S, et al: Transplacental cardioversion of fetal supraventricular tachycardia with procainamide. N Engl J Med 307: 1128–1131, 1982

    Article  PubMed  CAS  Google Scholar 

  44. Gladstone GR, Hordorf A, Gersony WM: Propranolol administration during pregnancy: Effects on the fetus. J Pediatr 86: 962–964, 1975

    Article  PubMed  CAS  Google Scholar 

  45. Habib A, McCarthy JS: Effects on the neonate of propranolol administered during pregnancy. J Pediatr 91: 808–811, 1977

    Article  PubMed  CAS  Google Scholar 

  46. Bray RE, Boe RW, Johnson WL: Transfer of ampicillin into the fetus and amniotic fluid from maternal plasma in late pregnancy. Am J Obstet Gynecol 96: 938–942, 1966

    PubMed  CAS  Google Scholar 

  47. Depp RC, Kind AC, Kirby WMM, et al: Transplacental passage of methicillin and dicloxacillin into the fetus and amniotic fluid. Am J Obstet Gynecol 107: 1054–1057, 970

    Google Scholar 

  48. Szeto HH, Mann LI, Ghaktharathsalan A, et al: Meperedine pharmacokinetics in the maternal-fetal unit. J Pharmacol Exp Ther 206: 448–459, 1978

    PubMed  CAS  Google Scholar 

  49. Idanpaan-Heikkala JE, Jouppila JE, Poulakka, et al: Placental transfer and fetal metabolism of diazepam in early human pregnancy. Am J Obstet Gynecol 109: 1011–1061, 1971

    Google Scholar 

  50. Abramovich DR, Wade DP: Transplacental passage of steroids: The presence of corticosteroids in amniotic fluid. J Obstet Gynecol Br Commonw 76: 610–614, 1969

    Article  CAS  Google Scholar 

  51. Anderson ABM, Gennser G, Jeremy JY, et al: Placental transfer and metabolism of betamethasone in human pregnancy. Obstet Gynecol 49: 471–474, 1977

    PubMed  CAS  Google Scholar 

  52. Fouron JC: Dynamics of the placental transfer of digoxin in the dog. Biol Neonate 23: 116–122, 1973

    Article  PubMed  CAS  Google Scholar 

  53. Carrier G, Hume AS, Douglas BH, et al: Disposition of barbiturates in the maternal blood, fetal blood and amniotic fluid. Am J Obstet Gynecol 105: 1069–1071, 1969

    PubMed  CAS  Google Scholar 

  54. Basso A, Fernandez A, Olthade O, et al: Passage of mannitol from mother to amniotic fluid to fetus. Obstet Gynecol 49: 628–631, 1977

    PubMed  CAS  Google Scholar 

  55. Sack J, Fischer DA, Lam RW: Thyroid hormone metabolism in amniotic and allantoic fluids of the sheep. Pediatr Res 9: 837–841, 1975

    PubMed  CAS  Google Scholar 

  56. Seeds AE: Current concepts of amniotic fluid dynamics. Am J Obstet Gynecol 138: 575–586, 1980

    PubMed  CAS  Google Scholar 

  57. Duenhoeffer JH, Pritchard JA: Fetal respiration: Quantitative measurements of amniotic fluid inspired near term by human and rhesus fetuses. Am J Obstet Gynecol 125: 306–309, 1976

    Google Scholar 

  58. Shier RW, Sprague AD, Dilts PV: Placental transfer of meperidine HCI. Part II. Am J Obstet Gynecol 115: 556–559, 1973

    PubMed  CAS  Google Scholar 

  59. Seeds AE: Basic concepts of maternal-fetal amniotic fluid exchange—their relevance to fetal therapeutics. Pediatr Clin North Am 28: 231–240, 1981

    PubMed  CAS  Google Scholar 

  60. Shoeman DW, Kaufman RE, Azarnoff DL, et al: Placental transfer of diphenylhydantoin in the goat. Biochem Pharmacol 21: 1237–1244, 1972

    Article  PubMed  CAS  Google Scholar 

  61. Lien EJ, Kuwahara J, Koda RT: Diffusion of drugs into prostatic fluid and milk. Drug Intell Clin Pharm 8: 470–475, 1974

    CAS  Google Scholar 

  62. Catz CS, Giacoia GP: Drugs in breast milk. Pediatr Clin North Am 19: 151–166, 1972

    PubMed  CAS  Google Scholar 

  63. Vorheer H: Drug excretion in breast milk. Postgrad Med 56: 97–104, 1974

    Google Scholar 

  64. Dickey RP: Drugs affecting lactation. Semin Perinatol 3: 279–286, 1979

    PubMed  CAS  Google Scholar 

  65. Sousa PLR: Reestablishment of lactation with metoclopramide. J Trop Pediatr 21: 214–216, 1975

    Google Scholar 

  66. Briggs CG, Bodendorfer TW, Freeman RK, et al: Drugs in Pregnancy and Lactation. A Reference Guide to Fetal and Neonatal Risk. Baltimore, London, Williams & Wilkins, 1983

    Google Scholar 

  67. Barr WH: Principles of biopharmaceutics. Am J Pharm Educ 52: 958–981, 1968

    Google Scholar 

  68. Richens AL, Dunlop A: Serum-phenytoin levels in the management of epilepsy. Lancet 2: 247–248, 1975

    Article  PubMed  CAS  Google Scholar 

  69. Swintosky JV: Illustrations and pharmaceutical interpretations of first order drug elimination rate from the bloodstream. J Am Pharm Assoc Sci Ed 45: 395–400, 1956

    Article  CAS  Google Scholar 

  70. Berkow R (ed): Merck Manual, ed 14. Rahway, Merck Sharp and Dohme Research Laboratories, 1982, p 2255

    Google Scholar 

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© 1985 Plenum Press Publishing Corporation

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Cupit, G.C., Rotmensch, H.H. (1985). Principles of Drug Therapy in Pregnancy. In: Gleicher, N. (eds) Principles of Medical Therapy in Pregnancy. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-2415-7_7

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  • DOI: https://doi.org/10.1007/978-1-4613-2415-7_7

  • Publisher Name: Springer, Boston, MA

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