Pharmacokinetics and pharmacotherapy of thionamides in pregnancy

Shannon Clark, George Saade, Wayne R. Snodgrass, Gary Hankins

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Hyperthyroidism occurs in approximately 1 in every 1000 to 2000 pregnancies. Although the signs and symptoms of the disease are similar in the pregnant and nonpregnant patient, the complications of hyperthyroidism can have even more profound consequences for the mother and fetus during gestation. These include maternal heart failure, preeclampsia, miscarriage, and preterm labor; as well as fetal loss and low birth weight. Furthermore, thyroid function and laboratory testing for hyperthyroidism are altered in pregnancy. The gestational increase in thyroid size, increased thyroid-binding globulin levels, increased serum total T4 and total T3 levels, and decreased thyroid stimulating hormone levels often confuses the evaluation of the thyroid status in pregnancy. Worldwide, the thionamides-propylthiouracil, methimazole, and carbimazole-have been used in pregnancy for the treatment of hyperthyroidism. However, propylthiouracil has been the drug of choice in the United States because it is believed to have less potential to induce fetal/neonatal hypothyrodism, to cross the placenta and into breast milk to a lesser degree, and to be less teratogenic than methimazole or carbimazole. None of the above have been substantiated in more recent studies. The pharmacokinetics of the thionamides in the pregnant and nonpregnant states, as well as the pharmacotherapeutic recommendation for hyperthyroidism will be reviewed.

Original languageEnglish (US)
Pages (from-to)477-483
Number of pages7
JournalTherapeutic Drug Monitoring
Volume28
Issue number4
DOIs
StatePublished - Aug 2006

Fingerprint

Carbimazole
Methimazole
Drug therapy
Propylthiouracil
Pharmacokinetics
Hyperthyroidism
Thyroid Gland
Drug Therapy
Pregnancy
Globulins
Thyrotropin
Personnel
Mothers
Testing
Pharmaceutical Preparations
Premature Obstetric Labor
Low Birth Weight Infant
Human Milk
Spontaneous Abortion
Pre-Eclampsia

Keywords

  • Pharmacokinetics
  • Pharmacotherapy
  • Pregnancy
  • Thioamides

ASJC Scopus subject areas

  • Toxicology
  • Health, Toxicology and Mutagenesis
  • Pharmacology
  • Biochemistry
  • Biochemistry, Genetics and Molecular Biology(all)
  • Pharmacology (medical)
  • Public Health, Environmental and Occupational Health

Cite this

Pharmacokinetics and pharmacotherapy of thionamides in pregnancy. / Clark, Shannon; Saade, George; Snodgrass, Wayne R.; Hankins, Gary.

In: Therapeutic Drug Monitoring, Vol. 28, No. 4, 08.2006, p. 477-483.

Research output: Contribution to journalArticle

Clark, Shannon ; Saade, George ; Snodgrass, Wayne R. ; Hankins, Gary. / Pharmacokinetics and pharmacotherapy of thionamides in pregnancy. In: Therapeutic Drug Monitoring. 2006 ; Vol. 28, No. 4. pp. 477-483.
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