Physiologic and pharmacokinetic changes in pregnancy

Maged Costantine

Research output: Contribution to journalArticle

136 Citations (Scopus)

Abstract

Physiologic changes in pregnancy induce profound alterations to the pharmacokinetic properties of many medications. These changes affect distribution, absorption, metabolism, and excretion of drugs, and thus may impact their pharmacodynamic properties during pregnancy. Pregnant women undergo several adaptations in many organ systems. Some adaptations are secondary to hormonal changes in pregnancy, while others occur to support the gravid woman and her developing fetus. Some of the changes in maternal physiology during pregnancy include, for example, increased maternal fat and total body water, decreased plasma protein concentrations, especially albumin, increased maternal blood volume, cardiac output, and blood flow to the kidneys and uteroplacental unit, and decreased blood pressure. The maternal blood volume expansion occurs at a larger proportion than the increase in red blood cell mass, which results in physiologic anemia and hemodilution. Other physiologic changes include increased tidal volume, partially compensated respiratory alkalosis, delayed gastric emptying and gastrointestinal motility, and altered activity of hepatic drug metabolizing enzymes. Understating these changes and their profound impact on the pharmacokinetic properties of drugs in pregnancy is essential to optimize maternal and fetal health.

Original languageEnglish (US)
Article numberArticle 65
JournalFrontiers in Pharmacology
Volume5 APR
DOIs
StatePublished - 2014

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Pharmacokinetics
Pregnancy
Mothers
Blood Volume
Respiratory Alkalosis
Pharmaceutical Preparations
Erythrocyte Volume
Hemodilution
Gastrointestinal Motility
Body Water
Gastric Emptying
Tidal Volume
Cardiac Output
Anemia
Blood Proteins
Pregnant Women
Albumins
Fetus
Erythrocytes
Fats

Keywords

  • Fetus
  • Pharmacokinetics
  • Pharmacology
  • Physiology
  • Pregnancy

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology

Cite this

Physiologic and pharmacokinetic changes in pregnancy. / Costantine, Maged.

In: Frontiers in Pharmacology, Vol. 5 APR, Article 65, 2014.

Research output: Contribution to journalArticle

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