PK Changes in Pregnancy Flashcards
GI absorption is affected in pregnancy…
Consider motility, pH, secretions, clinical status…
Increased progesterone decreases intestinal motility - prolonging gastric emptying
Increasing pH, affecting ionization of drugs
Increased mucous secretions, reducing membrane permeability
Nausea and vomiting
Increased cardiac output and intestinal blood flow allow for overall increased absorption
Pulmonary absorption may be affected by…
Increased tidal volume - increased pulmonary blood flow, increased alveolar uptake
Volume of distribution of drugs is affected by…
Increased body water (plasma volume) - may see decrease in Cmax
Protein binding in pregnancy is affected by…
Dilutional hypoalbuminemia
Steroid/placental hormones binding to proteins may decrease drug binding
Hepatic metabolism in pregnancy…
May be increased/decreased by estrogen and progesterone
Renal excretion in pregnancy may be affected by…
Increased GFR - increasing elimination, but generally not clinically significant
Check LexiComp
Fetoplacental absorption is mostly…
Passive diffusion
Fetal protein binding affinity is different from maternal protein binding. For example, fetal albumin…
Concentration progressively increases while maternal albumin decreases.
Elimination of fetoplacental drugs is…
Mainly diffusion to maternal compartment, efflux transporters present
Overtime concentrations in both compartments are similar
