Pregnancy-Associated Changes in Pharmacokinetics: A Systematic Review
Publication Date
November 01, 2016
Authors
Gali Pariente, Tom Leibson, Alexandra Carls, Thomasin Adams Webber, et al
Volume
13
Issue
11
Pages
e1002160
DOI
https://dx.plos.org/10.1371/journal.pmed.1002160
Publisher URL
http://journals.plos.org/plosmedicine/article?id=10.1371%2Fjournal.pmed.1002160
Scopus
84999723784
Mendeley
http://www.mendeley.com/research/pregnancyassociated-changes-pharmacokinetics-systematic-review
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{"title"=>"Pregnancy-Associated Changes in Pharmacokinetics: A Systematic Review", "type"=>"journal", "authors"=>[{"first_name"=>"Gali", "last_name"=>"Pariente", "scopus_author_id"=>"34875566300"}, {"first_name"=>"Tom", "last_name"=>"Leibson", "scopus_author_id"=>"25947474700"}, {"first_name"=>"Alexandra", "last_name"=>"Carls", "scopus_author_id"=>"56039931600"}, {"first_name"=>"Thomasin", "last_name"=>"Adams-Webber", "scopus_author_id"=>"6504762220"}, {"first_name"=>"Shinya", "last_name"=>"Ito", "scopus_author_id"=>"57192178467"}, {"first_name"=>"Gideon", "last_name"=>"Koren", "scopus_author_id"=>"7402925940"}], "year"=>2016, "source"=>"PLoS Medicine", "identifiers"=>{"scopus"=>"2-s2.0-84999723784", "pmid"=>"27802281", "sgr"=>"84999723784", "issn"=>"15491676", "pui"=>"613530934", "isbn"=>"1549-1676", "doi"=>"10.1371/journal.pmed.1002160"}, "id"=>"3233d998-c1b8-37ad-b63d-dc5bf3b4dae2", "abstract"=>"Background Women are commonly prescribed a variety of medications during pregnancy. As most organ systems are affected by the substantial anatomical and physiological changes that occur during pregnancy, it is expected that pharmacokinetics (PK) (absorption, distribution, metabolism, and excretion of drugs) would also be affected in ways that may necessitate changes in dosing schedules. The objective of this study was to systematically identify existing clinically relevant evidence on PK changes during pregnancy. Methods and Findings Systematic searches were conducted in MEDLINE (Ovid), Embase (Ovid), Cochrane Central Register of Controlled Trials (Ovid), and Web of Science (Thomson Reuters), from database inception to August 31, 2015. An update of the search from September 1, 2015, to May 20, 2016, was performed, and relevant data were added to the present review. No language or date restrictions were applied. All publications of clinical PK studies involving a group of pregnant women with a comparison to nonpregnant participants or nonpregnant population data were eligible to be included in this review. A total of 198 studies involving 121 different medications fulfilled the inclusion criteria. In these studies, commonly investigated drug classes included antiretrovirals (54 studies), antiepileptic drugs (27 studies), antibiotics (23 studies), antimalarial drugs (22 studies), and cardiovascular drugs (17 studies). Overall, pregnancy-associated changes in PK parameters were often observed as consistent findings among many studies, particularly enhanced drug elimination and decreased exposure to total drugs (bound and unbound to plasma proteins) at a given dose. However, associated alterations in clinical responses and outcomes, or lack thereof, remain largely unknown. Conclusion This systematic review of pregnancy-associated PK changes identifies a significant gap between the accumulating knowledge of PK changes in pregnant women and our understanding of their clinical impact for both mother and fetus. It is essential for clinicians to be aware of these unique pregnancy-related changes in PK, and to critically examine their clinical implications.", "link"=>"http://www.mendeley.com/research/pregnancyassociated-changes-pharmacokinetics-systematic-review", "reader_count"=>40, "reader_count_by_academic_status"=>{"Unspecified"=>2, "Professor > Associate Professor"=>1, "Librarian"=>2, "Researcher"=>6, "Student > Doctoral Student"=>2, "Student > Ph. D. Student"=>6, "Student > Postgraduate"=>2, "Other"=>3, "Student > Master"=>8, "Student > Bachelor"=>3, "Lecturer"=>1, "Professor"=>4}, "reader_count_by_user_role"=>{"Unspecified"=>2, "Professor > Associate Professor"=>1, "Librarian"=>2, "Researcher"=>6, "Student > Doctoral Student"=>2, "Student > Ph. D. Student"=>6, "Student > Postgraduate"=>2, "Other"=>3, "Student > Master"=>8, "Student > Bachelor"=>3, "Lecturer"=>1, "Professor"=>4}, "reader_count_by_subject_area"=>{"Unspecified"=>3, "Agricultural and Biological Sciences"=>1, "Arts and Humanities"=>1, "Chemistry"=>1, "Computer Science"=>1, "Biochemistry, Genetics and Molecular Biology"=>3, "Nursing and Health Professions"=>1, "Mathematics"=>1, "Medicine and Dentistry"=>18, "Neuroscience"=>1, "Pharmacology, Toxicology and Pharmaceutical Science"=>7, "Social Sciences"=>1, "Immunology and Microbiology"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>18}, "Social Sciences"=>{"Social Sciences"=>1}, "Mathematics"=>{"Mathematics"=>1}, "Unspecified"=>{"Unspecified"=>3}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>7}, "Arts and Humanities"=>{"Arts and Humanities"=>1}, "Chemistry"=>{"Chemistry"=>1}, "Neuroscience"=>{"Neuroscience"=>1}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>1}, "Computer Science"=>{"Computer Science"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>1}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>3}}, "reader_count_by_country"=>{"United States"=>2, "France"=>1}, "group_count"=>4}

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Scopus | Further Information

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