Lewis Clinical Pharmacology in Obstetrics

1. Auflage 2013
ISBN: 978-1-4831-9345-8
Verlag: Elsevier Science & Techn.
Format: PDF
Kopierschutz: 1 - PDF Watermark

E-Book, Englisch, 406 Seiten, Web PDF

Clinical Pharmacology in Obstetrics presents an extensive examination of drug usage in pregnancy. It discusses the principles behind the adverse effects of drugs on the fetus. It addresses studies in the drug treatment of heart disease in pregnancy. Some of the topics covered in the book are the examination of pharmacokinetics in pregnancy; analgesia intake of pregnant women; drug treatment of gastrointestinal disorders; antibiotics and antimicrobial chemotherapy; anemia and hematinics of pregnant women, use of cytotoxic drugs; and treatment of threatened and recurrent abortion. The definition and description of antihypertensive drugs, therapy for asthma, and tocolytic therapy for pretern labor are fully covered. An in-depth account of the prophylactic treatment of idiopathic respiratory distress syndrome is provided. The drug treatment of thyroid and adrenal disease are completely presented. A chapter is devoted to description and effect of perinatal drugs on new born baby. Another section focuses on the treatment of renal disease. The book can provide useful information to obstetricians, doctors, students, and researchers.

Autoren/Hrsg.

Lewis, Peter

Inhaltsverzeichnis

1;Front Cover;1
2;Clinical Pharmacology in Obstetrics;4
3;Copyright Page;5
4;Table of Contents;10
5;PREFACE;6
6;LIST OF CONTRIBUTORS;8
7;FOREWORD;12
8;Chapter 1. Drug usage in pregnancy;14
8.1;Drugs Used in Pregnancy;14
8.2;New Drug Treatments in Obstetrics;15
8.3;Clinical Pharmacological Research in Obstetrics;16
8.4;References;17
9;Chapter 2. Pharmacokinetics in pregnancy;18
9.1;Elimination of Drugs;18
9.2;Single-compartment Model and First-order Elimination;19
9.3;Apparent Volume of Distribution;19
9.4;The Two-compartment Model;21
9.5;Changes in Pharmacokinetic Parameters in Pregnancy;23
9.6;Influence of the Fetus and Placenta;26
9.7;Conclusion;26
9.8;References;26
10;Chapter 3. Adverse effects of drugs on the fetus;30
10.1;Introduction;30
10.2;Acute Pharmacological Effects on the Fetus;30
10.3;Structural Teratogenicity;31
10.4;Behavioural Teratogenicity;33
10.5;Enzyme Induction;35
10.6;Predictability of Animal Tests for Teratogenicity;36
10.7;False and Negative Animal Tests;36
10.8;False Positive Animal Tests;36
10.9;Why are Animal Tests Inaccurate?;37
10.10;Future Teratogenicity Tests;37
10.11;Teratogenicity in Practice;38
10.12;References;38
11;Chapter 4. Anaemia and haematinics in pregnancy;41
11.1;Haematological Changes in Pregnancy;41
11.2;Iron;42
11.3;Folic Acid;49
11.4;Interpretation of Investigations during Pregnancy;51
11.5;Megaloblastic Anaemia and Pregnancy;52
11.6;Vitamin B12;53
11.7;Haemoglobinopathies;54
11.8;Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency;56
11.9;Rare Haematological Diseases in Pregnancy;56
11.10;Drugs Administered to or Taken by the Mother during Pregnancy which may Cause Haematological Abnormality in the Neonate;57
11.11;Drugs Given to the Mother to Treat a Haematological Condition which may adversely Affect the Fetus;58
11.12;References;59
12;Chapter 5. Analgesia in pregnancy;62
12.1;Aspirin and Related Drugs;62
12.2;Aspirin as an Inhibitor of Prostaglandin Biosynthesis;63
12.3;Aspirin Pharmacokinetics and Placental Transfer;64
12.4;Effects on Fetal Circulation and Postnatal Adaption;65
12.5;Paracetamol;66
12.6;Conclusions;67
12.7;References;67
13;Chapter 6. Antibiotics and antimicrobial chemotherapy in pregnancy;70
13.1;Introduction;70
13.2;Teratogenicity and Toxicity of Antimicrobial Drugs in Pregnancy;70
13.3;Pharmacology and Pharmacokinetics;72
13.4;The Classification of Antibiotics;73
13.5;Antibiotics in Obstetric Practice;74
13.6;Treatment of Specified Conditions;75
13.7;References;80
14;Chapter 7. Drug treatment of heart disease in pregnancy;85
14.1;Digoxin;85
14.2;Diuretic Therapy;86
14.3;The Treatment of Arrhythmias;86
14.4;Hypertrophic Obstructive Cardiomyopathy ( HOCM );87
14.5;Antibiotic Prophylaxis in Patients with Heart Disease in Pregnancy;87
14.6;Cardiovascular Side-effects of Sympathomimetic Drugs;88
14.7;References;89
15;Chapter 8. Anticoagulants in pregnancy;92
15.1;Importance of Venous Embolism in Pregnancy;92
15.2;Venous Thrombo-embolism Treatment;92
15.3;The Prophylaxis of Thrombo-embolism;96
15.4;Artificial Heart Valves and Mitral Valve Disease;97
15.5;References;98
16;Chapter 9. Antihypertensive treatment in pregnancy;101
16.1;Introduction;101
16.2;Pathogenesis and Natural History of Hypertension in Pregnancy;101
16.3;Aims of Treatment;105
16.4;What Level of Blood Pressure to Treat?;105
16.5;Which Patients to Treat?;106
16.6;How to Treat?;106
16.7;Recommendations for Treatment of Hypertension in Pregnancy;118
16.8;References;120
17;Chapter 10. Drug treatment of gastrointestinal disorders in pregnancy;127
17.1;Introduction;127
17.2;Antacids, Mucosal Protective Agents and Antireflux Therapy;127
17.3;Therapy for Peptic Ulcer in Pregnancy;128
17.4;Antiemetic Therapy in Pregnancy;131
17.5;Laxative Therapy in Pregnancy;133
17.6;Antidiarrhoeals, Antimicrobials, Anthelmintics;135
17.7;Salazopyrine, Corticosteroids, Immunosuppressive Agents in Bowel and Liver Disease;137
17.8;Immunization Procedures and Maternofetal Transmission of Hepatitis B Virus (HBV);140
17.9;Penicillamine in Liver Disease;140
17.10;Hepatotoxic Drugs in Pregnancy;140
17.11;Bile Acid Therapy for Gallstones in Pregnancy;142
17.12;Pancreatitis in Pregnancy;142
17.13;References;142
18;Chapter 11. Therapy for asthma in pregnancy;151
18.1;Natural History of Asthma in Pregnancy;151
18.2;The Treatment of Asthma;152
18.3;Acute severe asthma (Status Asthmaticus);154
18.4;References;155
19;Chapter 12. Cytotoxic drugs in pregnancy;157
19.1;Tissue Effects;157
19.2;Effects on Female Fertility;158
19.3;Effects on Male Fertility;159
19.4;Effects of Cytotoxic Drugs on Subsequent Pregnancies;159
19.5;Carcinogenicity;161
19.6;Correlation between Clinical Experience and Animal Studies;161
19.7;Summary of Individual Drugs;163
19.8;Alkylating Agents;163
19.9;Antimetabolites;164
19.10;Low Birthweight;166
19.11;References;166
20;Chapter 13. Treatment of diabetes in pregnancy;169
20.1;Introduction;169
20.2;Classification;169
20.3;Complications of Diabetic Pregnancy;169
20.4;Screening for Diabetes in Pregnancy;171
20.5;The Combined Diabetic-Antenatal Clinic;172
20.6;The Treatment of Chemical Diabetes in Pregnancy;172
20.7;Oral Hypoglycaemic Agents;173
20.8;Management of Insulin-dependent Diabetics in Pregnancy;174
20.9;The Management of Labour in the Pregnant Diabetic;175
20.10;The Management of Premature Labour;175
20.11;Diabetic Pregnancy Associated with Complications;176
20.12;Congenital Abnormalities in Diabetic Pregnancy;176
20.13;References;177
21;Chapter 14. Treatment of threatened and recurrent abortion;179
21.1;The Natural History of Threatened and Recurrent Abortion;179
21.2;The Diethylstilboestrol Problem;181
21.3;Treatment of Threatened and Recurrent Abortion;182
21.4;Recurrent Abortion;182
21.5;Threatened Abortion;183
21.6;The Question of Hormone Imbalance;183
21.7;Recommendations for Treatment;189
21.8;References;189
22;Chapter 15. Tocolytic therapy for preterm labour;195
22.1;Introduction;195
22.2;Definition;195
22.3;Frequency and Consequences of Preterm Labour;195
22.4;Aetiology of Preterm Labour;196
22.5;Mechanism of Uterine Activity;197
22.6;Selection of Patients for Treatment;198
22.7;Tocolytic Substances—Beta-mimetics;199
22.8;Miscellaneous Substances with Tocolytic Action;217
22.9;Conclusions;219
22.10;References;220
23;Chapter 16. Prophylactic treatment of idiopathic respiratory distress syndrome;232
23.1;Introduction;232
23.2;Pulmonary Surfactant and the Pathogenesis of IRDS;233
23.3;Drugs—Animal Studies;235
23.4;Drugs —Human Studies;238
23.5;References;241
24;Chapter 17. Drug treatment of thyroid and adrenal disease during pregnancy;245
24.1;Thyroid Disease;245
24.2;Adrenal Disease;255
24.3;References;258
25;Chapter 18. Bromocriptine, hyperprolactinaemia and pregnancy;264
25.1;Introduction;264
25.2;Human Prolactin;264
25.3;Investigation and Management of Hyperprolactinaemia;265
25.4;Bromocriptine Pharmacology;267
25.5;Clinical Use of Bromocriptine;268
25.6;Conduct of Bromocriptine-induced Pregnancy;270
25.7;Outcome of Bromocriptine-induced Pregnancies;271
25.8;Other Drugs for Hyperprolactinaemia;273
25.9;References;273
26;Chapter 19. Antiepileptic drugs, pregnancy and the newborn;277
26.1;Introduction;277
26.2;Effect of Pregnancy on Epilepsy;277
26.3;Kinetics of Antiepileptic Drugs During Pregnancy;278
26.4;Effect of Epilepsy and Antiepileptic Drugs on Pregnancy and Labour;284
26.5;Effect of Epilepsy and Antiepileptic Drugs on the Offspring;285
26.6;Antiepileptic Drug Disposition in the Newborn;291
26.7;Antiepileptic Drugs and Breastfeeding;292
26.8;Family Planning in the Epileptic Patient;294
26.9;Antiepileptic Drugs in Pregnancy and Puerperium: Summary and Recommendations;294
26.10;References;295
27;Chapter 20. Treatment of renal disease in pregnancy;301
27.1;Normal Renal Physiology of Pregnancy;301
27.2;Urinary Tract Infections in Pregnancy;303
27.3;Pregnancy-induced Hypertension;304
27.4;Pregnancy in the Hypertensive Woman;305
27.5;The Pregnant Patient with Glomerular or Tubulointerstitial Disease;306
27.6;Pregnancy in Lupus Nephritis;309
27.7;Pregnancy on Dialysis and after Transplantation;310
27.8;Chronic Renal Disease Appearing during Pregnancy;311
27.9;Renal Stones during Pregnancy;311
27.10;Acute Uraemia in Association with Pregnancy;312
27.11;References;312
28;Chapter 21. Prostaglandins in pregnancy;316
28.1;Introduction;316
28.2;Synthesis of Natural Prostaglandins;316
28.3;Physiological Role of Prostaglandins in Pregnancy;316
28.4;Prostaglandins for Therapeutic Abortion;319
28.5;Prostaglandins for Induction of Labour;323
28.6;References;329
29;Chapter 22. Oxytocic drugs in labour;337
29.1;Introduction;337
29.2;Oxytocin;337
29.3;Naturally Occurring Oxytocin;338
29.4;Actions of Oxytocin;338
29.5;Metabolism of Oxytocin;339
29.6;Administration of Oxytocin;339
29.7;Dosage;339
29.8;Quantitation of Effect;340
29.9;Indications and Contraindications;341
29.10;Side-Effects;344
29.11;References;346
30;Chapter 23. Analgesia in labour;350
30.1;Introduction;350
30.2;Narcotic Analgesics;350
30.3;Extradural Opiates;354
30.4;Patient Administration;354
30.5;Assessment of a New Method of Analgesia;355
30.6;Inhalation Analgesia;355
30.7;Extradural Analgesia;357
30.8;Local Anaesthetic Agents;357
30.9;Maternal Mortality due to Anaesthesia and Analgesia;359
30.10;General Anaesthesia;361
30.11;Drugs used in General Anaesthesia;363
30.12;Maintenance Anaesthesia;366
30.13;References;367
31;Chapter 24. Effects of perinatal drugs on the newborn baby;373
31.1;Sedatives and Analgesia in Labour;373
31.2;Measurement of the Behavioural Effects of Drugs on the Newborn;374
31.3;General Anaesthesia;375
31.4;Epidural Anaesthesia;375
31.5;The Comparative Advantages of Different Methods of Analgesia;376
31.6;References;377
32;Chapter 25. Drugs and breastfeeding;379
32.1;Introduction;379
32.2;Advantages of Breastfeeding;379
32.3;Medication in the Puerperium;379
32.4;Drugs to Control Lactation;380
32.5;Passage of Drugs into Breast Milk;381
32.6;Specific Drugs;385
32.7;References;388
33;INDEX;392