妊娠期临床治疗学
Clinical therapeutics in pregnancy.
作者信息
Feghali Maisa N, Mattison Donald R
机构信息
Department of Obstetrics and Gynecology, Washington Hospital Center, Washington, DC 20010, USA.
出版信息
J Biomed Biotechnol. 2011;2011:783528. doi: 10.1155/2011/783528. Epub 2011 Jul 6.
Abstract
Most drugs are not tested for use during pregnancy, consequently, labeling, which may include information about fetal safety, includes nothing about dosing, efficacy, or maternal safety. Yet these are concerns of health care providers considering treatment of disease during pregnancy. Therefore, the practitioner treats the pregnant woman with the same dose recommended for use in adults (typically men) or may decide not to treat the disease at all. However, is the choice of not treating a woman during pregnancy better than dealing with the challenges which accompany treatment? This paper, which summarizes metabolic and physiologic changes induced by pregnancy, illustrates that standard adult dosing is likely to be incorrect during pregnancy.
摘要
大多数药物未在孕期进行使用测试，因此，药品标签（其中可能包含有关胎儿安全性的信息）未提及任何关于给药剂量、疗效或母体安全性的内容。然而，这些都是医疗保健人员在考虑孕期疾病治疗时所关心的问题。所以，从业者会按照推荐给成年人（通常为男性）使用的相同剂量来治疗孕妇，或者可能干脆决定不对疾病进行治疗。但是，在孕期不治疗女性的选择是否比应对治疗带来的挑战更好呢？本文总结了孕期引起的代谢和生理变化，表明孕期使用标准成人剂量很可能是不正确的。
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本文引用的文献
1
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Drug Metab Dispos. 2010 Sep;38(9):1393-6. doi: 10.1124/dmd.110.033878. Epub 2010 Jun 22.
2
Environmental exposures and development.环境暴露与发育
Curr Opin Pediatr. 2010 Apr;22(2):208-18. doi: 10.1097/MOP.0b013e32833779bf.
3
Developmental expression of drug metabolizing enzymes and transporter proteins in human placenta and fetal tissues.人胎盘和胎儿组织中药物代谢酶和转运蛋白的发育表达。
Expert Opin Drug Metab Toxicol. 2009 Dec;5(12):1483-99. doi: 10.1517/17425250903304049.
4
ASH position paper: hypertension in pregnancy.美国血液学会立场文件：妊娠期高血压
J Clin Hypertens (Greenwich). 2009 Apr;11(4):214-25. doi: 10.1111/j.1751-7176.2009.00085.x.
5
Management issues for women with epilepsy--focus on pregnancy (an evidence-based review): III. Vitamin K, folic acid, blood levels, and breast-feeding: Report of the Quality Standards Subcommittee and Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and the American Epilepsy Society.癫痫女性的管理问题——聚焦妊娠（循证综述）：III. 维生素K、叶酸、血药浓度及母乳喂养：美国神经病学学会和美国癫痫协会质量标准小组委员会及治疗与技术评估小组委员会报告
Epilepsia. 2009 May;50(5):1247-55. doi: 10.1111/j.1528-1167.2009.02130.x.
6
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7
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Epilepsia. 2009 May;50(5):1229-36. doi: 10.1111/j.1528-1167.2009.02128.x.
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10
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Am J Gastroenterol. 2009 Jan;104(1):228-33. doi: 10.1038/ajg.2008.71.
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