Haas David M
Associate Professor and Vice Chair for Research, Department of Obstetrics & Gynecology, Indiana University School of Medicine, and Director, PREGMED, The Indiana University Center for Pharmacogenetics and Therapeutics Research in Maternal and Child Health, Indianapolis, IN.
Obstet Gynecol Surv. 2013 Sep;68(9):650-4. doi: 10.1097/OGX.0b013e3182a66180.
Most pregnant women take prescription medications. There are many factors related to pregnancy that make finding the most effective and safe dose of a therapeutic drug difficult for providers. Genetic differences in drug-metabolizing enzymes, transporters, and receptors may also account for some of the differences in drug response. Single-nucleotide polymorphisms in drug-metabolizing enzymes, such as the cytochrome P450 families, have been studied in relation to drugs used in pregnancy. Combining clinical characteristics, physiologic parameters in pregnancy, and possibly pharmacogenetic models may allow for providers to individualize pharmacotherapy in pregnancy and get to the most effective and safe dose of medication more quickly than in the current practice model. This article discusses these issues along with helpful Web sites and references for providers.
大多数孕妇会服用处方药。与怀孕相关的诸多因素使得医疗服务提供者难以确定治疗药物的最有效和安全剂量。药物代谢酶、转运体和受体的基因差异也可能是药物反应差异的部分原因。药物代谢酶中的单核苷酸多态性，如细胞色素P450家族，已针对孕期使用的药物进行了研究。结合临床特征、孕期生理参数以及可能的药物遗传学模型，或许能让医疗服务提供者在孕期实现药物治疗的个体化，并比当前的实践模式更快地达到最有效和安全的药物剂量。本文将讨论这些问题，并为医疗服务提供者提供有用的网站和参考文献。
