Hepatic metabolism of psychotropic medications is also altered due to pregnancy-associated changes in the activity of various metabolic enzymes. The increased plasma volume, change in protein binding, and lower ratio of lean muscle to adipose tissue during pregnancy may result in a greater volume of drug distribution for lipophilic drugs. In summary, drug levels may be affected by the following changes that take place during pregnancy:ĭrug absorption is affected by slower gastric emptying and slower bowel and colonic transit time. This is a very thorough and clinically relevant article and definitely worth tracking down. A recent review summarizes how pregnancy affects the pharmacokinetics of psychotropic medications and provides guidelines for therapeutic drug monitoring. These pharmacokinetic changes may result in lower psychotropic drug levels and, in some cases, loss of clinical effectiveness. Physiologic changes take place during pregnancy which may affect the absorption, distribution, metabolism, and elimination of medications. Much less research, however, has focused on how pregnancy may affect how these medications work. We have an abundance of articles which address the impact of psychotropic medications on pregnancy.
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