Klin Farmakol Farm. 2019;33(4):20-23
Therapeutic drug monitoring in pregnancy
- 1 Oddělení klinické farmakologie, Ústav laboratorní diagnostiky, Fakultní nemocnice Ostrava
- 2 Ústav klinické farmakologie, Lékařská fakulta, Ostravská univerzita, Ostrava
Therapeutic drug monitoring is a specific method of clinical pharmacology for monitoring of pharmacotherapy using measurement of drug serum concentrations followed by interpretation of erudite clinical pharmacologist (eventually clinical pharmacist) and good cooperation with clinician. The concept of the method rests on the assumption that clinical effect correlates better with drug concentration than with the dose. Pregnancy is associated with significant physiological changes that alter the pharmacokinetic of drugs (absorption, distribution, metabolism and excretion) and potentially affect both their efficacy and safety. These variations occur during pregnancy and return to the nonpregnant state some weeks after delivery. However, little is known about these pharmacokinetic changes and dose requirements during pregnancy. Therefore therapeutic drug monitoring may be a useful tool for dose adjustment as the pregnancy progresses. In addition, measuring the umbilical cord/maternal serum drug level ratio at birth is the method recommended to assess transplacental transfer and it is more useful for the estimation of fetal exposure and minimization of the risk of fetal effects than the given dose. We would like to present informations relating to utilization of therapeutic drug monitoring method in pregnant patients.
Keywords: pregnancy, pharmacokinetics, therapeutic drug monitoring.
Received: December 13, 2019; Revised: December 13, 2019; Accepted: December 18, 2019; Published: January 1, 2020 Show citation
