Book contents
- Frontmatter
- Contents
- Preface
- List of contributors
- Part I Introduction
- 1 Cancer in pregnancy: identification of unanswered questions on maternal and fetal risks
- 2 The pregnant with malignant disease: maternal–fetal conflict
- 3 Changes in drug disposition during pregnancy and their clinical implications
- 4 The role of the placenta in the biotransformation of carcinogenic compounds
- 5 Antepartum fetal monitoring in the oncologic patient
- 6 The Toronto Study Group: methodological notes
- 7 Motherisk: the process of counselling in reproductive toxicology
- Part II Specific tumors during pregnancy
- Part III Fetal effects of cancer and its treatment
- Index
3 - Changes in drug disposition during pregnancy and their clinical implications
from Part I - Introduction
Published online by Cambridge University Press: 06 July 2010
- Frontmatter
- Contents
- Preface
- List of contributors
- Part I Introduction
- 1 Cancer in pregnancy: identification of unanswered questions on maternal and fetal risks
- 2 The pregnant with malignant disease: maternal–fetal conflict
- 3 Changes in drug disposition during pregnancy and their clinical implications
- 4 The role of the placenta in the biotransformation of carcinogenic compounds
- 5 Antepartum fetal monitoring in the oncologic patient
- 6 The Toronto Study Group: methodological notes
- 7 Motherisk: the process of counselling in reproductive toxicology
- Part II Specific tumors during pregnancy
- Part III Fetal effects of cancer and its treatment
- Index
Summary
For obvious reasons, almost none of the research projects involved in understanding pregnancy-induced changes in drug disposition has been conducted in women with cancer or in other women receiving cancer chemotherapy for adverse indications.
This chapter, therefore, will overview general principles governing changes in drug disposition during pregnancy, assuming that these mechanisms will be operative for cancer drugs too.
Clinical case
One of your patients, a G1 P0 epileptic woman (65 kg in late gestation) who was maintained on 400 mg/d of phenytoin taken in two equal doses every 12 hours has just had her first and only grand mal seizure during pregnancy at 26 weeks of gestation. Upon arrival to the emergency room her phenytoin level was 5 mg/L 10 hours after her evening dose. Three through levels taken before, at various times during pregnancy, were between 12 and 17 mg/L. What are your thoughts about the mechanism leading to this seizure?
Introduction
While the potential hazards to the unborn baby from medications administered to the pregnant woman are a major concern, one should be very careful not to neglect the maternal part of the fetomaternal unit. It has been universally agreed that the well-being of the mother should dictate her need for drug therapy and that one should not subject pregnant women to suboptimal therapy that may endanger them.
- Type
- Chapter
- Information
- Cancer in PregnancyMaternal and Fetal Risks, pp. 27 - 37Publisher: Cambridge University PressPrint publication year: 1996
- 1
- Cited by