Hepatic Elimination of Drugs in Gestational Diabetes.

IF 3.2 Q2 Pharmacology, Toxicology and Pharmaceutics
Claudio Daniel Gonzalez, Jorge Alvarinas, Ricardo Bolanos, Guillermo Di Girolamo
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引用次数: 2

Abstract

Background: The liver is the major metabolic clearance organ for chemical agents from the human body. Pregnancy is associated with several physiological changes that may affect one or more of these factors, and also induces changes in the hepatic clearance of certain drugs. The aim of this paper was to review some of the currently available information in the field to provide some insights about the relevance of these changes on the clearance of some drugs.

Methods: A comprehensive literature search was carried out to identify eligible studies from MEDLINE/PubMed, EMBASE and SCIELO databases through 1970 first semester.

Results: Gestational Diabetes Mellitus (GDM) is a frequent disease commonly associated with other entities as obesity, hypertension, dyslipidemia, non-alcoholic fatty liver disease, prothrombotic conditions, changes in intestinal microbiome. These entities, together with the glycemic fluctuations associated with GDM might affect the determinants of the hepatic clearance (hepatic blood flow, the unbound fraction of drugs, and the hepatic intrinsic clearance). GDM is frequently associated with multi-drug treatments. While many of these drugs are cleared by the liver, little is known about the clinical relevance of these GDM associated pharmacokinetic changes.

Conclusion: Considering the frequency of the disease and the effects that these pharmacokinetic changes might have on the mother and child, the need for further research seems advisable. In the meantime, cautious clinical judgment in the management of drug administration in women affected by this disease is recommended.

妊娠期糖尿病药物的肝脏消除。
背景:肝脏是人体化学物质的主要代谢清除器官。妊娠与几种生理变化有关,这些生理变化可能影响这些因素中的一种或多种,也会导致某些药物的肝脏清除率发生变化。本文的目的是回顾该领域目前可用的一些信息,以提供一些关于这些变化与某些药物清除的相关性的见解。方法:对1970年第一学期MEDLINE/PubMed、EMBASE和SCIELO数据库中符合条件的研究进行全面的文献检索。结果:妊娠期糖尿病(GDM)是一种常见病,通常与肥胖、高血压、血脂异常、非酒精性脂肪性肝病、血栓前病变、肠道微生物群改变等相关。这些因素以及与GDM相关的血糖波动可能影响肝清除的决定因素(肝血流量、药物的未结合部分和肝内清除)。GDM通常与多种药物治疗有关。虽然许多这些药物被肝脏清除,但对这些与GDM相关的药代动力学变化的临床相关性知之甚少。结论:考虑到该病的发病率和这些药代动力学变化可能对母亲和孩子产生的影响,需要进一步研究似乎是可取的。同时,建议临床谨慎判断女性本病患者的用药管理。
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来源期刊
Current clinical pharmacology
Current clinical pharmacology PHARMACOLOGY & PHARMACY-
CiteScore
3.60
自引率
0.00%
发文量
0
期刊介绍: Current Clinical Pharmacology publishes frontier reviews on all the latest advances in clinical pharmacology. The journal"s aim is to publish the highest quality review articles in the field. Topics covered include: pharmacokinetics; therapeutic trials; adverse drug reactions; drug interactions; drug metabolism; pharmacoepidemiology; and drug development. The journal is essential reading for all researchers in clinical pharmacology.
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