Pharmacokinetics of routinely administered compounds during pregnancy reflect pregnancy related physiological changes
The general pharmacokinetic principles of disposition and elimination of exogenous compounds apply, irrespective of population specific characteristics. However, pregnancy and delivery warrant a focussed approach because important alterations in physiology (e.g. renal, hepatic, metabolism, body composition) affect drug disposition in a clinical relevant way. During pregnancy, there are changes in distribution volume due to changes in body composition, in metabolic activity affecting drug metabolism and in renal elimination (GFR, tubular) capacity. The link between pregnancy related changes in medical physiology and changes in drug disposition will be illustrated based on aspects of cefazolin and paracetamol disposition during pregnancy and after delivery. Beyond these anecdotal observations, patterns related to medical physiology are unveiled. Key-Words: pregnancy – drug disposition – medical physiology – paracetamol – cefazolin