Drug Therapy in Special Populations 特殊人群的药物治疗学 PRINCIPLES Of CLINICAL PHARMACOLOGY Jingyu Chen SECONB FDmON Institute of clinical pharmacology Charlee E.Daninis,Betert Denlct
Drug Therapy in Special Populations 特殊人群的药物治疗学 1 Jingyu Chen Institute of clinical pharmacology
Drug Therapy in Pregnant and Nursing Women 妊娠期和哺乳期女性用药 2
Drug Therapy in Pregnant and Nursing Women 妊娠期和哺乳期女性用药 2
Why pregnant is special population? Drug concentration is different. Special physiology can result in different absoption,distribution, metabolism,and excretion. Toxicity or teratogenesis. Drug and metabolites can affect on fetus. 2
Why pregnant is special population? Drug concentration is different . Special physiology can result in different absoption, distribution, metabolism, and excretion. Toxicity or teratogenesis . Drug and metabolites can affect on fetus. 2
Thalidomide event Developed in Germany in 1957 and was used against nausea and morning sickness in pregnant women. In Germany,between 5000 and 7000 infants were born with phocomelia. various abnormalities to the face,limbs,ears,nose,vessels 3
Thalidomide event Developed in Germany in 1957 and was used against nausea and morning sickness in pregnant women. In Germany, between 5000 and 7000 infants were born with phocomelia. 3 various abnormalities to the face ,limbs, ears, nose, vessels
Diethylstilbestrol event Diethylstilbestrol,DES In 1950,it was used against abortion in pregnant women. In 1953,it was proved to be useless. In 1960,it was proved to related with malformation in genital tract and carcinoma of vagina ● In 1971,it was forbidden to be used in pregnant women by FDA. g
Diethylstilbestrol event Diethylstilbestrol, DES In 1950,it was used against abortion in pregnant women. In 1953,it was proved to be useless. In 1960,it was proved to related with malformation in genital tract and carcinoma of vagina In 1971, it was forbidden to be used in pregnant women by FDA. 4
Pharmacokinetics of drugs Pharmacokinetics of drugs in mother Pharmacokinetics of drugs in fetus 5
Pharmacokinetics of drugs Pharmacokinetics of drugs in mother Pharmacokinetics of drugs in fetus 5
Pharmacokinetics of drugs in mother Absorption Gastric acid ● Changes of Gastric Hormone emptying time Absorption of Oral drugs Peristalsis Vomit in early pregnant Absorption of poor circulation of lower limbs injection drugs 6
Pharmacokinetics of drugs in mother Absorption Gastric acid Changes of Gastric Hormone Absorption of Oral drugs Gastric emptying time Peristalsis Hormone Vomit in early pregnant 6 poor circulation of lower limbs Absorption of injection drugs
Pharmacokinetics of drugs in mother Distribution >Increase of blood volume Drug concentration >Distribution of drugs to fetal in serum Plasma free Drug concentration protein ↓ in tissue 个 >Fatty tissue↑I Fat soluble drugs distribution 个 7
Distribution Increase of blood volume Distribution of drugs to fetal Drug concentration in serum Pharmacokinetics of drugs in mother 7 Plasma free protein drugs Drug concentration in tissue Fatty tissue Fat soluble drugs distribution
Pharmacokinetics of drugs in mother Metablism Hepatic microsomal enzyme activity Metablism speed 9
Metablism Hepatic microsomal enzyme activity Pharmacokinetics of drugs in mother Metablism speed 9
Pharmacokinetics of drugs in mother Excretion Blood flow in kidney elimination Glomerular filtration in kidney rate (50%) Later period: Elimination Blood flow in kidney↓ in kidney 10
elimination Excretion Blood flow in kidney Pharmacokinetics of drugs in mother Glomerular filtration in kidney rate （50%） Blood flow in kidney 10 Elimination in kidney Later period：