Cardiovascular pharmacotherapeutic considerations during pregnancy and lactation.
Cardiovascular drugs are often used in pregnancy for the treatment of maternal and fetal conditions. Mothers could also require continued postpartum drug therapy. Most cardiovascular drugs taken by pregnant women can cross the placenta and therefore expose the developing embryo and fetus to their pharmacologic and teratogenic effects. These effects are influenced by the intrinsic pharmacokinetic properties of a given drug as well as by the complex physiological changes occurring during pregnancy. Many drugs are also transferred into human milk and therefore can potentially have adverse effects on the nursing infant. This 2-part article summarizes some of the available literature concerning the risks and benefits of using various cardiovascular drugs and drug classes during pregnancy and lactation. Included in the discussion are cardiac glycosides, antiarrhythmic drugs, drugs used to treat both acute and chronic hypertension, cholesterol-lowering agents, anticoagulants, thrombolytics, and antiplatelet drugs.
Qasqas
Shadi A
SA
Departments of Medicine, Washington University School of Medicine/Barnes-Jewish Hospital, St. Louis, Missouri, USA.
McPherson
Camille
C
Frishman
William H
WH
Elkayam
Uri
U
D000014:Abnormalities, Drug-Induced / Q000517:prevention & control*; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D001942:Breast Feeding / Q000009:adverse effects; D002301:Cardiac Glycosides / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D002319:Cardiovascular System / Q000187:drug effects; D005260:Female; D005333:Fetus / Q000098:blood supply; D006801:Humans; D007223:Infant; D007774:Lactation; D008431:Maternal-Fetal Exchange / Q000187:drug effects*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects
D000889:Anti-Arrhythmia Agents; D002301:Cardiac Glycosides