Altered drug metabolism during pregnancy: hormonal regulation of drug-metabolizing enzymes.
BACKGROUND
Medication use during pregnancy is prevalent, but pharmacokinetic information of most drugs used during pregnancy is lacking in spite of known effects of pregnancy on drug disposition. Accurate pharmacokinetic information is essential for optimal drug therapy in mother and fetus. Thus, understanding how pregnancy influences drug disposition is important for better prediction of pharmacokinetic changes of drugs in pregnant women.


METHODS
Pregnancy is known to affect hepatic drug metabolism, but the underlying mechanisms remain unknown. Physiological changes accompanying pregnancy are probably responsible for the reported alteration in drug metabolism during pregnancy. These include elevated concentrations of various hormones such as estrogen, progesterone, placental growth hormones and prolactin. This review covers how these hormones influence expression of drug-metabolizing enzymes (DMEs), thus potentially responsible for altered drug metabolism during pregnancy.


RESULTS
The reader will gain a greater understanding of the altered drug metabolism in pregnant women and the regulatory effects of pregnancy hormones on expression of DMEs.


CONCLUSIONS
In-depth studies in hormonal regulatory mechanisms as well as confirmatory studies in pregnant women are warranted for systematic understanding and prediction of the changes in hepatic drug metabolism during pregnancy.
Jeong
Hyunyoung
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Department of Pharmacy Practice, University of Illinois at Chicago, College of Pharmacy, Departments of Pharmacy Practice and Biopharmaceutical Sciences, Chicago, IL 60612, USA. yjeong@uic.edu
D000818:Animals; D005260:Female; D015971:Gene Expression Regulation, Enzymologic / Q000502:physiology*; D006728:Hormones / Q000378:metabolism*; D006801:Humans; D008099:Liver / Q000201:enzymology*; D004364:Pharmaceutical Preparations / Q000378:metabolism*; D011247:Pregnancy / Q000378:metabolism*
D006728:Hormones; D004364:Pharmaceutical Preparations