Labetalol pharmacokinetics in pregnancy-induced hypertension

Rogers, Rebecca C.; Sibai, Bahaeddine M; Whybrew, W.D.

doi:10.1016/0002-9378(90)90386-l

Cited by 69 publications

(36 citation statements)

References 11 publications

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“…Labetalol is metabolized through conjugation to glucuronide metabolites. Conjugation also appears to be upregulated in pregnancy such that labetalol has a reported half‐life of 1.7 h following oral ingestion [15].…”

Section: Antihypertensive Therapymentioning

confidence: 99%

How to manage hypertension in pregnancy effectively

Magee

Ábalos

Dadelszen

et al. 2011

Brit J Clinical Pharma

125

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The hypertensive disorders of pregnancy (HDP) are a leading cause of maternal mortality and morbidity in both well and under-resourced settings. Maternal, fetal, and neonatal complications of the HDP are concentrated among, but not limited to, women with pre-eclampsia. Pre-eclampsia is a systemic disorder of endothelial cell dysfunction and as such, blood pressure (BP) treatment is but one aspect of its management. The most appropriate BP threshold and goal of antihypertensive treatment are controversial. Variation between international guidelines has more to do with differences in opinion rather than differences in published data. For women with severe hypertension [defined as a sustained systolic BP (sBP) of Ն160 mmHg and/or a diastolic BP (dBP) of Ն110 mmHg], there is consensus that antihypertensive therapy should be given to lower the maternal risk of central nervous system complications. The bulk of the evidence relates to parenteral hydralazine and labetalol, or to oral calcium channel blockers such as nifedipine capsules. There is, however, no consensus regarding management of non-severe hypertension (defined as a sBP of 140-159 mmHg or a dBP of 90-109 mmHg), because the relevant randomized trials have been underpowered to define the maternal and perinatal benefits and risks. Although antihypertensive therapy may decrease the occurrence of BP values of 160-170/100-110 mmHg, therapy may also impair fetal growth. The potential benefits and risks do not seem to be associated with any particular drug or drug class. Oral labetalol and methyldopa are used most commonly, but many different b-adrenoceptor blockers and calcium channel blockers have been studied in clinical trials.

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Section: Antihypertensive Therapymentioning

confidence: 99%

How to manage hypertension in pregnancy effectively

Magee

Ábalos

Dadelszen

et al. 2011

Brit J Clinical Pharma

125

View full text Add to dashboard Cite

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“…Beta-adrenergic blocking agents cross the placental barrier (29-3 I). The pharmacokinetics of the drugs in the fetus and the newborn are partly known (30,32). Pharmacological plasma levels with postpartal bradycardia and hypoglycemia have been reported in newborns to treated mothers (3 I , [33][34][35][36].…”

Section: Discussionmentioning

confidence: 99%

Perinatal factors associated with retinopathy of prematurity

1993

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The etiology of retinopathy of prematurity appears to be multifactorial. Introduction of new treatments in neonatal care may add new risk factors. We have analyzed thc relationship between 42 perinatal factors and the development of retinopathy of prematurity in 78 infants with a birth weight < 1501 g and/or gestational age < 33 weeks. We have also applied a chronological analysis of the maximum and minimum pO2 and pCO2 values. Retinopathy of prematurity was seen in 37 of 78 infants (47.4%). Nineteen factors were found to be related to the development of retinopathy of prematurity. However, when step‐wise logistic regression analysis was used, only birth weight, number of days of oxygen therapy and use of beta‐blocking agents by the mother before birth were found to be associated with the development of retinopathy or prematurity. The results suggest that medication with beta blockers immediately before birth should be used cautiously.

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“…(16–18) For example, the half-life of labetalol, a commonly used anti-hypertensive during pregnancy, decreases significantly during pregnancy due to altered pharmacokinetics during pregnancy. (19) The exact effects of some of these physiologic changes are hard to quantify on an individual drug basis, as studies are limited, and many are performed in only the third trimester when the fetal risk is thought to be the lowest. A thorough review of the pharmacokinetic and pharmacodynamics changes that occur during pregnancy is beyond the scope of this review, but an overview of major changes is summarized in Table 2.…”

Section: Challenges Involved With Pharmacogenomics Applications In Obmentioning

confidence: 99%

Pharmacogenomics of preterm birth prevention and treatment

Manuck

2015

BJOG

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Pharmacogenomics and personalized medicine incorporate genetic factors, historical data, and environmental exposures to predict individual variation in response to medications. The study of pharmacology and pharmacogenomics is challenging in obstetrics, and knowledge lags behind other disciplines of medicine. However, some preliminary data suggest that some of the inter-individual variation seen in response to medications given for the prevention (progesterone) and treatment (nifedipine, terbutaline, others) of preterm labor may be due to pharmacogenomic effects. A comprehensive approach, integrating clinical data, environmental factors including concomitant medications, and genotype to optimize prevention and treatment strategies for preterm birth, is urgently needed.

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Labetalol pharmacokinetics in pregnancy-induced hypertension

Cited by 69 publications

References 11 publications

How to manage hypertension in pregnancy effectively

How to manage hypertension in pregnancy effectively

Perinatal factors associated with retinopathy of prematurity

Pharmacogenomics of preterm birth prevention and treatment

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