Skal gravide ha lavere eller høyere legemiddeldoser?

Abstract

Avdeling for klinisk farmakologi St. Olavs hospital Han har bidratt med idé, litteratursøk, utforming av utkast og godkjenning av innsendte manusversjon. Andreas Austgulen Westin er spesialist i klinisk farmakologi og overlege. Forfatter har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. ARNE REIMERS Avdelning för klinisk kemi och farmakologi Skånes universitetssjukhus, Lund, Sverige og Avdelning för klinisk kemi och farmakologi Lunds universitet, Lund, Sverige Han har bidratt med idé, revisjon av manus og godkjenning av innsendte manusversjon. Arne Reimers er dr.philos., spesialist i klinisk farmakologi, overlege og førsteamanuensis. Forfatter har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. OLAV SPIGSET Avdeling for klinisk farmakologi St. Olavs hospital og Institutt for klinisk og molekylaer medisin Norges teknisk-naturvitenskapelige universitet Han har bidratt med idé, revisjon av manus og godkjenning av innsendte manusversjon. Olav Spigset er dr.med., spesialist i klinisk farmakologi, overlege og professor. Forfatter har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter.

A user-driven framework for dose selection in pregnancy: proof-of-concept for sertraline

“…To our knowledge, this is the first available framework to guide antenatal dose selection based on existing data. As such, it may provide the impetus and necessary guidance for guideline committees to establish adequate doses in pregnancy, thereby addressing an unmet health need(4, 11, 12, 14). While other dose selection frameworks exist focusing on pediatric dosing(74), or the general population(75), these are not fit-for-purpose for issuing best-evidence, and potentially, model-informed, antenatal doses.…”

“…Examples of maternal changes affecting drug pharmacokinetics in pregnancy include an increased plasma volume, augmented renal filtration and changes in the expression and activity of drug metabolizing enzymes(1–3). These pharmacokinetic changes, along with potential alterations in pharmacodynamics, may affect drug safety and efficacy during pregnancy, in some cases warranting adjusted antenatal doses(4). However, while over 80% of pregnant women use medications(5), specifically researched antenatal doses are lacking for most drugs(4, 6).…”

“…These pharmacokinetic changes, along with potential alterations in pharmacodynamics, may affect drug safety and efficacy during pregnancy, in some cases warranting adjusted antenatal doses(4). However, while over 80% of pregnant women use medications(5), specifically researched antenatal doses are lacking for most drugs(4, 6). Despite efforts to increase enrollment of pregnant women in clinical research(7, 8), ethical concerns about potential fetal harm and the lack of obligation for pharmaceutical companies to investigate antenatal dosing before market access contribute to a paucity of data to support evidence-based antenatal doses(9, 10).…”

How well do doctors understand a scientific article in English when it is not their first language? A randomised controlled trial

“…Participants were randomised to read the same review article on paper in either Norwegian or English. 9 Setting and participants Approximately 1200 doctors working within primary care or public health attended the conference. Participants were consecutively recruited in the conference exhibition area.…”

“…The topic of the article was the use of medication in pregnancy, 9 thought to be a relevant issue for general practitioners. The article had been accepted for publication in the Journal of the Norwegian Medical Association but was not yet published at the time of the study.…”