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Chapter 14 - Pharmacology, pharmacokinetics, and management of the patient after overdose

from Section 2 - General medical considerations

Published online by Cambridge University Press:  05 July 2013

By
Edward J. Hayes  and
Warwick D. Ngan Kee
Edited by
Marc van de Velde ,
Helen Scholefield  and
Lauren A. Plante
Marc van de Velde
Affiliation:
University Hospital Leuven
Helen Scholefield
Affiliation:
Liverpool Women's Hospital
Lauren A. Plante
Affiliation:
Drexel University College of Medicine
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Summary

Pregnancy is a state of flux with the placental-fetal unit undergoing constant changes that affect both pharmacodynamics and pharmacokinetics of many drugs. Pregnancy affects hepatic biotransformation in an enzyme-specific manner. Increased cardiac output, tissue flow, and vasodilatation during pregnancy may enhance absorption of drugs administered subcutaneously, intramuscularly, epidurally, transvaginally, and via mucous membranes. The treatment of drug overdose in pregnancy presents a unique challenge because of changes in the pharmacodynamics and pharmacokinetics of drugs during gravid state. The most frequently used agents for self-inflicted poisoning during pregnancy are analgesics, antipyretics, and antirheumatics. The treatment of acetaminophen overdose is aimed at decreasing the absorption of acetaminophen and protecting the hepatocytes from the toxic effects of the highly reactive metabolites. The therapeutic approach in carbon monoxide poisoning is to deliver high-dose oxygen to displace carbon monoxide from the hemoglobin molecule.

Keywords

viable fetal patientpreventive ethics approachpreviable fetal patientpregnant patientpower of attorneymaternal critical carehealthcare decisions
Type
Chapter
Information
Maternal Critical Care
A Multidisciplinary Approach
 , pp. 150 - 159
Publisher: Cambridge University Press
Print publication year: 2013

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