一些抗早产药物用于有早产风险的孕妇的临床药理学研究

E. A. Sоkоvа, R. Chilova, O. A. Demidova, K. Akopov
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引用次数: 0

摘要

自发性早产是产科最紧迫的问题之一,因为它仍然是新生儿发病和死亡的主要原因之一。病因、发病机制和缺乏用于治疗自发性早产的药品等悬而未决的问题对合理的药物治疗提出了挑战。本文介绍了自然早产的合理药物治疗问题的科学文献综述的结果溶胎药物-钙通道阻滞剂,环氧化酶抑制剂。本文综述了这些药物在妊娠期的具体药动学参数。它讨论了在孕妇中使用抗早产药物的药理学方面及其潜在的临床效果。结果表明,根据cyp3a5基因型,先兆流产妇女硝苯地平血药浓度具有较高的个体间差异。结果表明,cyp2c9的某些遗传多态性可能导致代谢率增加和吲哚美辛清除率增加,从而降低其疗效。然而,关于这个问题的研究很少。因此,cyp3a5和cyp2c9基因型对硝苯地平和吲哚美辛在产科用作抗产药的疗效和安全性的影响有待进一步研究。
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Clinical Pharmacology Aspects of Some Tocolytic Drugs Used in Pregnant Women at Risk of Preterm Birth
Spontaneous preterm birth is one of the most pressing issues in obstetrics, as it remains one of the leading causes of newborn morbidity and mortality. Pending issues of aetiology, pathogenesis, and absence of medicinal products indicated for the treatment of spontaneous preterm labour pose a challenge for rational pharmacotherapy. The paper presents the results of a scientific literature review on the problem of rational pharmacotherapy of spontaneous preterm labour using tocolytic drugs — calcium channel blockers, cyclooxygenase inhibitors. The paper summarises specific pharmacokinetic parameters of these drugs during pregnancy. It discusses pharmacogenetic aspects of using tocolytic drugs in pregnant women and their potential clinical effects. It was demonstrated that women with threatened miscarriage had high interindividual variability in nifedipine plasma concentrations depending onCYP3A5genotype. It was shown that certain genetic polymorphisms ofCYP2C9may lead to an increased metabolic rate and an increase in indomethacin clearance resulting in the reduction of its efficacy. Yet, there is minimal research regarding this issue. Therefore, further research is needed to assess the impact ofCYP3A5andCYP2C9genotypes on the efficacy and safety of nifedipine and indomethacin used as tocolytic drugs in obstetrics.
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