14.1 Introduction Reports of substance abuse during pregnancy are recorded in nursing literature as early as the 1980s with an increase in substance use continuing through to the present [ , ]. Data from the National Survey on Drug Use…
13.1 Introduction Cancer is the second leading cause of death in women of reproductive age and accounts for 16% of deaths among women between ages 20–44 years [ ]. The incidence is commonly reported as 1 per 1000 pregnancies, but…
Serious infections can occur during pregnancy and must be treated to prevent maternal and fetal adverse outcomes. While some anti-infectives have been studied in pregnancy, many agents have inadequate data available to evaluate safety, efficacy, and appropriate dosing, posing a…
11.1 Nausea and vomiting of pregnancy One of the most frequently encountered common discomforts related to pregnancy is nausea and vomiting. Nausea and vomiting of pregnancy (NVP) is often most difficult to deal with, often debilitating to patients, relationships, work…
10.1 Introduction Asthma is one of the most common potentially serious medical problems to complicate pregnancy, and may adversely affect both maternal quality of life and perinatal outcomes. Optimal management of asthma during pregnancy (MAP) is thus important for both…
9.1 Introduction The challenges of general and regional anesthesia in pregnancy are to optimize maternal physiological function, preserve uteroplacental blood flow and oxygen delivery while avoiding unwanted effects of fetal exposure to drugs. The likelihood of maternal and fetal exposure…
8.1 Pharmacogenomics If it were not for the great variability among individuals, medicine might as well be a science and not an art. Sir William Osler (1892). While much drug development and many clinical practice guidelines do not directly address…
7.1 Introduction The development of a new drug for use in humans classically follows a strict sequence, beginning with in-vitro and animal experiments to identify promising novel molecules, their sites of action, and biological effects. After efficacy and safety in…
6.1 Introduction Generally, from the perspective of clinical pharmacology, one thinks of the placenta as the route of passage from mother to fetus or the reverse [ ], with or without metabolism. With few exceptions, it is generally not thought…
Acknowledgments The authors wish to thank Sanaalarab Al-Enazy for her assistance with Fig. 5.1 and Wayne Snodgrass for helpful suggestions. E.R. and M.S.A. are grateful for research support from NIH grants HD083003 and HD047891. 5.1 Introduction The intention of most drugs…