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…
4.1 Medication use by the breastfeeding mother Mothers may need medication both during and after pregnancy. In both cases, it is important not only to protect the infant but also to provide the mother with necessary drug treatment. The infant…
3.1 Introduction Variability in drug efficacy and safety is multifactorial. Both the pharmacokinetics (how the body handles the drug) and the pharmacodynamics (how the body responds to the drug) play significant roles in drug efficacy and safety. This chapter will…
2.1 Physiologic changes during pregnancy Human pregnancy is characterized by profound anatomic and physiologic changes that affect virtually all systems and organs in the body. Many of these changes begin in early gestation. Understanding of the various physiologic adaptations in…
Answers Chapter 1 Q1. Answer: c – Puborectalis Laterally, the muscle sheets of the iliococcygeus and ischiococcygeus are oblique The medial fibres of the puborectalis are inserted into the upper part of the perineal body and the succeeding fibres turn…
Answers Chapter 2 Q1. Answer: e – When it has been more than 12 months since her last period Explanation: Menopause can only be diagnosed retrospectively, which is 12 months after the last menstrual period. Symptoms of hot flushes, mood…