Table 2.
Summary of physiologic and metabolic changes potentially affecting pharmacotherapy during pregnancy.
| Change | Impact on Pharmacotherapy |
|---|---|
| Slower gastric emptying, reduced intestinal motility | - May impact drug absorption |
| Increase in gastric pH | - May impact drug absorption |
| Increased glomerular filtration rate (40–80%) | - Enhanced renal drug elimination - Decreased steady-state concentrations of many drugs |
| Increase in total volume of distribution | - Altered drug distribution - Decreased peak serum concentration of many drugs |
| Hypoalbuminemia | - Decreased protein binding, and increased free drug fraction |
| Change in metabolic enzyme activity | - Altered drug metabolism:
|
| Presence of placenta | - Additional metabolism and transport of some drugs |