- Maternal and perinatal outcomes associated with the use of renin-angiotensin system (RAS) blockers for chronic hypertension in early pregnancy. [Journal Article]
- PHPregnancy Hypertens 2018; 14:156-161
- CONCLUSIONS: No association between early pregnancy exposure to ACEIs and ARBs and perinatal outcomes was observed, however, the possibility of an association cannot be ruled out due to limited power. Nonetheless, this study suggests that the magnitude of risk is smaller than that reported previously.
- Risk analysis of suicidal ideations and postpartum depression with antenatal alpha methyldopa use. [Journal Article]
- AJAsian J Psychiatr 2018 Oct 29; 38:42-44
- Out of the various risk factors for postpartum depression, use of pharmacotherapy during pregnancy is the most poorly understood. The present study aimed to establish risk of postpartum depression an...
Out of the various risk factors for postpartum depression, use of pharmacotherapy during pregnancy is the most poorly understood. The present study aimed to establish risk of postpartum depression and suicidal ideations with antenatal use of alpha methyldopa. Out of the 100 postpartum women assessed, 77.78% of the women who were prescribed alpha methyldopa had significant postpartum depression. There was statistically significant risk of postpartum depression associated with alpha methyldopa (p = 0.026, OR = 6.45). There was no increased suicidal risk with use of alpha methyldopa in these women (p = 1.00).
- Review of Cardiovascular Drugs in Pregnancy. [Journal Article]
- JWJ Womens Health (Larchmt) 2018 Nov 08
- Cardiovascular disease is now the leading cause of pregnancy-related deaths in the United States. Increasing maternal mortality in the United States underscores the importance of proper cardiovascula...
Cardiovascular disease is now the leading cause of pregnancy-related deaths in the United States. Increasing maternal mortality in the United States underscores the importance of proper cardiovascular management. Significant physiological changes during pregnancy affect the heart's ability to respond to pathological processes such as hypertension and heart failure. These physiological changes further affect the pharmacokinetic and pharmacodynamic properties of cardiac medications. During pregnancy, these changes can significantly alter medication efficacy and metabolism. This article systematically reviews the literature on safety, efficacy, pharmacokinetics, and pharmacodynamics of cardiovascular drugs used for hypertension and heart failure during pregnancy and lactation. The 2017 American College of Cardiology/American Heart Association hypertension guidelines recommend transitioning pregnant patients to methyldopa, nifedipine, or labetalol. Heart failure medications, including beta-blockers, furosemide, and digoxin, are relatively safe and can be used effectively. Medications that block the renin angiotensin-aldosterone system have been shown to be beneficial in the general population; however, they are teratogenic and, therefore, contraindicated in pregnancy. Cardiovascular medications can also enter breast milk and, therefore, care must be taken when selecting drugs during the lactation period. A summary of the safety of drugs during pregnancy and lactation from an online resource, LactMed by the National Library of Medicine's TOXNET database, is included. High-risk pregnant patients with cardiovascular disease require a multispecialty team of doctors, including health care providers from obstetrics and gynecology, maternal fetal medicine, internal medicine, cardiovascular disease specialists, and specialized pharmacology expertise.
- The management of hypertension in women planning for pregnancy. [Journal Article]
- BMBr Med Bull 2018 Dec 01; 128(1):75-84
- Poorly-controlled hypertension in the first trimester significantly increases maternal and fetal morbidity and mortality. The majority of guidelines and clinical trials focus on the management and tr...
Poorly-controlled hypertension in the first trimester significantly increases maternal and fetal morbidity and mortality. The majority of guidelines and clinical trials focus on the management and treatments for hypertension during pregnancy and breast-feeding, while limited evidence could be applied to the management for hypertension before pregnancy. In this review, we summarized the existing guidelines and treatments of pre-pregnancy treatment of hypertension.
- Nanostructured TiO₂ Carbon Paste Based Sensor for Determination of Methyldopa. [Journal Article]
- PPharmaceuticals (Basel) 2018 Oct 05; 11(4)
- Methyldopa is a catecholamine widely used in the treatment of mild to moderate hypertension whose determination in pharmaceutical formulae is of upmost importance for dose precision. Henceforth, a lo...
Methyldopa is a catecholamine widely used in the treatment of mild to moderate hypertension whose determination in pharmaceutical formulae is of upmost importance for dose precision. Henceforth, a low-cost carbon paste electrode (CPE) consisting of graphite powder obtained from a crushed pencil stick was herein modified with nanostructured TiO₂ (TiO₂@CPE) aiming for the detection of methyldopa in pharmaceutical samples. The TiO₂-modified graphite powder was characterized by scanning electron microscopy and X-ray diffraction, which demonstrated the oxide nanostructured morphology. Results evidenced that sensitivity was nonetheless increased due to electro-catalytic effects promoted by metal modification, and linear response obtained by differential pulse voltammetry for the determination of methyldopa (pH = 5.0) was between 10⁻180 μmol/L (Limit of Detection = 1 μmol/L) with the TiO₂@CPE sensor. Furthermore, the constructed sensor was successfully applied in the detection of methyldopa in pharmaceutical formulations and excipients promoted no interference, that indicates that the sensor herein developed is a cheap, reliable, and useful strategy to detect methyldopa in pharmaceutical samples, and may also be applicable in determinations of similar compounds.
- Antihypertensive drug therapy for mild to moderate hypertension during pregnancy. [Review]
- CDCochrane Database Syst Rev 2018 10 01; 10:CD002252
- CONCLUSIONS: Antihypertensive drug therapy for mild to moderate hypertension during pregnancy reduces the risk of severe hypertension. The effect on other clinically important outcomes remains unclear. If antihypertensive drugs are used, beta blockers and calcium channel blockers appear to be more effective than the alternatives for preventing severe hypertension. High-quality large sample-sized randomised controlled trials are required in order to provide reliable estimates of the benefits and adverse effects of antihypertensive treatment for mild to moderate hypertension for both mother and baby, as well as costs to the health services, women and their families.
- Antihypertensives prescribed for pregnant women in Japan: Prevalence and timing determined from a database of health insurance claims. [Journal Article]
- PDPharmacoepidemiol Drug Saf 2018 Sep 25
- CONCLUSIONS: Various types of antihypertensives are prescribed for Japanese pregnant women. The effects of exposing pregnant Japanese women to these agents should be evaluated.
- A new validated HPLC method for the determination of levodopa: Application to study the impact of ketogenic diet on the pharmacokinetics of levodopa in Parkinson's participants. [Journal Article]
- BCBiomed Chromatogr 2018 Sep 11; :e4382
- A simple, accurate, and reproducible HPLC-UV method has been developed and validated for the quantification of levodopa (l-Dopa) in human plasma. The method involves a simple protein precipitation pr...
A simple, accurate, and reproducible HPLC-UV method has been developed and validated for the quantification of levodopa (l-Dopa) in human plasma. The method involves a simple protein precipitation procedure to extract both l-Dopa and methyldopa, the internal standard. The chromatographic analysis was achieved on a Shimadzu LC 20A HPLC system equipped with a Zorbax Eclipse XDB C18 column and an isocratic mobile phase consisting of 20 mm KH2 PO4 (pH 2.5) and methanol (95:5, v/v) run at a flow rate of 1 mL/min. The UV detection wavelength was set at 230 nm. The method exhibited good linearity (R2 > 0.999) over the assayed concentration range (0.1-10 μg/mL) and demonstrated good intra- and inter-day precision and accuracy (relative standard deviations and the deviation from predicted values were <15%). This method was also successfully applied for studying the potential effect of ketogenic diet on the pharmacokinetics of l-Dopa in Parkinson's participants. Our data analysis indicates that ketogenic diet does not significantly affect the pharmacokinetics of l-Dopa.
- Increased rate of birth defects after first trimester use of angiotensin converting enzyme inhibitors - Treatment or hypertension related? An observational cohort study. [Journal Article]
- PHPregnancy Hypertens 2018; 13:65-71
- CONCLUSIONS: Women with hypertension treated with ACEIs in early pregnancy are at higher risk for major birth defects, which may be explained by other factors associated with maternal hypertension. Women (inadvertently) exposed during early pregnancy may be reassured and treatment switched to antihypertensive drugs recommended for pregnancy.
New Search Next
- [Levodopa-carbidopa intestinal gel treatment introduced by surgical gastrostomy in a patient of Parkinson's disease after Billroth II gastrojejunostomy]. [Journal Article]
- RSRinsho Shinkeigaku 2018 Sep 28; 58(9):570-573
- A 68-year-old man, who had received Billroth II gastrojejunostomy because of duodenal ulcer at the age of 20, was diagnosed to have Parkinson's disease at age 57 years. The drug therapy has been effe...
A 68-year-old man, who had received Billroth II gastrojejunostomy because of duodenal ulcer at the age of 20, was diagnosed to have Parkinson's disease at age 57 years. The drug therapy has been effective in the first 10 years, however, recently he was suffering from troublesome dyskinesia and wearing-off in spite of diligent drug adjustments. Although the indication of levodopa-carbidopa intestinal gel (LCIG) treatment was good, percutaneous endoscopic gastrostomy was difficult because of abdominal adhesion. Therefore, we introduced LCIG by surgical gastrostomy. After LCIG therapy, wearing-off and dyskinesia disappeared. This is the first case of Parkinson's disease patient with LCIG therapy by surgical gastrostomy in Japan.