Drug interactions at the human placenta: what is the evidence?
Pregnant women (and their fetuses) are treated with a significant number of prescription and nonprescription medications. Interactions among those drugs may affect their efficacy and toxicity in both mother and fetus. Whereas interactions that result in altered drug concentrations in maternal plasma...
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Format: | Article |
Language: | English |
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Frontiers Media S.A.
2012-07-01
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Series: | Frontiers in Pharmacology |
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Online Access: | http://journal.frontiersin.org/Journal/10.3389/fphar.2012.00126/full |
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author | Miriam eRubinchik-Stern Sara eEyal |
author_facet | Miriam eRubinchik-Stern Sara eEyal |
author_sort | Miriam eRubinchik-Stern |
collection | DOAJ |
description | Pregnant women (and their fetuses) are treated with a significant number of prescription and nonprescription medications. Interactions among those drugs may affect their efficacy and toxicity in both mother and fetus. Whereas interactions that result in altered drug concentrations in maternal plasma are detectable, those involving modulation of placental transfer mechanisms are rarely reflected by altered drug concentrations in maternal plasma. Therefore, they are often overlooked. Placental-mediated interactions are possible because the placenta is not only a passive diffusional barrier, but also expresses a variety of influx and efflux transporters and drug metabolizing enzymes. Current data on placental-mediated drug interactions are limited. In rodents, pharmacological or genetic manipulations of placental transporters significantly affect fetal drug exposure. In contrast, studies in human placentae suggest that the magnitude of such interactions is modest in most cases. Nevertheless, under certain circumstances, such interactions may be of clinical significance. This review describes currently known mechanisms of placental-mediated drug interactions and the potential implications of such interactions in humans. Better understanding of those mechanisms is important for minimizing fetal toxicity from drugs while improving their efficacy when directed to treat the fetus. |
first_indexed | 2024-12-21T01:38:27Z |
format | Article |
id | doaj.art-6a30724217f64528ac61974d1e13f7b4 |
institution | Directory Open Access Journal |
issn | 1663-9812 |
language | English |
last_indexed | 2024-12-21T01:38:27Z |
publishDate | 2012-07-01 |
publisher | Frontiers Media S.A. |
record_format | Article |
series | Frontiers in Pharmacology |
spelling | doaj.art-6a30724217f64528ac61974d1e13f7b42022-12-21T19:20:12ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122012-07-01310.3389/fphar.2012.0012627396Drug interactions at the human placenta: what is the evidence?Miriam eRubinchik-Stern0Sara eEyal1Hebrew University of JerusalemHebrew University of JerusalemPregnant women (and their fetuses) are treated with a significant number of prescription and nonprescription medications. Interactions among those drugs may affect their efficacy and toxicity in both mother and fetus. Whereas interactions that result in altered drug concentrations in maternal plasma are detectable, those involving modulation of placental transfer mechanisms are rarely reflected by altered drug concentrations in maternal plasma. Therefore, they are often overlooked. Placental-mediated interactions are possible because the placenta is not only a passive diffusional barrier, but also expresses a variety of influx and efflux transporters and drug metabolizing enzymes. Current data on placental-mediated drug interactions are limited. In rodents, pharmacological or genetic manipulations of placental transporters significantly affect fetal drug exposure. In contrast, studies in human placentae suggest that the magnitude of such interactions is modest in most cases. Nevertheless, under certain circumstances, such interactions may be of clinical significance. This review describes currently known mechanisms of placental-mediated drug interactions and the potential implications of such interactions in humans. Better understanding of those mechanisms is important for minimizing fetal toxicity from drugs while improving their efficacy when directed to treat the fetus.http://journal.frontiersin.org/Journal/10.3389/fphar.2012.00126/fullDrug InteractionsP-GlycoproteinPlacentaPregnancyBreast cancer resistance proteinMaternal-fetal pharmacology |
spellingShingle | Miriam eRubinchik-Stern Sara eEyal Drug interactions at the human placenta: what is the evidence? Frontiers in Pharmacology Drug Interactions P-Glycoprotein Placenta Pregnancy Breast cancer resistance protein Maternal-fetal pharmacology |
title | Drug interactions at the human placenta: what is the evidence? |
title_full | Drug interactions at the human placenta: what is the evidence? |
title_fullStr | Drug interactions at the human placenta: what is the evidence? |
title_full_unstemmed | Drug interactions at the human placenta: what is the evidence? |
title_short | Drug interactions at the human placenta: what is the evidence? |
title_sort | drug interactions at the human placenta what is the evidence |
topic | Drug Interactions P-Glycoprotein Placenta Pregnancy Breast cancer resistance protein Maternal-fetal pharmacology |
url | http://journal.frontiersin.org/Journal/10.3389/fphar.2012.00126/full |
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