Pharmacokinetics and Pharmacodynamics of Atenolol During Pregnancy and Postpartum
Preexisting hypertension complicates 5% of all pregnancies. The objective of this study was to evaluate steady‐state atenolol pharmacokinetics and pharmacodynamics (n = 17) during the second trimester (2nd T), third trimester (3rd T), and 3 months postpartum. Pregnancy as compared to 3 months postpa...
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| Veröffentlicht in: | Journal of clinical pharmacology 2005-01, Vol.45 (1), p.25-33 |
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| container_title | Journal of clinical pharmacology |
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| creator | Hebert, Mary F. Carr, Darcy B. Anderson, Gail D. Blough, David Green, Grace E. Brateng, Debra A. Kantor, Eric Benedetti, Thomas J. Easterling, Thomas R. |
| description | Preexisting hypertension complicates 5% of all pregnancies. The objective of this study was to evaluate steady‐state atenolol pharmacokinetics and pharmacodynamics (n = 17) during the second trimester (2nd T), third trimester (3rd T), and 3 months postpartum. Pregnancy as compared to 3 months postpartum (nonpregnant control) resulted in significant (P < .05) changes, including the following: 42% (2nd T) and 50% (3rd T) increase in creatinine clearance, 38% (2nd T) and 36% (3rd T) increase in atenolol renal clearance, 12% (2nd T) and 11% (3rd T) decrease in atenolol half‐life, 20% (2nd T) and 28% (3rd T) increase in cardiac output, 15% (2nd T) and 23% (3rd T) increase in resting heart rate, and 22% (2nd T) and 21% (3rd T) decrease in total peripheral resistance in subjects on steady‐state oral atenolol for treatment of hypertension in pregnancy. In conclusion, the renal clearance of atenolol along with creatinine clearance is increased during pregnancy. However, this does not translate into an increase in apparent oral clearance of atenolol, possibly related to the high variability in bioavailability. Atenolol administration did not appear to change the pattern of the increase in cardiac output and the decrease in total peripheral resistance, which normally occurs during pregnancy. |
| doi_str_mv | 10.1177/0091270004269704 |
| format | Article |
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The objective of this study was to evaluate steady‐state atenolol pharmacokinetics and pharmacodynamics (n = 17) during the second trimester (2nd T), third trimester (3rd T), and 3 months postpartum. Pregnancy as compared to 3 months postpartum (nonpregnant control) resulted in significant (P < .05) changes, including the following: 42% (2nd T) and 50% (3rd T) increase in creatinine clearance, 38% (2nd T) and 36% (3rd T) increase in atenolol renal clearance, 12% (2nd T) and 11% (3rd T) decrease in atenolol half‐life, 20% (2nd T) and 28% (3rd T) increase in cardiac output, 15% (2nd T) and 23% (3rd T) increase in resting heart rate, and 22% (2nd T) and 21% (3rd T) decrease in total peripheral resistance in subjects on steady‐state oral atenolol for treatment of hypertension in pregnancy. In conclusion, the renal clearance of atenolol along with creatinine clearance is increased during pregnancy. However, this does not translate into an increase in apparent oral clearance of atenolol, possibly related to the high variability in bioavailability. Atenolol administration did not appear to change the pattern of the increase in cardiac output and the decrease in total peripheral resistance, which normally occurs during pregnancy.</description><identifier>ISSN: 0091-2700</identifier><identifier>EISSN: 1552-4604</identifier><identifier>DOI: 10.1177/0091270004269704</identifier><identifier>PMID: 15601802</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Adult ; Atenolol ; Atenolol - blood ; Atenolol - pharmacokinetics ; Atenolol - pharmacology ; Creatinine - urine ; Drug therapy ; Female ; Humans ; Hypertension ; Hypertension in pregnancy ; Hypertension, Pregnancy-Induced - blood ; Hypertension, Pregnancy-Induced - drug therapy ; Milk, Human - drug effects ; Milk, Human - metabolism ; pharmacodynamics ; Pharmacokinetics ; postpartum ; Postpartum Period - blood ; Postpartum Period - drug effects ; Pregnancy ; Pregnancy Trimester, Second - blood ; Pregnancy Trimester, Second - drug effects ; Pregnancy Trimester, Third - blood ; Pregnancy Trimester, Third - drug effects</subject><ispartof>Journal of clinical pharmacology, 2005-01, Vol.45 (1), p.25-33</ispartof><rights>2005 American College of Clinical Pharmacology</rights><rights>2005 SAGE Publications</rights><rights>COPYRIGHT 2005 Sage Publications, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4662-557c168a37d3e9e55793757bfab91abf255cf8289eef0dc1a3ebb1795d51d763</citedby><cites>FETCH-LOGICAL-c4662-557c168a37d3e9e55793757bfab91abf255cf8289eef0dc1a3ebb1795d51d763</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1177%2F0091270004269704$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1177%2F0091270004269704$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15601802$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hebert, Mary F.</creatorcontrib><creatorcontrib>Carr, Darcy B.</creatorcontrib><creatorcontrib>Anderson, Gail D.</creatorcontrib><creatorcontrib>Blough, David</creatorcontrib><creatorcontrib>Green, Grace E.</creatorcontrib><creatorcontrib>Brateng, Debra A.</creatorcontrib><creatorcontrib>Kantor, Eric</creatorcontrib><creatorcontrib>Benedetti, Thomas J.</creatorcontrib><creatorcontrib>Easterling, Thomas R.</creatorcontrib><title>Pharmacokinetics and Pharmacodynamics of Atenolol During Pregnancy and Postpartum</title><title>Journal of clinical pharmacology</title><addtitle>J Clin Pharmacol</addtitle><description>Preexisting hypertension complicates 5% of all pregnancies. The objective of this study was to evaluate steady‐state atenolol pharmacokinetics and pharmacodynamics (n = 17) during the second trimester (2nd T), third trimester (3rd T), and 3 months postpartum. Pregnancy as compared to 3 months postpartum (nonpregnant control) resulted in significant (P < .05) changes, including the following: 42% (2nd T) and 50% (3rd T) increase in creatinine clearance, 38% (2nd T) and 36% (3rd T) increase in atenolol renal clearance, 12% (2nd T) and 11% (3rd T) decrease in atenolol half‐life, 20% (2nd T) and 28% (3rd T) increase in cardiac output, 15% (2nd T) and 23% (3rd T) increase in resting heart rate, and 22% (2nd T) and 21% (3rd T) decrease in total peripheral resistance in subjects on steady‐state oral atenolol for treatment of hypertension in pregnancy. In conclusion, the renal clearance of atenolol along with creatinine clearance is increased during pregnancy. However, this does not translate into an increase in apparent oral clearance of atenolol, possibly related to the high variability in bioavailability. Atenolol administration did not appear to change the pattern of the increase in cardiac output and the decrease in total peripheral resistance, which normally occurs during pregnancy.</description><subject>Adult</subject><subject>Atenolol</subject><subject>Atenolol - blood</subject><subject>Atenolol - pharmacokinetics</subject><subject>Atenolol - pharmacology</subject><subject>Creatinine - urine</subject><subject>Drug therapy</subject><subject>Female</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension in pregnancy</subject><subject>Hypertension, Pregnancy-Induced - blood</subject><subject>Hypertension, Pregnancy-Induced - drug therapy</subject><subject>Milk, Human - drug effects</subject><subject>Milk, Human - metabolism</subject><subject>pharmacodynamics</subject><subject>Pharmacokinetics</subject><subject>postpartum</subject><subject>Postpartum Period - blood</subject><subject>Postpartum Period - drug effects</subject><subject>Pregnancy</subject><subject>Pregnancy Trimester, Second - blood</subject><subject>Pregnancy Trimester, Second - drug effects</subject><subject>Pregnancy Trimester, Third - blood</subject><subject>Pregnancy Trimester, Third - drug effects</subject><issn>0091-2700</issn><issn>1552-4604</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkEuP0zAUhS0EYsrAnhXqil0GX8ePZFkVmAcjKFIl2FmOc9OGJnbHTjT03-MoBSQ2yAvL557v6vgQ8hroFYBS7ygtgSlKKWeyVJQ_IQsQgmVcUv6ULKZxNs0vyIsYf1AKkgt4Ti5ASAoFZQvydbM3oTfWH1qHQ2vj0rh6-VusT870k-ib5WpA5zvfLd-PoXW75SbgzhlnTzPh43A0YRj7l-RZY7qIr873Jdl-_LBd32T3X65v16v7zHIpWSaEsiALk6s6xxLTs8yVUFVjqhJM1TAhbFOwokRsaG3B5FhVoEpRC6iVzC_J23ntMfiHEeOg-zZa7Drj0I9RS5UzkQpIxqvZuDMd6tY1fgjGplNj-pp32LRJXwGnquRFDgmgM2CDjzFgo4-h7U04aaB6ql3_W3tC3pzDjFWP9V_g3HMy8Nnw6LsBQzx04yMGvUfTDfu0L61K-zJGqaCQXtkkTZg8Yynj6b859N16cwMpTwKzGWzjgD__gCYcpmKU0N8-X2v1iYH8zpXe5r8AJMWqfQ</recordid><startdate>200501</startdate><enddate>200501</enddate><creator>Hebert, Mary F.</creator><creator>Carr, Darcy B.</creator><creator>Anderson, Gail D.</creator><creator>Blough, David</creator><creator>Green, Grace E.</creator><creator>Brateng, Debra A.</creator><creator>Kantor, Eric</creator><creator>Benedetti, Thomas J.</creator><creator>Easterling, Thomas R.</creator><general>Blackwell Publishing Ltd</general><general>SAGE Publications</general><general>Sage Publications, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200501</creationdate><title>Pharmacokinetics and Pharmacodynamics of Atenolol During Pregnancy and Postpartum</title><author>Hebert, Mary F. ; Carr, Darcy B. ; Anderson, Gail D. ; Blough, David ; Green, Grace E. ; Brateng, Debra A. ; Kantor, Eric ; Benedetti, Thomas J. ; Easterling, Thomas R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4662-557c168a37d3e9e55793757bfab91abf255cf8289eef0dc1a3ebb1795d51d763</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adult</topic><topic>Atenolol</topic><topic>Atenolol - blood</topic><topic>Atenolol - pharmacokinetics</topic><topic>Atenolol - pharmacology</topic><topic>Creatinine - urine</topic><topic>Drug therapy</topic><topic>Female</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypertension in pregnancy</topic><topic>Hypertension, Pregnancy-Induced - blood</topic><topic>Hypertension, Pregnancy-Induced - drug therapy</topic><topic>Milk, Human - drug effects</topic><topic>Milk, Human - metabolism</topic><topic>pharmacodynamics</topic><topic>Pharmacokinetics</topic><topic>postpartum</topic><topic>Postpartum Period - blood</topic><topic>Postpartum Period - drug effects</topic><topic>Pregnancy</topic><topic>Pregnancy Trimester, Second - blood</topic><topic>Pregnancy Trimester, Second - drug effects</topic><topic>Pregnancy Trimester, Third - blood</topic><topic>Pregnancy Trimester, Third - drug effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hebert, Mary F.</creatorcontrib><creatorcontrib>Carr, Darcy B.</creatorcontrib><creatorcontrib>Anderson, Gail D.</creatorcontrib><creatorcontrib>Blough, David</creatorcontrib><creatorcontrib>Green, Grace E.</creatorcontrib><creatorcontrib>Brateng, Debra A.</creatorcontrib><creatorcontrib>Kantor, Eric</creatorcontrib><creatorcontrib>Benedetti, Thomas J.</creatorcontrib><creatorcontrib>Easterling, Thomas R.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of clinical pharmacology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hebert, Mary F.</au><au>Carr, Darcy B.</au><au>Anderson, Gail D.</au><au>Blough, David</au><au>Green, Grace E.</au><au>Brateng, Debra A.</au><au>Kantor, Eric</au><au>Benedetti, Thomas J.</au><au>Easterling, Thomas R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pharmacokinetics and Pharmacodynamics of Atenolol During Pregnancy and Postpartum</atitle><jtitle>Journal of clinical pharmacology</jtitle><addtitle>J Clin Pharmacol</addtitle><date>2005-01</date><risdate>2005</risdate><volume>45</volume><issue>1</issue><spage>25</spage><epage>33</epage><pages>25-33</pages><issn>0091-2700</issn><eissn>1552-4604</eissn><abstract>Preexisting hypertension complicates 5% of all pregnancies. The objective of this study was to evaluate steady‐state atenolol pharmacokinetics and pharmacodynamics (n = 17) during the second trimester (2nd T), third trimester (3rd T), and 3 months postpartum. Pregnancy as compared to 3 months postpartum (nonpregnant control) resulted in significant (P < .05) changes, including the following: 42% (2nd T) and 50% (3rd T) increase in creatinine clearance, 38% (2nd T) and 36% (3rd T) increase in atenolol renal clearance, 12% (2nd T) and 11% (3rd T) decrease in atenolol half‐life, 20% (2nd T) and 28% (3rd T) increase in cardiac output, 15% (2nd T) and 23% (3rd T) increase in resting heart rate, and 22% (2nd T) and 21% (3rd T) decrease in total peripheral resistance in subjects on steady‐state oral atenolol for treatment of hypertension in pregnancy. In conclusion, the renal clearance of atenolol along with creatinine clearance is increased during pregnancy. However, this does not translate into an increase in apparent oral clearance of atenolol, possibly related to the high variability in bioavailability. Atenolol administration did not appear to change the pattern of the increase in cardiac output and the decrease in total peripheral resistance, which normally occurs during pregnancy.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>15601802</pmid><doi>10.1177/0091270004269704</doi><tpages>9</tpages></addata></record> |
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| subjects | Adult Atenolol Atenolol - blood Atenolol - pharmacokinetics Atenolol - pharmacology Creatinine - urine Drug therapy Female Humans Hypertension Hypertension in pregnancy Hypertension, Pregnancy-Induced - blood Hypertension, Pregnancy-Induced - drug therapy Milk, Human - drug effects Milk, Human - metabolism pharmacodynamics Pharmacokinetics postpartum Postpartum Period - blood Postpartum Period - drug effects Pregnancy Pregnancy Trimester, Second - blood Pregnancy Trimester, Second - drug effects Pregnancy Trimester, Third - blood Pregnancy Trimester, Third - drug effects |
| title | Pharmacokinetics and Pharmacodynamics of Atenolol During Pregnancy and Postpartum |
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