dc.date.accessioned | 2018-07-18T12:54:09Z | |
dc.date.available | 2018-07-18T12:54:09Z | |
dc.date.created | 2017-06-14T11:12:44Z | |
dc.date.issued | 2017 | |
dc.identifier.citation | Westin, Andreas Brekke, Malin Molden, Espen Skogvoll, Eirik Aadal, Marianne Spigset, Olav . Changes in drug disposition of lithium during pregnancy: A retrospective observational study of patient data from two routine therapeutic drug monitoring services in Norway. BMJ Open. 2017, 7(3) | |
dc.identifier.uri | http://hdl.handle.net/10852/62319 | |
dc.description.abstract | Objectives: Pregnancy may cause changes in drug disposition, dose requirements and clinical response. For lithium, changes in disposition during pregnancy have so far been explored in a single-dose study on 4 participants only. The aim of this study was to determine the effect of pregnancy on serum levels of lithium in a larger patient material in a naturalistic setting.
Design: A retrospective observational study of patient data from 2 routine therapeutic drug monitoring services in Norway, linked to the Medical Birth Registry of Norway.
Setting: Norway, October 1999 to December 2011.
Measurements: Dose-adjusted drug concentrations of lithium during pregnancy were compared with the women's own baseline (non-pregnant) values, using a linear mixed model.
Results: Overall, coupling 196 726 serum concentration measurements from 54 393 women to the national birth registry identified 25 serum lithium concentration analyses obtained from a total of 14 pregnancies in 13 women, and 63 baseline analyses from the same women. Dose-adjusted serum concentrations in the third trimester were significantly lower than baseline (−34%; CI −44% to −23%, p<0.001).
Conclusions: Pregnancy causes a clinically relevant decline in maternal lithium serum concentrations. In order to maintain stable lithium concentrations during the third trimester of pregnancy, doses generally need to be increased by 50%. Individual variability in decline implies that lithium levels should be even more closely monitored throughout pregnancy and in the puerperium than in non-pregnant women to ensure adequate dosing. | en_US |
dc.language | EN | |
dc.publisher | BMJ Publishing Group | |
dc.rights | Attribution-NonCommercial 4.0 International | |
dc.rights.uri | https://creativecommons.org/licenses/by-nc/4.0/ | |
dc.title | Changes in drug disposition of lithium during pregnancy: A retrospective observational study of patient data from two routine therapeutic drug monitoring services in Norway | en_US |
dc.type | Journal article | en_US |
dc.creator.author | Westin, Andreas | |
dc.creator.author | Brekke, Malin | |
dc.creator.author | Molden, Espen | |
dc.creator.author | Skogvoll, Eirik | |
dc.creator.author | Aadal, Marianne | |
dc.creator.author | Spigset, Olav | |
cristin.unitcode | 185,15,23,20 | |
cristin.unitname | Farmasøytisk kjemi | |
cristin.ispublished | true | |
cristin.fulltext | original | |
cristin.qualitycode | 1 | |
dc.identifier.cristin | 1475976 | |
dc.identifier.bibliographiccitation | info:ofi/fmt:kev:mtx:ctx&ctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=BMJ Open&rft.volume=7&rft.spage=&rft.date=2017 | |
dc.identifier.jtitle | BMJ Open | |
dc.identifier.volume | 7 | |
dc.identifier.issue | 3 | |
dc.identifier.doi | http://dx.doi.org/10.1136/bmjopen-2016-015738 | |
dc.identifier.urn | URN:NBN:no-64912 | |
dc.type.document | Tidsskriftartikkel | en_US |
dc.type.peerreviewed | Peer reviewed | |
dc.source.issn | 2044-6055 | |
dc.identifier.fulltext | Fulltext https://www.duo.uio.no/bitstream/handle/10852/62319/2/A%2B194.%2BLitium%2Bog%2BPK%2Bhos%2Bgravide.pdf | |
dc.type.version | PublishedVersion | |