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KMID : 0869619970140010044
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Journal of Korean Society of Hospital Pharmacists
1997 Volume.14 No. 1 p.44 ~ p.47
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Change of Pharmacokinetic paramer of Lithium in Pregnancy
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Abstract
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Lithium carbonate is used to treat patients with manic and bipolar depressive. The drug requires therapeutic drug monitoring because it has narrow therapeutic window its pharmacokinetic parameters show large interpatient variation. The physiological changes which occur as a result of the pregnancy influence upon the disposition of lithium carbonate in the pregnancy women. Those changes associated with pregnancy include in bodyweight with expansion of bodywater, induction of cardiac output and volume of distribution and renal function changes with and almost doubling of renal plasma flow and an approximately increase in the glomerular filtration rate. Lithium is eliminated through renal excretion renal excretion only. It is not binding protein nor metabolized after absorption. Lithium clearance increases with the renal function changes associated with pregnancy. This case presentation reports the changes of lithium clearance with the twenty nine-year-old pregnant woman. Lithium clearance was estimated by Bayesian method with moning trough level. Lithium clearance which was 0.398㎖/min/㎏ before pregnancy rose to 0.749㎖/min/㎏ when she became pregnant and fell to 0.319㎖/min/㎏ when she had therapeutic abortion.
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