May 27, 2020
It has been estimated that up to 80 percent of pregnant women take at least one medication during pregnancy.
The problem with that, according to Craig Lee, associate professor in the Division of Pharmacotherapy and Experimental Therapeutics at the UNC Eshelman School of Pharmacy, is that most medications prescribed during pregnancy lack dosing information specific to that vulnerable population. This often results in off-label prescribing, trial-and-error drug dosing, therapeutic failures, and toxic effects.
Lee, along with a team of researchers from across the UNC-Chapel Hill health science campus, are teaming up to find out how pregnancy hormones affect the elimination of medications from the body. The National Institutes of Health is supporting them with a $1.6 million grant over the course of four years to investigate “Mechanisms of Altered Hepatic Drug Metabolism and Transport in Pregnancy.” The NIH grant was facilitated by an Eshelman Institute for Innovation pilot grant.
“More precise dosing recommendations are lacking in large part because the key factors that alter how medications are eliminated by the liver in pregnant women are poorly understood,” said Kim Brouwer, investigator on the project and associate dean for research and graduate education at the School.
Completion of this research project will provide fundamental new information on how pregnancy alters drug elimination from the liver and to what extent pregnancy hormones change the hepatic metabolism and transport of medications commonly prescribed during pregnancy.
Lee said there is an urgent need to predict maternal changes more precisely in medication elimination, optimize medication dosing, reduce inter-patient variability in medication response, and improve patient outcomes.
“Ultimately, we want to improve medication dosing, safety and effectiveness in obstetric patients,” Lee said.
Investigators and collaborators on the project include: Craig Lee, PharmD, PhD (Principal Investigator, School of Pharmacy, DPET), Jacqueline Bezençon, PhD (School of Pharmacy, DPET), Philip Smith, PhD (School of Pharmacy, DPMP), Kim Boggess, MD (School of Medicine), Paul Watkins, MD (School of Pharmacy, DPET), Kim Brouwer, PharmD, PhD (School of Pharmacy, DPET), Angela Kashuba, PharmD (School of Pharmacy, DPET), and Kun Lu, PhD (School of Public Health).