Pharmacists are playing an increasingly crucial role in addressing maternal and neonatal emergencies, according to insights shared by Morgan King, PharmD, BCPPS, a clinical pharmacy specialist at Cleveland Clinic Health System. In a recent interview with Pharmacy Times, King discussed the leading causes of preventable maternal and neonatal mortality and emphasized the importance of pharmacists in bridging gaps in care.
King highlighted that the primary causes of preventable maternal mortality include conditions such as preeclampsia, eclampsia, postpartum hemorrhage, and sepsis. In neonates, prematurity often contributes significantly to mortality rates. King pointed out that many neonatal emergencies are respiratory in nature, necessitating effective respiratory support.
Understanding Physiological Changes and Drug Responses
Pregnancy induces a series of physiological changes that affect drug pharmacokinetics and pharmacodynamics, particularly during emergencies. King explained that alterations such as increased plasma volume lead to an expanded volume of distribution for medications. Hormonal changes can also impact drug absorption and metabolism, while varying levels of cytochrome P450 (CYP) enzymes fluctuate throughout pregnancy.
These factors mean that pregnant individuals often require higher doses of medications as they progress through their pregnancy. For instance, if a patient is septic and requires vasopressors, it is critical to manage the risk of uterine constriction, which could impair blood supply to the fetus. King emphasized, “Having a general idea of what these changes are allows you to provide optimal drug therapy.”
Strategies for Pharmacists in Emergency Situations
When managing emergencies such as preeclampsia, eclampsia, or sepsis, pharmacists must prioritize specific strategies. King noted that treatment protocols for emergencies often overlap with those used for non-pregnant patients, but there are important considerations. For instance, preferred medications for hypertensive emergencies in pregnant patients include IV labetalol and IV hydralazine.
Pharmacists who understand these preferred treatment options are better equipped to respond effectively when a pregnant patient presents in the emergency room. King remarked on the importance of this knowledge, stating that familiarity with these guidelines can significantly enhance patient care during critical moments.
The insights shared by King illuminate the vital role pharmacists play in maternal and neonatal health. As healthcare continues to evolve, their expertise in medication management can lead to improved outcomes for both mothers and infants in emergency situations.
