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A excreção de fármacos para o leite materno e os fatores intervenientes no processo
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Abstract(s)
A amamentação é um ato de extrema importância para o desenvolvimento e saúde
do bebé, sendo amplamente recomendada por profissionais de saúde em todo o mundo. No
entanto, uma das preocupações que surge frequentemente entre as mães que amamentam
é a possibilidade de substâncias indesejáveis, como fármacos, serem transferidas para o
leite materno e, consequentemente, ingeridas pelo bebé.
A excreção de fármacos no leite materno é um processo complexo que depende de
vários fatores. A via pela qual o fármaco é administrado é um fator determinante, assim como
a composição do leite, sendo que ambos podem influenciar a quantidade de fármaco que
passa para o leite materno. A lactante e o lactente são também determinantes na quantidade
de fármaco ingerido através do leite, uma vez que as suas caraterísticas fisiológicas e
metabólicas terão um impacto direto na quantidade de fármaco presente na corrente
sanguínea da lactante e da capacidade de metabolização do lactente. Por fim, há que
mencionar o próprio fármaco, já que dependendo da sua massa molecular, pKa, coeficiente
de partilha, biodisponibilidade oral, capacidade de ligação às proteínas plasmáticas, volume
de distribuição, tempo de semi-vida, tempo que demora a atingir o pico de concentração no
plasma materno e concentração no plasma materno, irá apresentar um perfil de passagem
para o leite materno distinto.
Neste contexto, o objetivo desta dissertação consiste em explorar em detalhe todos
estes fatores, de forma a proporcionar uma compreensão mais aprofundada sobre o
processo de passagem de um fármaco para o leite materno, o qual é complexo e culmina
numa ingestão pelo lactente.
Breastfeeding is extremely important for the baby’s development and health, and is widely recommended by health professionals around the world. However, one of the concerns that frequently arises among breastfeeding mothers is the possibility of undesirable substances, such as drugs, being transferred into breast milk and, consequently, ingested by the baby. The excretion of drugs in breast milk is a complex process that depends on several factors. The route by which the drug is administered is a determining factor, as is the composition of the milk, both of which can influence the amount of drug that passes into breast milk.Tha lactating woman and the infant are also determinants of the amount of drug ingested through milk, since their physiological and metabolic characteristics will have a direct impact on the amount of drug present in the lactating woman’s bloodstream and the infant’s metabolization capacity. Finally, it is important to mention the drug itself, as depending on its molecular mass, pKa, sharing coefficient, ,oral bioavailability, binding capacity to plasma proteins, volume of distribution, half-life, time it takes to reach peak plasma concentration maternal milk and concentration in maternal plasma, will present a different profile of passage into breast milk. In this context, the objective of this dissertation is to explore all these factors in detail, in order to provide a more in-depth understanding of the process of passage of a drug into breast milk, which is complex and culminates in ingestion by the infant.
Breastfeeding is extremely important for the baby’s development and health, and is widely recommended by health professionals around the world. However, one of the concerns that frequently arises among breastfeeding mothers is the possibility of undesirable substances, such as drugs, being transferred into breast milk and, consequently, ingested by the baby. The excretion of drugs in breast milk is a complex process that depends on several factors. The route by which the drug is administered is a determining factor, as is the composition of the milk, both of which can influence the amount of drug that passes into breast milk.Tha lactating woman and the infant are also determinants of the amount of drug ingested through milk, since their physiological and metabolic characteristics will have a direct impact on the amount of drug present in the lactating woman’s bloodstream and the infant’s metabolization capacity. Finally, it is important to mention the drug itself, as depending on its molecular mass, pKa, sharing coefficient, ,oral bioavailability, binding capacity to plasma proteins, volume of distribution, half-life, time it takes to reach peak plasma concentration maternal milk and concentration in maternal plasma, will present a different profile of passage into breast milk. In this context, the objective of this dissertation is to explore all these factors in detail, in order to provide a more in-depth understanding of the process of passage of a drug into breast milk, which is complex and culminates in ingestion by the infant.
Description
Keywords
Excreção de fármaco Fármaco Lactante Lactente Leite materno Passagem de fármaco para o leite materno