Cardiovascular Drugs in Pregnancy and Lactation

The pharmacological profiles of cardiovascular drugs and the potential adverse events associated with their use are well described in adult populations, including in non-pregnant women, and most physicians are comfortable with prescribing these agents to their non-pregnant adult patients.  However, drug response and toxicity may be altered by the physiological changes that accompany normal pregnancy and most physicians are likely unaware of the potential risks of cardiovascular medications to the pregnant woman.  There is generally less experience, if any, with the use of many of these drugs in pediatric populations, and the risks of cardiovascular medications to the developing fetus, neonate or lactating infant are even less well known.  This chapter provides practicing physicians with an accessible reference to the current knowledge relating to the pharmacology, indications, and potential risks during pregnancy and lactation of currently-available antiarrhythmic drugs, beta-blocking agents and calcium channel antagonists, based on a comprehensive review of the published literature.