Drugs Avoided during Pregnancy
Some medicines can harm a developing baby or beget a confinement or birth. Occasionally, not taking a certain drug can beget further problems for you or your baby than if you do take them. Generally, you shouldn’t take any OTC drug while pregnant unless it’s necessary. Gestation is a special physiological condition where medicine treatment presents a special concern because the physiology of gestation affects the pharmacokinetics of specifics used and certain specifics can reach the fetus and beget detriment. Total avoidance of pharmacological treatment in gestation isn’t possible and may be dangerous because some women enter gestation with medical conditions that bear ongoing and episodic treatment (e.g. asthma, epilepsy, and hypertension). Also during gestation new medical problems can develop and old bones can be aggravated (e.g. migraine, headache) taking pharmacological remedy. The fact that certain medicines given during gestation may prove dangerous to the future child is one of the classical problems in medical treatment.
Introduction
The use of drug in gestation is the norm — not the exception. According to a French study, medicines are specified to 90 of all pregnant women [1]. For utmost Retinoids, systemic (acitretin, etretinate, isotretinoin, tretinoin) Ear, CNS, heart, skeleton Thalidomide Extremities, multiple malformations Mycophenolate Ear, palate suggestions, sufficiently proven specifics are available. Detailed information about the tolerability and safety of specifics in gestation or in persons asking to have children can be set up in handbooks [2], online databases [3, 4].
| Valproic acid | Neural tube defect (lumbar spina bifida), heart, palate, urogenital system, extremities, dysmorphic facial features |
|---|---|
| Androgens | Masculinization |
| Carbamazepine | Neural tube defect, heart, palate, urogenital system, extremities, dysmorphic facial features |
| Coumarin derivatives (phenprocoumon, warfarin) | Nose, extremities |
| Cyclophosphamide | Multiple malformations |
| Methotrexate*2 | Multiple malformations |
| Misoprostol (for attempted induction of abortion) | Moebius sequence, extremities |
| Penicillamine | Cutis laxa |
| Phenobarbital/primidone (anticonvulsant treatment) | Heart, palate, urogenital system, extremities, dysmorphic facial features |
| Phenytoin | Heart, palate, urogenital system, extremities, dysmorphic facial features |
| Topiramate | Palate |
| Aminoglycosides (systemic) | Inner ear and kidneys |
| Amiodarone | Hypothyroidism |
| Androgens | Masculinization |
| AT1-receptor blockers | Kidneys, oligohydramnios, anuria, joint contractures, hypoplasia of the skull |
| Azathioprine | Bone marrow depression |
| Coumarin derivatives (phenprocoumon, warfarin) | Intracerebral hemorrhage |
| Ergotamines (in contraction-ready uterus) | Fetal hypoxia |
| Radioiodine (in therapeutic dose) | Thyroid hypoplasia/aplasia |
| Tetracyclines (after 15 weeks’ gestation) | Yellow discoloration of teeth |
| Antithyroid drugs | Hypothyroidism |
| Cytostatics (general) | Growth retardation, bone marrow depression |
Table 1: The most important medications with proven teratogenic potential when used in the first trimester of pregnancy.
Conclusion
Specifics respectable for use in gestation (and while breastfeeding) are available for nearly all suggestions. drug should be named grounded on information in the good literature [2, 3, 4, 5, 6, 7, 8, 9] or after discussion of applicable centers( for illustration Embryotox)-in case of habitual complaint or intermittent symptoms taking treatment, these specifics should best be introduced before a gestation is established. Women of travail eventuality should primarily be treated with gestation-compatible specifics. New or rightly studied specifics are only respectable if the treatments of first choice aren’t effective enough or not permitted. It’s obligatory not to use substances with proven experimental- poisonous effect. also again, the input of a drug contraindicated in gestation doesn’t inescapably represent a high- threat situation. The fact that such an exposure has passed is by no means a valid reason to terminate the gestation. The comforting- associated attestation of the course of exposed gravidity by Embryotox enables high- quality experimental data to further clarify drug safety.
References
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Berard A, Abbas-Chorfa F, Kassai B, Vial T, Nguyen KA, et al. (2019) The French Pregnancy Cohort: Medication use during pregnancy in the French population. PloS One 14(7): e0219095.
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Schaefer C, Peters P, Miller RK (2015) Drugs during pregnancy and lactation 3rd (edn.).Elsevier/Academic Press; New York.
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Mother to baby (2019) Medications & more during pregnancy & breastfeeding. Ask the experts. In: Fact Sheets. Organization of Teratology Information Specialists (OTIS), Brentwood, Tennessee.
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Reprotox (2019) Welcome to Reprotox.
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(2019) Pharmakovigilanz- und Beratungszentrum für Embryonaltoxikologie.
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Rohde A, Dorsch V, Schaefer C. Thieme 4, Stuttgart (2016) Psychopharmakotherapie in Schwangerschaft und Stillzeit.
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Erickson NL, Hancock GR, Oberlander TF, Brain U, Grunau RE, et al. (2019) Prenatal SSRI antidepressant use and maternal internalizing symptoms during pregnancy and postpartum: exploring effects on infant temperament trajectories for boys and girls. J Affect Disord 258: 179- 194.
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Bethesda (2019) drugs and lactation database (LactMed®). U.S. National Library of Medicine.
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(2011) Medicines during pregnancy and breastfeeding. In: Schaefer C, Spielmann H, Vetter K, Weber-Schöndorfer C(Eds.),Elsevier, Urban & Fischer, 8th (Edn.).
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Briggs GG, Freeman RK, Towers CV, Forinash AB (2017) Drugs in pregnancy and lactation. Wolters Kluwer. 11. Philadelphia.
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