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Drug Use in Pregnancy and Lactation
Drug Use in Pregnancy and Lactation
Drug Use in Pregnancy and Lactation
Changing in pharmacokinetics
and pharmacodynamics
Plasma concentration
Fetus
Types of teratogenesis
Death => abortion
Malformation / anomalies
Changing in behavior
Retardation
Examples
Anticonvulsants: fetal hydantoin syndrome
Anticoagulants: warfarin syndrome
Alcohol: fetal alcohol syndrome
Antithyroid drugs: ablatio thyroid
Mefenamic acid: embryotoxic
Aminoglycosides: N. VIII, ototoxic, nephrotoxic
DES: late abnormality
The factors contribute to
congenital anomalies
Teratogenic potency of drugs and other
disadvantages
Drug dosage and the ability to cross the
placenta
The stadium of pregnancy
General condition of the mother.
Classification of drugs used in pregnancy
(Australian Drug Evaluation Commeetee)
Pregnant women and reproductive women use
drugs - no increase malformation - directly or
indirectly.
Used by pregnant women - no increase - directly
or indirectly.
Pharmacologically the drugs may cause problems
in fetus, without malformation - reversible.
Drugs result in malformation - irreversible.
Drugs exactly have high risk and cause
irreversible malformation.
Drugs often used during pregnancy
Analgesic-antipyretics Tuberculostatics
Antibiotics Anti thyroid drugs
Anti emetic- Hypnotic-sedatives-
antihistaminic psychotropics
Anti hypertensives Corticosteroidal drugs
Anti malarial drugs Drugs used in asthma.
Antidiabetics
General principles of drug used in pregnancy
Absolute reasons
Correct benefits
Appropiate drugs
Contribute the changes in pharmacodynamics and
pharmacokinetics in pregnant women to dosage, route
of administration and duration.
Avoid the combination of drugs
Do not take self medication
Effect on the fetus are not always as same as on the
mother
Some drugs cause late abnormal effect.
Giving drugs during pregnancy must
be considered to these factors:
Stadium of pregnancy
General condition and complicated disease
The potency of teratogenecity
Monitoring during longterm therapy
DRUG USE DURING
LACTATION
WIWIK RAHAYU
Depart. of Pharmacology & Therapy
Medical Faculty Riau University
Most drugs administered to lactating women
are detectable in breast milk