logging in or signing up Drugs in Pregnancy Lactation pattersonby Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 4880 Category: Education License: All Rights Reserved Like it (8) Dislike it (0) Added: November 11, 2008 This Presentation is Public Favorites: 6 Presentation Description No description available. Comments Posting comment... By: ethoo7 (6 month(s) ago) nice presentation. send this ppt through my email (detamojafer@yahoo.com) Saving..... Post Reply Close Saving..... Edit Comment Close By: ter3 (8 month(s) ago) please send this lec. to my mail f1h1d@windowslive.com Saving..... Post Reply Close Saving..... Edit Comment Close By: ter3 (8 month(s) ago) nice presentation Saving..... Post Reply Close Saving..... Edit Comment Close By: bassimim2003 (9 month(s) ago) Dear Dr.Brooke I would like to thank you for your distinguished presentation. Further, may I have PPT or video version. Thanks Dr.Bassim I Mohammad Iraqi Physician and clinical Pharmacologist jumabassim@yahoo.co.uk Saving..... Post Reply Close Saving..... Edit Comment Close By: Yin Moe3750 (10 month(s) ago) Please let me download your presentation. Saving..... Post Reply Close Saving..... Edit Comment Close loading.... See all Premium member Presentation Transcript Drugs in Pregnancy & Lactation: Drugs in Pregnancy and Lactation Brooke Y. Patterson, PharmD, BCPS NU 7080 Advanced Pharmacology Research College of NursingIntroduction: Introduction 4 million live births in the United States annually 50% unplanned Failure to seek pre-natal care Drug-induced teratogenicity FDA Drug Classification System Lack of clinical trial evidence Animal studies vs. human studiesPhysiology: Physiology First 2 weeks after conception Cell division Implantation in uterus 2-8 weeks after conception Embryonic period Organogenesis 8 weeks after conception to delivery Growth DevelopmentPhysiologic Changes in Pregnancy: Physiologic Changes in Pregnancy Gastrointestinal Reduced motility Increased pH Decreased serum albumin binding capacity Hepatic metabolism Renal drug clearance Placental drug transferExposure to Medication During Pregnancy: Exposure to Medication During Pregnancy Organogenesis First trimester Deformity Death Growth 2nd and 3rd trimester Growth suppression Development 3rd trimester Improper development of vital systemsFDA Drug Categories for Pregnancy: FDA Drug Categories for Pregnancy Created based on clinical data Animal vs. human Limited Controversial Comparison to other systemsFDA Drug Categories for Pregnancy: FDA Drug Categories for PregnancyCategory X Medications: Category X Medications HMG CoA Reductase Inhbitors (Statins) Cholesterol synthesis important in fetal development Oral Contraceptives Controversial Ergotamines Convulsions, vomiting, diarrhea, gangrene Ethanol Fetal Alcohol Syndrome Isotretinoin Abnormalities, spontaenous abortion Methotrexate Immune system dysfunction Raloxifene Spontaneous abortionCategory D Medications: Category D Medications ACE Inhibitors 2nd and 3rd trimester Renal defects Benzodiazepines Neonatal withdrawal, respiratory problems ASA Doses >81 mg/day Closure of the ductus arteriosus, inhibit labor Atenolol Intrauterine growth retardationCategory D Medications: Category D Medications Carbamazepine Neural tube defect, BMS(?) Divalproex Neural tube defect, facial abnormalities Doxycycline 2nd and 3rd trimester Tooth abnormalities Angiotensin Receptor Blockers 2nd and 3rd trimester Renal abnormalities Lithium Cardiovascular dysfunctionCategory D Medications: Category D Medications NSAIDs Use near term may cause peramture closure of the ductus arteriosus, inhibits labor SSRIs Congenital malformations, neonatal behavior syndrome, persistent pulmonary hypertension Phenobarbital Sedation, withdrawal, blood dyscrasias Phenytoin Fetal Hydantoin Syndrome Warfarin Facial abnormalities, fetal hemorrhageSelecting Medications in Pregnancy: Selecting Medications in Pregnancy FDA Pregnancy Category Drugs used most commonly in pregnancy Timing of medication use 1st trimester vs. 2nd or 3rd trimester Lowest effective dose Resources Briggs et al. Drugs in Pregnancy and Lactation FDALactation: LactationBreastfeeding & Maternal Medication: Breastfeeding and Maternal Medication Few drugs Medication Properties Lipophilicity Non-ionized Small molecular weight Resources Briggs et al. Drugs in Pregnancy and Lactation WHO Breastfeeding and Maternal MedicationBreastfeeding Classifications: Breastfeeding Classifications Compatible with breastfeeding No known or theoretical contraindications for use Compatible with breastfeeding. Monitor infant for side-effects. Drugs that theoretically could cause side-effects in infant, but have either not been observed to do so or have only occasionally caused mild side-effects. Avoid if possible. Monitor infant for side-effects. Has been reported to cause side effects in the infant. Avoid if possible. May inhibit lactation Avoid. Drugs that have dangerous side-effects on the infant.Breastfeeding Contraindicated: Breastfeeding Contraindicated Radioactive substances ChemotherapyAvoid Use: Avoid Use Tetracycline Metronidazole Quinolone antibioticsMonitor Baby For Sleepiness: Monitor Baby For Sleepiness Psychiatric medications AnticonvulsantsMonitor Baby for Jaundice: Monitor Baby for Jaundice Sulfonamides Dapsone TMP/SMXMay Inhibit Lactation: May Inhibit Lactation Estrogens Progesterone Thiazide diureticsSlide21: If pregnancy were a book, they would cut the last two chapters -Nora Ephron You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.
Drugs in Pregnancy Lactation pattersonby Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 4880 Category: Education License: All Rights Reserved Like it (8) Dislike it (0) Added: November 11, 2008 This Presentation is Public Favorites: 6 Presentation Description No description available. Comments Posting comment... By: ethoo7 (6 month(s) ago) nice presentation. send this ppt through my email (detamojafer@yahoo.com) Saving..... Post Reply Close Saving..... Edit Comment Close By: ter3 (8 month(s) ago) please send this lec. to my mail f1h1d@windowslive.com Saving..... Post Reply Close Saving..... Edit Comment Close By: ter3 (8 month(s) ago) nice presentation Saving..... Post Reply Close Saving..... Edit Comment Close By: bassimim2003 (9 month(s) ago) Dear Dr.Brooke I would like to thank you for your distinguished presentation. Further, may I have PPT or video version. Thanks Dr.Bassim I Mohammad Iraqi Physician and clinical Pharmacologist jumabassim@yahoo.co.uk Saving..... Post Reply Close Saving..... Edit Comment Close By: Yin Moe3750 (10 month(s) ago) Please let me download your presentation. Saving..... Post Reply Close Saving..... Edit Comment Close loading.... See all Premium member Presentation Transcript Drugs in Pregnancy & Lactation: Drugs in Pregnancy and Lactation Brooke Y. Patterson, PharmD, BCPS NU 7080 Advanced Pharmacology Research College of NursingIntroduction: Introduction 4 million live births in the United States annually 50% unplanned Failure to seek pre-natal care Drug-induced teratogenicity FDA Drug Classification System Lack of clinical trial evidence Animal studies vs. human studiesPhysiology: Physiology First 2 weeks after conception Cell division Implantation in uterus 2-8 weeks after conception Embryonic period Organogenesis 8 weeks after conception to delivery Growth DevelopmentPhysiologic Changes in Pregnancy: Physiologic Changes in Pregnancy Gastrointestinal Reduced motility Increased pH Decreased serum albumin binding capacity Hepatic metabolism Renal drug clearance Placental drug transferExposure to Medication During Pregnancy: Exposure to Medication During Pregnancy Organogenesis First trimester Deformity Death Growth 2nd and 3rd trimester Growth suppression Development 3rd trimester Improper development of vital systemsFDA Drug Categories for Pregnancy: FDA Drug Categories for Pregnancy Created based on clinical data Animal vs. human Limited Controversial Comparison to other systemsFDA Drug Categories for Pregnancy: FDA Drug Categories for PregnancyCategory X Medications: Category X Medications HMG CoA Reductase Inhbitors (Statins) Cholesterol synthesis important in fetal development Oral Contraceptives Controversial Ergotamines Convulsions, vomiting, diarrhea, gangrene Ethanol Fetal Alcohol Syndrome Isotretinoin Abnormalities, spontaenous abortion Methotrexate Immune system dysfunction Raloxifene Spontaneous abortionCategory D Medications: Category D Medications ACE Inhibitors 2nd and 3rd trimester Renal defects Benzodiazepines Neonatal withdrawal, respiratory problems ASA Doses >81 mg/day Closure of the ductus arteriosus, inhibit labor Atenolol Intrauterine growth retardationCategory D Medications: Category D Medications Carbamazepine Neural tube defect, BMS(?) Divalproex Neural tube defect, facial abnormalities Doxycycline 2nd and 3rd trimester Tooth abnormalities Angiotensin Receptor Blockers 2nd and 3rd trimester Renal abnormalities Lithium Cardiovascular dysfunctionCategory D Medications: Category D Medications NSAIDs Use near term may cause peramture closure of the ductus arteriosus, inhibits labor SSRIs Congenital malformations, neonatal behavior syndrome, persistent pulmonary hypertension Phenobarbital Sedation, withdrawal, blood dyscrasias Phenytoin Fetal Hydantoin Syndrome Warfarin Facial abnormalities, fetal hemorrhageSelecting Medications in Pregnancy: Selecting Medications in Pregnancy FDA Pregnancy Category Drugs used most commonly in pregnancy Timing of medication use 1st trimester vs. 2nd or 3rd trimester Lowest effective dose Resources Briggs et al. Drugs in Pregnancy and Lactation FDALactation: LactationBreastfeeding & Maternal Medication: Breastfeeding and Maternal Medication Few drugs Medication Properties Lipophilicity Non-ionized Small molecular weight Resources Briggs et al. Drugs in Pregnancy and Lactation WHO Breastfeeding and Maternal MedicationBreastfeeding Classifications: Breastfeeding Classifications Compatible with breastfeeding No known or theoretical contraindications for use Compatible with breastfeeding. Monitor infant for side-effects. Drugs that theoretically could cause side-effects in infant, but have either not been observed to do so or have only occasionally caused mild side-effects. Avoid if possible. Monitor infant for side-effects. Has been reported to cause side effects in the infant. Avoid if possible. May inhibit lactation Avoid. Drugs that have dangerous side-effects on the infant.Breastfeeding Contraindicated: Breastfeeding Contraindicated Radioactive substances ChemotherapyAvoid Use: Avoid Use Tetracycline Metronidazole Quinolone antibioticsMonitor Baby For Sleepiness: Monitor Baby For Sleepiness Psychiatric medications AnticonvulsantsMonitor Baby for Jaundice: Monitor Baby for Jaundice Sulfonamides Dapsone TMP/SMXMay Inhibit Lactation: May Inhibit Lactation Estrogens Progesterone Thiazide diureticsSlide21: If pregnancy were a book, they would cut the last two chapters -Nora Ephron