Author: Guan Yanping, Sun Yixian Memorial Hospital of Sun Yat -sen University
Review: Chen Chuxiong, Sun Yixian Memorial Hospital of Sun Yat -sen University
"Doctor, if I don’t know if I don’t know 30 days pregnant, will I take a cold medicine, will the child affect it?"
"Doctor, I was allergic some time ago. After eating for two weeks, I was fixed, and I found that I was pregnant. Will I have an impact on the fetus? I am 40 years old this year.
"Doctor, I am inflamed in my tonsils, what kind of medicine should I take?"
Nympho
It seems simple to take medicine and take medicine, but it has become a big problem for pregnant women. Especially taking medicines in the case of unknown pregnancy, it is also great for the psychological burden brought by novice pregnant mothers.
Don’t worry, get dry goods first!
1. Does taking drugs during pregnancy affect your baby?
New pregnant mothers need to pay attention!Taking drugs during different periods of pregnancy may have different degrees of impact on the fetus.It mainly includes the following three periods [1-2]::
1. Early cell proliferation: before fertilization to the third week of pregnancy; the medication before fertilization has no effect. If the fertilized egg is affected by the medicine within two weeks after fertilization, it may be eliminated naturally, and the output of labor is a safe period.
2. Organization period: 3rd to the third month of pregnancy; this stage cannot be ignored. If expectant mothers need to seek medical treatment in time if there is a physical discomfort, they cannot take medicine without permission.Throughout the stage, the fetal organs are gradually formed, the cells are accelerated and split, and they are easily affected by factors such as drugs. In order to avoid the occurrence of deformities in external force stimulation, medication care is needed during this period.
3. Period formation period: 3 months of pregnancy to full month, the final stage of fetal development; the fetus is basically mature. Except for the central nervous system or reproductive system, other organs generally do not teratogenic.However, the intensity and duration of the function of teratogenic factors can also affect the physiological function and development of the fetus.
Therefore, the new pregnant mother should inform the doctor in detail the time of the last menstrual period (cycle) and so on.
2. Under the circumstances during pregnancy?
1. The medication must be clearly indicated, avoid abuse, and avoid excessive panic and illness.
2. Users that are available or useless should be used as little as possible.
3. Pay attention to the gestational week for medication, strictly grasp the dose and duration.Adhere to the reasonable medication, stop the medicine in time after the condition control.
4. Avoid combined medication by being able to take medicine alone.
5. If necessary, try to use drugs that are less harmful to the fetus.
6. Affordable teratogenic drugs are prohibited.If pregnant women are in danger, they can be used after weighing the advantages and disadvantages carefully.
7. Forbidden test drugs during pregnancy, including pregnancy tests [1].
3. How should the impact of drugs on fetal fetuses be identified during pregnancy?
First of all, the impact of drugs on fetuses can refer to the US Food and Drug Administration (FDA) according to the danger of drugs to the fetus into five hazard levels of A, B, C, D, and X [3].
Class A: In the study of the control group, women who have 3 months of pregnancy have not seen signs of harm to the fetus (and there is no evidence of the harmfulness of the next 6 months), that is, the safety of medication during pregnancy, noneAdverse effects.
Class B: In the study of animal reproductiveness (no comparison study of pregnant women), no impact on the fetus was seen.There are adverse reactions in animal reproductive research, and some adverse reactions have not been confirmed in women who have not been 3 months pregnant (there is no evidence of the harmfulness of the next 6 months).
Category C: The study of animals proves that it has adverse reactions to the fetus (deformed or killed embryo), but did not study in women in the control group, or did not study parallel in women and animals.This type of drugs can only be applied after weighing the benefits of pregnant women than the harm to the fetus.
Category D: There is a clear evidence of the harmfulness of the fetus. Although it is harmful, pregnant women have absolute benefits after medication (for example, pregnant women are threatened by death or severe diseases, so it needs to be used.But), demand is more harmful.
Category X: Research on animals or people shows that it can make the fetus abnormal.Or it is harmful to people or animals based on experience.It is obviously unhelpful to apply such drugs in pregnant women.This type of drug is prohibited for pregnancy or patients with pregnancy.
Therefore, choosing A and B drugs as much as possible during pregnancy, Class C drugs need to weigh the advantages and disadvantages, and use it carefully under the guidance of a doctor. Unless the D -level drugs are in dying the life of pregnant women, or with other safer drugs invalidated, seriously invalidateThe disease is only considered, and the X -level drug must be strictly banned.Regarding the pregnancy grades of drugs, the following common drugs are enumerated:
Class A: Various vitamins, potassium chloride, left norexorine, etc. of normal doses.
Grade B: Most β -laidide drugs and macrolactone drugs, clinamycin, ethylene butanol, golovir, Akaba candy, di metarison, insulin, acetaminol, thunderbolt, thunderbolt, thunderNicotine, osoma, lactose, etc.
Class C: onone, craticin, claxycin, subbritol, pheasitin, rightcelistel, pioglitidone, glitamine, omeprazole, and ammlidal are equal.
Grade D: amino glycoside, tetracycline, autumn water portrarine, antidrazole, metalazole, propyl oxyraine, iodone, and azozimine;Lorr, Pesool, Pribi drugs, Salin drugs.
Grade X: Hittin drugs, Libavarin, Azimzole, Saraidamine, Huafarin, methotrexate, plybind, and different vitamin A.
4. Medication of common diseases during pregnancy
1. Cold
First of all, distinguish the type of cold. For normal colds (manifested as nasal congestion, runny nose, etc.), the general symptoms are mild, and they can heal themselves. Pay attention to rest, proper water supplementationNeed to be vigilant.Symptoms of influenza must seek medical treatment in time. If the symptoms are milder, symptomatic treatment can be used to relieve symptoms.Some proprietary Chinese medicines (such as Shuanghuanglian oral liquid, antiviral oral solution, Lianhua Qingjuan capsule, etc.) are usually safe, but they need to be taken under the guidance of a doctor.If there are more sputum, acetylcysteine can be selected; the bronchial asthma or cough mutant asthma can be selected for symptomatic treatment of Monte Ste sodium, Budi, Tibalin, and isopycromide.
2. Fei fever
If the fever is lower than 38 ° C, it can use physical methods such as warm water bath and cold compress to cool down; if the fever exceeds 38.5 ° C, the use of antipyretic analgesic drugs is a safer choice for acetaminol, which can be used at any stage of pregnancy.
3. Infection
Bacterial infections are safer with penicillin, cephalosporin, Achigromycin, clinithromycin, and phosphate; vaginal fungal infection can be selected to use clonazole locally; tuberculosis can be selected for ethylene glycol, pudding in Lifa; herpes virus infection can be available.Choose Arcloville, Pancoswell, etc.; Anti -hepatitis B virus can be chosen as Bobidin and Solofover ester.
4. Vomiting
Vitamin B6 is safe and effective in pregnancy during pregnancy during early pregnancy. It is recommended as a first -line medication.Nausea and vomiting in early pregnancy can be given vitamin B6 10-20 mg/time, and take it 3 times a day.For pregnant women who need to be hospitalized for pregnancy drama vomiting and ketone disease, treatment measures include venous tonic, supplementing multiple vitamins, correcting dehydration and electrolyte disorders, rational use of vomiting drugs, preventing complications.Taking potassium.
5. Constipation during pregnancy
The characteristic of lactose is not to be absorbed by human blood, does not affect fetal development, high safety, and good tolerance. It is the first choice for treating constipation of pregnant women;Need to add enough liquid to take effect slowly, select drugs for constipation for pregnant women, suitable for mild constipation patients; pregnant women can use compound coridenate embolism when they have hemorrhoids;Drugs (such as phenolic) are prohibited for pregnant women.
6. Skin allergic disease
If you have skin allergic diseases, you can choose A -grade antihistamines such as decentor, chloroprotidin, Sitrodizine, chlorophenicamin, etc.; If accompanied by skin bacterial infections, you can choose MoproprotoStar Popularity; Most external hormones are C -Class C -drugs and can be used in small areas under the guidance of a doctor.
7. Gastrointestinal disease
It is accompanied by digestive diseases such as digestive ulcers, gastritis, reflux esophagitis, ulcerative colitis, cholesticidal accumulation, etc., which can be safely selected, such as Renitidine, most proton pump inhibitors (such as orchids (such as orchidsSorpazole, osteoprazole, anionalprazole, etc.), linzine, mosarazine, glycosamine, and bear -removed oxygenic acid.
8. Diabetes
For the blood glucose control intervention with diabetes with diabetes, insulin is the preferred drug; the two -metal dual -duplex and Gebenben 脲 are only used as a secondary plan due to lack of sufficient safety evidence.
9. Pregnancy hypertension
Some of the antihypertensive drugs (such as Rabell) are almost adversely affected by the fetus.However, the medication must be used safely and reasonably under the guidance of doctors and pharmacists. Do not use it at will, and do not stop at will.Oral antihypertensive drugs commonly used by hypertension pregnant women include Labelol, Niferpine, Nika Horizon, methylbaba, and Nimotidi, and small doses of hydrochlorozine can be used as second- and third -line therapy drugs.choose.
Yixian Pharmacist reminds that you should avoid medication as much as possible in the early pregnancy, and the medicine should be used as soon as possible when the disease must be used.In terms of the choice of drugs, you can use single medicine to avoid combined use. Try to choose drugs that existing conclusions for fetal safety to avoid using new drugs that are not sure if you have an influence on the fetus.The treatment effect is maximized with fetal safety efficiency.
references:
[1] Liu Haifang. The impact of women’s medication on fetuses during pregnancy [J]. Chinese national folk medicine, 2013,22 (03): 45.
[2] The impact of Chen Hongmei. Pregnant women’s medication on the fetus [J]. All -departmental diagram electronic magazine, 2019,6 (21): 17.
[3] Chen Xinqian, Jin Youyu, Tang Guang. New Pharmaceutical [M]. 17th edition. Beijing: People’s Health Press, 2011: 21-25, 960-980.
