WHAT IS PREGNANCY? Pregnancy medicines
Also known as gestation, which is the time where single or multiple offspring develops inside a woman.
There may be multiple pregnancies in which multiple offspring are born such as twins.
It is a period of nine months which takes the baby to fully develop inside a woman.
Pregnancy consists of three trimesters:-
- First Trimester:- from week 1-12. This stage has the highest risk of miscarriage (natural death of the embryo or the fetus)
- Second Trimester:- from week 13-28. In this, the movement of the fetus can be felt.
- Third Trimester:- from 29-40 week.
Pregnancy Sign & Symptoms:-
- Pelvic girdle pain
- Back pain
- Edema (swelling)
- Increased urinary frequency
- Urinary tract infection
- Varicose veins
- Regurgitation, heartburn, and nausea
- Stretch marks
- Breast tenderness which is common during the first trimester.
- Pregnancy-induced hypertension
- Postpartum depression
- Postpartum psychosis
- Thromboembolic disorders.
- PUPPP (Pruritic Urticarial Papules and Plaques of Pregnancy), it is a skin disease that develops around the 32nd week of pregnancy. Signs of this disease are red plaques, papules, and itchiness around the belly button which spreads all over the body except for the inside of hands and face.
- Ectopic pregnancy (implantation of the embryo outside the uterus).
- Hyperemesis gravidarum means excessive nausea and vomiting.
- Pulmonary embolism, blood clots that form in the legs that might migrate to the lungs.
The pregnancy medicine list includes the following:-
Analgesics & Anti-inflammatory drugs:-
People generally worry about what pain medication is safe when pregnant. Below is the answer.
- Paracetamol (acetaminophen):- It can be used at a usual dosage at any stage of pregnancy.
- Aspirin (acetylsalicylic acid):- It is the second choice after paracetamol. It should not be taken regularly in the third trimester.
- Morphine:- If compellingly indicated, it can be used. Regular use of this drug may lead to neonatal respiratory depression and long-term use may lead to withdrawal symptoms.
- Codeine:- Can be used in place of paracetamol if it is not much effective. It can be used as an antitussive drug. Regular use of this drug may lead to neonatal respiratory depression and long-term use may lead to withdrawal symptoms.
- Fentanyl:- It should be only used for urgent indications. It may cause respiratory depression.
- Ibuprofen & Diclofenac:- These drugs can be given in the first and second trimester only. After the 28th week of pregnancy, these drugs are contraindicated.
Disease Modifying Anti-rheumatic Drugs (DMARDs):-
- Sulfasalazine:- First choice of drugs during pregnancy.
- Azathioprine, Cyclosporine, Hydroxychloroquine, D-penicillamine are reserve treatment options.
- Gout Therapy:- Probenecid is the drug of choice to achieve elimination and uric acid. Allopurinol is contraindicated.
- Gout Attacks Therapy:- Ibuprofen is the drug of choice. Colchicine is the second drug of choice.
Anti-allergic & Desensitization:-
- Antihistaminics:- First Generation H-1 Blockers like Chlorpheniramine, Dexchlorpheniramine, Clemastine & Dimetindene can be used for the treatment of allergic reactions. Second Generation H-2 blockers like Loratadine & Cetrizine can also be used.
- Immunotherapy:- Allergen immunotherapy can be carefully continued during pregnancy in patients those who are benefiting from it and are not experiencing any adverse effects.
Anti-asthmatic & Cough Medications:-
- Selective Beta-2 Adrenergic Agonists:- Salbutamol & Terbutaline are short-acting first-line drugs. Formoterol & Salmeterol are long-acting and should only be used if essential.
- Corticosteroids:- Inhaled corticosteroids like Beclomethasone & Budesonide are first-line drugs. Systemic corticosteroids like Prednisone should be given in severe asthma.
- Anticholinergic Drugs:- Ipratropium Bromide inhaler is the first choice drug.
- Theophylline:- can be used where the above-mentioned drugs are not effective.
Expectorants & Mucolytic Agents:-
- N-acetylcysteine, Ambroxol & Bromohexine are first choice drugs.
- Anti-tussive drugs like Codeine & Dextromethorphan are given for a cough and can be given in all trimesters.
Anti-emetic Drugs for Nausea & Vomiting:-
- Antihistaminics:- Doxylamine being the first choice drug should be given with Vitamin B-6.
- Dopamine antagonists:- Metoclopramide is first choice drug and is safe and has less sedative effect.
- Vitamin B-6 (Pyridoxine):- If alone not successful then combine with Doxylamine.
- Vitamin B-1 (Thiamine)
- Serotonin Antagonists:- Should be given only if other drugs fail.
- Proton Pump Inhibitors:- Omeprazole is the first choice drug. It should be given as a second option if ranitidine and other drugs fail.
Constipation During Pregnancy:-
- Lactulose is the first choice drug. Lactitol, Mannitol & Sorbitol can be given during pregnancy. Sodium & magnesium sulfate at higher doses are contraindicated.
- Bisacodyl can be given if other drugs fail.
Castor Oil should not be given during pregnancy as it may stimulate uterine contraction.
Antibiotics During Pregnancy:-
- Penicillin:- first choice drug at normal doses.
- Cephalosporins:- can be used if needed.
- Macrolides:- Erythromycin is a first choice drug. It should not be given in the second & third trimester. Azithromycin, Clarithromycin & Roxithromycin ar second choice drugs.
- Lincomycin & Clindamycin:- these drugs are only given if the above antibiotics fail.
- Sulphonamide, Trimethoprim & Clotrimoxazole:- are safe drugs for urinary tract infection and can be given if penicillin and cephalosporins fail.
- Quinolones:- Ciprofloxacin & Norfloxacin can be used in complicated infections.
- Polypeptide Antibiotics:- Vancomycin should be used only in case of life-threatening infections.
- Aminoglycosides:- Should be given only in case of life-threatening bacterial infections.
- Chloramphenicol:- Chloramphenicol & Thiamphenicol are contraindicated during pregnancy and should be used unless there is a serious indication.