Can you take medicine when you are pregnant?

Do you take medicine during pregnancy?

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Before, we shared an article "After I found that I was pregnant after taking the X -rays, can the child still need it?"》 Article, many friends in the background leave a message to know the impact of drugs on fetal development and whether you can take cold medicines after pregnancy. Today we will answer these doubts!

"It is three poisonous medicines" everyone knows, especially for young children and pregnant women, the medication is more cautious.

Medication during pregnancy can be simply summarized into three categories:

1. Unexpected pregnancy: I found pregnancy after using the drug

2. Pregnancy During pregnancy: How to choose drug treatment

3. Chronic basic diseases: Do not stop drugs and have pregnancy needs

For medication during pregnancy, many countries and regions will classify the drugs according to the degree of drugs.The most authoritative is that the US Food and Drug Administration (FDA) is regularly adjusted and announced in a timely manner according to the clinical use of the drug. At present, the drugs are divided into five levels: A, B, C, D, and X.Some drugs are two different levels of danger, one is the level of commonly used, and the other is the excessive use level.

Table: FDA pregnancy drug classification

When you find that you are pregnant after the medication, if you use drugs such as A or B, you usually do not need to worry. These drugs are relatively safe. If there are controversial drugs such as C and D levels, you needConsider to evaluate.

1. Take medicine at different periods, the impact is different!

The impact of drugs on different development stages:

1. Early embryo (early bed)

This stage is a non -sensitive period. Within 2 weeks after fertilization, it is 14 to 28 days of the last menstruation.

The effect of drugs on embryos at this stage shows "all or no".Embryo death and spontaneous abortion are common, and deformed is not prone to occur.

"All" means that all harmful drugs are all or partially destroyed by embryo cells, causing early deaths of embryo → terminating pregnancy, abortion, and absorption by the mother.

"None" means that harmful drugs are not damaged or in small amounts of damage, but the cell function of this period can compensate or repair damage to cells. At this time, the embryo is in the process of ovation and the formation of the original intestine, and no tissue organs are differentiated.

"All or none", simply "life or death", either continue to grow healthily or "go".

2. Embryo period (organ formation period)

This stage is a highly sensitive period, 14 to 56 days after fertilization, that is, 28-70 days after menopause.

At this stage, the cells have been divided rapidly, and the organ of the embryo is in the stage of development and formation.If it is affected by harmful drugs, the cells are not easy to differentiate compensation and repair, and it is prone to form abnormalities, and severe structural malformation may occur.

The formation and development of different systems and organs are not fully synchronized. Most organs have a special sensitive period for teratogenic effects:

The central system is 15-25 days in conception

The heart is over 20-40 days in the heart

The limbs are 24-46 days in conception

The impact caused by this order is an important congenital abnormalities, such as the limbless fetus (no arms, no legs).

For example, the widespread use of Saliamine (reaction) in the world in the early 1950s to the early 1960s can effectively prevent women from vomiting in the early stages of pregnancy, but also hinders pregnant women’s blood supply to the fetus.As a result, the drug caused a large number of "seal malformation babies" at the time.

3. Fetal period (organ formation has ended)

This stage starts from 56 to 58 days of pregnancy until delivery.

After 3 months of pregnancy, most organs have been formed. Fervable drugs have a weaker impact on most organs, causing relatively small possibilities for malformations.However, organs (reproductive organs, central systems, etc.) that require long -term differentiation and development can have an impact, such as deafness, blindness, and low intelligence, such as central nervous system damage.

Most of the fetal "hardware" at this stage has matured, and it has less affected. Most of them have functional defects and tiny abnormalities.

Therefore, do not panic when you find that you are pregnant after taking the medicine. The effects of drugs on the fetus need to be evaluated based on many comprehensive factors such as medication time, fetal age, and drug nature.

It is worth mentioning that the problem of birth defects is not the main reason. Structural malformations and functional defects often include the results caused by human genetic defects, external environmental factors, and unknown factors.

For example, the elders in my family, the two uncles are color blindness, but neither aunt and my mother have no defects in this area.

Many reasons for birth defects are not clear, and more likely to be caused by genetic problems and environmental factors.Therefore, no one can guarantee that the child is 100 % no problem, and can only appropriately reduce the chance of birth defects through various inspections.

So, when you ask: Doctor, can you guarantee that 100%is okay?

cannot!Intersection

The doctor really can’t guarantee it!There is a certain risk of pregnancy itself. Medicine is a rigorous discipline. Even 99.99%is the possibility of 0.01%. What we can do is to avoid the risk to the minimum.

2. Can I take cold medicine during pregnancy?

Cold is the general term of the viral upper respiratory tract infection and is a self -limited disease that can heal itself.However, ordinary cold influenza.

Cold medicine does not really treat colds, but to relieve the symptoms of colds, make our bodies more comfortable.Most of the cold medicines include compound preparations such as knowing hot analgesic, expectorant drugs, antitussive drugs, and anti -group amines.

Taking common cold medicine as an example, the pregnancy classification of pregnancy for each component:

Artificial beef: Traditional Chinese medicine is not included in the hierarchical directory, but it is recorded as pregnant women with caution in the classic of traditional Chinese medicine.

Vajrayanamine: There are cases reports that cause the fetal cardiovascular abnormal danger.

Pseudocerine: Taking the risk of newborn abdominal cracks (closure of defects in the abdominal wall) during pregnancy.

Meshafin: Rodor research can cause teratogenic in the chicken embryo model.

Pregnancy C -level drugs are usually clearly toxic in animal research, but inadequate human research.After evaluation, it is confirmed that the benefit is greater than the risk, which can be used.But why not use it when you have a cold?It is still said before that the common cold itself is a disease that can also be healed without medication. It has no obvious advantage to benefit the use of drugs. Therefore, it is not recommended that pregnant mothers take risks to use drugs with inaccurate safety.

Although the cold does not need to be treated with drugs, hard resistance is too "cruel" for pregnant mothers.Therefore, it is recommended to choose some drugs with a single ingredient, such as headache fever, you can choose a relatively high safety of pregnancy -grade phenol, etc.

Antibacterial drugs are not required when a general cold infection is related to complications.Antibacterial drugs do not treat ordinary colds.

It is also important to emphasize that not to blindly use Libavilin antiviral treatment. Libavirin does not have a significant effect on normal colds.At the same time, Libavirin is likely to cause teratogenic and embryonic death. It is a drug X -level medication. Pregnant women and possible women’s women are banned. Valid contraceptive measures are needed during treatment and 6 months after drug discontinuation.

3. What should I do if there are chronic basic diseases and pregnancy needs?

For such pregnant mothers, the range of drugs is very small. Drugs during pregnancy cannot simply consider the fetus, or the condition of the mother should be considered.Therefore, for those who have clear application indicators, the interest and disadvantages of the balance, and the benefit of the time of medication is greater than the possible risks, the drugs can be used in close observation.

The most common example is hyperthyroidism during pregnancy (referred to as hyperthyroidism during pregnancy):

If hyperthyroidism during pregnancy is not effective, it will increase the risk of diseases such as severe eclampies and heart failure in pregnancy. At the same time, it will significantly increase the risk of severe results such as premature fetal birth, low birth weight, and abortion.The first choice for the first choice of propyl oxide (PTU) and the first choice of methalmazole (MMI) recommended by the early hyperthyroidism during pregnancy are all grades of pregnancy.

4. Summary of medication for patients with pregnancy

According to the needs of the disease, weighing the risk of interests under the guidance of a doctor or pharmacist.

1 It is necessary to clearly use the indicator of the drug, weigh the advantages and disadvantages, and avoid unnecessary use.

2 Must be used under the guidance of professionals and do not use it without authorization.

3 It can be used with a drug without combined with multiple drugs.

4 Choose medicines that have been used for a long time, clarifying safety and affirmed drugs, and avoid choosing new drugs that are not clear on the fetus.

5 Select the minimum effective dose when using the drug to avoid large doses.

6 Pay attention to the use of treatment, stop the medicine in time, except for the basic slow disease.

7 Consider the medication according to the fetal development period (gestational week). If the condition permits in the early pregnancy, the medication is delayed as much as possible to the middle and late pregnancy.

Finally, share a problem that often causes disputes: metronidazole oral administration, intestinal external administration, and local/skin external pregnancy grades are all B.However, many metronidazole preparation drugs indicate that pregnant women are banned.

This is because animal tests have found that metronidazole is a mutant and carcinogenic carcinogens of bacteria.However, the current results of the research are analyzed for the application of metronidazole in the first three months of pregnancy, and there is no conclusion that there is no conclusion that the tendency to generate tendencies will be obtained.

Pharmaceutical information registered in the United States: Trichomo patients with titulinopathy in the first trimester are disabled of metronidazole treatment, and titulinum patients with trichomoniasis in 3 months and at the end of pregnancy can receive metronidazole treatment.

In order to avoid disputes in clinical application, protect the rights and interests of both doctors and patients, and implement the patient’s informed consent and the choice of the patient’s knowledge as much as possible.

Reference materials:

[1] National Pharmacopoeia Commission, Chemical Pharmaceuticals and Biological Products (2015 edition): China Pharmaceutical Technology Press, 2017.9

[2] Instructions for clinical medication of the Pharmacopoeia of the People’s Republic of China: 2015 edition. Traditional Chinese Medicine Drinks/National Pharmacopoeia Committee.- Beijing: China Pharmaceutical Technology Publishing House 2017.9

[3] MIMS -FDA Drug Pregnancy Classification Index

[4] Yang Huixia, Duan Tao. During pregnancy and breastfeeding medication [m]. Seventh edition. Beijing: People’s Health Publishing House, 2008

[5] Guidelines for medication during pregnancy and breastfeeding/(beauty) Weiner (weiner, c.p.) And other writers; Sun Luzu Introduction. —— Beijing: People’s Army Medical Press, 2014.1

[6] Principles of Antibacterial Drugs Clinical Application: 2015 edition/"Antibacterial Drug Clinical Application Guidance Principles" revised work group editor. — Beijing: People’s Health Publishing House, 2015

[7] Yang Huixia, Duan Tao. During pregnancy and breastfeeding medication [m]. Seventh edition. Beijing: People’s Health Publishing House, 2008

[8] Pharmacist prescription review and training teaching materials/Wu Xinrong, editor of Yang Min. — Beijing: China Pharmaceutical Technology Press, 2017.7

[9] BURTIN P, ET Al.SaFETy of Metronidazole in Pregnancy: A Meta-analysis.am J OBSTET GYNECOL 1995; 172: 525-9-9

[10] Caro-Paton T, et al. Is Metronidazole Teratogenic? A meta -analysis. <

[11] NORA JJ, ET AL. Cardiovascular Maldevelpment Associated with Maternal Exposure to Amantadine. Lancet 1975; II: 607

[12] PANDIT PB, ET Al.tibal Hemimelia and Tetralogy of Fallot Associmted with FIRST TRIMESTER Exposure to AMANTADINE. REPROD TOXICOL 1994; 8: 89-92

[13] Related drugs in the article (Pinselerine, ammonia coffee Huangmin, ammonia Mimin) instructions.

The first post: pediatric channel in the medical community

Author of this article: Drustering Unruly Pharmaceutical Box

Editor in charge: Li Xiaorong

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