Monday, 07 November 2011

  • Medication Monday: Pregnant/Lactating Women! Dietary Supplements Are Not Always Good For You

     

    On a recent issue of Student Pharmacist, pharmacists discussed the importance that it reads that there are certain medications for pregnant patients, or patients that are breastfeeding.

    Did you know that taking even the safest over the counter drug can be potentially fatal?

    So pregnant/lactating patients: What do you do if you must relieve heartburn, pain, and common cold? Or want to take dietary supplements? 

    Heartburn:

    The safest option to treat heartburn is nonpharmacologic treatments. Unless it's severe, consult your pharmacist, and otherwise change your diet-- small frequent meals, avoid food before bedtime. Antacids containing calcium carbonate, calcium, aluminum is a good option. Tums is a good option! 

    Pain Relief:

    The safest option for pain is acetaminophen, which is your generic for Tylenol. However, if you are lactating, be very cautious, as that medication enters your breastmilk. NSAIDs, such as Advil, Aleve, etc. should be avoided during pregnancy, and used with caution during breastfeeding. You should consult your doctor or pharmacist for this. 

    Common cold and allergies:

    Again, use nonpharmacologic methods, such as resting, drinking fluids, and using a humidifer. 

    Vitamins

    You should take Folic acid, Calcium, Iron, B12, C and D.

    Remember that not all vitamins are good-- Vitamin A is dangerous during pregnancy. Usually you get all the Vitamin A you need find your diet.

     

    More information is provided here.
    Source: APhA Vol 7 Number 6 

Comments (7)

  • grizzlybearr@xanga

    tums were my savior during my first pregnancy. 

  • sarahsmurfette@xanga

    Babies receive less than 1% of what medication etc that we consume. Most rules, I feel, are overkill in the interest of legal protection.


    It's my personal opinion that being reasonable is all you need to do. And I can tell you from my personal experiences : Drs are SCARED to tell you any medication is ok, most pharmacists, too. The La Leche League and other breastfeeding experts disagree with physicians in this. I can't tell you how many arguments the lactation consultants and drs in my hospital had on a daily basis in L&D and even in my department in Radiology. The protectiveness is overkill. 
  • sarahsmurfette@xanga

    And by the way, with pain killers, do you know what I had to go thru when I was pregnant with my first? I had a headache and my drs scared me half to death that I had meningitis despite no other symptom and I had to get a spinal tap with only local anesthetic because they erred on the side of caution for the baby. No pain medication. Nothing.


    When I was pregnant with my second? I broke my foot and do you know what they gave me? A cast and tylenol. Adequate? Definitely not. You try being in such intense pain you're throwing up and sweating and all they'll allow you to have is tylenol. Then tell me it's in the best interest of mom AND baby.

  • CecilliaMarie@xanga

    @sarahsmurfette@xanga - In most circumstances not taking pain meds is best...that's all this person was trying to say, sheesh.


    I personally wouldn't take any medication at all while I was pregnant except for my inhaler (I have severe asthma) because I didn't want to risk something being transferred to my son. To me this is a personal topic...what one woman might be comfortable with taking during pregnancy may be different from what another woman would be comfortable taking. Thanks for the info nonetheless!
  • sarahsmurfette@xanga

    @CecilliaMarie@xanga - I don't happen to think that fearmongering is the best way to inform people. I don't think the message of moderation is a bad one.

  • olopocram2@xanga

    No drug use, period. 

    http://www.ncbi.nlm.nih.gov/pubmed/21338428

    As well as some research on eczema and reproductive health exists. 

    Stick to rest, food and hydration.  The heartburn could be due to GERD, so some changes in your lifestyle or what you eat would help.  Don't eat before you sleep, incline the bed near the head (elevate it), sleep on your left side, eat smaller, but more, meals, etc.  Basically, the lower esophageal sphincter is more known as a physiological sphincter, not so much as an anatomical one.  I'll explain.  A sphincter is any round muscle, completely round, that acts as a gate, pyloric sphincter between the lower stomach and duodenum is an example, as well as your lips. They are very strong muscles that can close very tightly.  The esophageal sphincter tends to be very weak by nature, again thus why they don't like to think of it as a sphincter, and so if you just ate and produce acid, and you are held upside down, odds are the food will come back up, or in this case down, due to gravity. The pyloric sphincter is very strong, as well as the internal and external (the voluntary one) rectal sphincters.  This is why when upright, we never have issues with our food or fecal matter just "refluxing" down without our desire.  Changes like mentioned above will keep you in a more upright position, so food is kept down by gravity.  The left side is due to the fundus of the stomach being on that side, where on the right side, is the cardiac area and the, dum dum dum, lower esophageal sphincter.

    For pain relief, again natural stuff.  There are some studies out there saying bad things, then some saying good things, but honestly, why risk it? Even if there is a .000001% that something bad will happen, why risk it?  I know not everyone can just sleep, but those that can, just do that or find ways to motivate you to sleep.  Mind over matter. 

    For a cold, just deal with it.  The fever normally is reduced by some form of NSAID, like acetaminophen, but since we are going all osteopathic here, just rest, and get plenty of fluids.  Humidifiers work well, but avoid over humidifying, as mold growth can be just as bad, for you and your child. 

    As for vitamins, there are both pre and post-natal vitamins. Ask your doctor.  For any vitamin usage you need to check with a doctor; pregnant or not.  Not everyone follows this though and it can be bad.  As an example,  B12 deficiency and folic acid (B9). Folic acid may mask B12 deficiencies and lead to belief that you are "better", but in reality it is not correcting the neurological impact a B12 deficiency has.  There are many other things that overtaking, undertaking, vitamins can cause, so it is best to check with an MD/DO.  I can't say a practice what I preach here, but if your pregnant or just had a child, you're seeing the doctor more often that I am, so on one of your visits, ask him/her. 

    And vitamin A is dangerous at all times.  The amount needed a day is small, so having a healthy varied diet will normally suffice; unless you have impaired absorption or a zinc deficiency, again need for testing there.  The normal intake required and even the upper limit are smalls, and the chance for toxicity, intracranial pressure, and neurological damage is just unnecessary. 

  • enoughtodiefor@xanga

    @sarahsmurfette@xanga - agree. this article seems rather inflammatory, especially starting out with "taking even the safest over the counter drug is potentially fatal". that's such a vague, open-ended statement obviously included to create fear.

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