Antimalarial Drugs in Pregnancy-The North American Experience

1997 ◽  
Vol 52 (2) ◽  
pp. 93-94
Author(s):  
A. L. Parke ◽  
N. F. Rothfield
Lupus ◽  
1996 ◽  
Vol 5 (1_suppl) ◽  
pp. 67-69 ◽  
Author(s):  
AL Parke ◽  
NF Rothfield

The use of the 4-aminoquinoline antimalarials in pregnancy is controversial. The current practice of discontinuing these medications because of pregnancy makes little sense as the half-life of these medications is so long. Patients with SLE have increased fetal wastage and one of the factors known to contribute to this fetal wastage is disease activity. It is also known that discontinuing the 4-aminoquinoline antimalarial drugs can precipitate flares of disease in lupus patients. Mothers and their potential offspring are therefore at risk for flares of disease and pregnancy failure if these medications are discontinued because of pregnancy. This review addresses the North American experience of the use of antimalarial drugs in pregnant lupus patients. Unlike most centers in North America, we continue our patients on these medications throughout pregnancy and to date have documented 16 lupus patients who have taken these drugs throughout pregnancy. Our most recent study documents nine pregnancies in eight women. All of these pregnancies resulted in live births (five pre-term deliveries and four full-term deliveries). There were no congenital abnormalities in these infants and follow-up to date has revealed no evidence of ocular or oral deficits in any of these children. One patient experienced a flare of disease when her antimalarial therapy was temporarily discontinued.


Author(s):  
David G. Haglund

Interstate relations among the North American countries have been irenic for so long that the continent is often assumed to have little if anything to contribute to scholarly debates on peaceful change. In good measure, this can be attributed to the way in which discussions of peaceful change often become intertwined with a different kind of inquiry among international relations scholars, one focused upon the origins and denotative characteristics of “pluralistic security communities.” Given that it is generally (though not necessarily accurately) considered that such security communities first arose in Western Europe, it is not difficult to understand why the North American regional-security story so regularly takes an analytical back seat to what is considered to be the far more interesting European one. This article challenges the idea that there is little to learn from the North American experience, inter alia by stressing three leading theoretical clusters within which can be situated the scholarly corpus of works attempting to assess the causes of peaceful change on the continent. Although the primary focus is on the Canada–US relationship, the article includes a brief discussion of where Mexico might be said to fit in the regional-security order.


Sign in / Sign up

Export Citation Format

Share Document