Guide for Drug Selection During Pregnancy and Lactation: What Pharmacists Need to Know for Current Practice

2018 ◽  
Vol 52 (8) ◽  
pp. 810-818 ◽  
Author(s):  
Brooke L. Griffin ◽  
Rebecca H. Stone ◽  
Shareen Y. El-Ibiary ◽  
Sarah Westberg ◽  
Kayce Shealy ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Chronic Disease ◽  
Fetal Development ◽  
Chronic Conditions ◽  
Medication Use ◽  
Care Providers ◽  
Drug Transfer ◽  
Pregnancy And Lactation ◽  
Trimester Exposure ◽  
In Pregnancy

Objective: To provide guidance for clinicians on risk assessment of medication use during pregnancy and lactation. Data Sources: Authors completed PubMed searches to identify articles focused on the use of medications in pregnancy, including fetal development, drug transfer across the placenta, trimester exposure, chronic conditions in pregnancy, medications in lactation, and lactation and chronic disease. Study Selection and Data Extraction: Articles were reviewed to provide overall guidance to medication selection during pregnancy. The following information was reviewed: medication use in pregnancy, including fetal development, drug transfer across the placenta, trimester exposure, chronic conditions in pregnancy, medications in lactation, and lactation and chronic disease. Data Synthesis: This article will provide an overview of medication safety considerations during pregnancy and lactation. Information was interpreted to help clinicians predict the potential risk and benefit in each patient to make an evidence-based decision. The article concludes with guidance on risk assessment and how pharmacists may support fellow health care providers and their patients when considering medication use. Conclusions: Information about the effects of medication use during reproductive periods is limited. With the removal of the Food and Drug Administration pregnancy categories, clinicians will be relying on pharmacists to aid in the appropriate selection of therapies for patients. It is critical that pharmacists keep abreast of resources available and be able to assess data to help prescribers and their patients.

scholarly journals Evaluating Medication Use in Pregnancy and Lactation: What Every Pharmacist Should Know

2013 ◽  
Vol 18 (3) ◽  
pp. 247-258 ◽  
Author(s):  
Betsy Walters Burkey ◽  
Amy P. Holmes
Keyword(s):  
Breast Milk ◽  
Drug Administration ◽  
Rating Scales ◽  
Food And Drug Administration ◽  
Medication Use ◽  
Drug Transfer ◽  
Drug Classes ◽  
Pregnancy And Lactation ◽  
In Pregnancy

As a pharmacist, being asked to give advice about medication use during pregnancy or lactation can be daunting. This article reviews the principles of drug transfer across the placenta, into breast milk, and reviews the rating scales and different resources available. The Food and Drug Administration classification scale is reviewed and the upcoming changes are explained, along with recent labeling changes for specific medications or drug classes when appropriate. This article provides the pharmacist with a practical set of tools to review the information available and assess the risks of treating or withholding a medication for mother and infant.

Medication use in pregnancy and lactation: A gap to be filled in postgraduate medical education

2021 ◽  
Vol 260 ◽  
pp. 52-55
Author(s):  
Claire M. McCarthy ◽  
Fergal O’Shaughnessy ◽  
Nicola Maher ◽  
Brian J. Cleary ◽  
Jennifer C. Donnelly
Keyword(s):  
Medical Education ◽  
Postgraduate Medical Education ◽  
Medication Use ◽  
Pregnancy And Lactation ◽  
In Pregnancy

Manganese in pregnancy and breastfeeding

2015 ◽  
Author(s):  
Sir Peter Gluckman ◽  
Mark Hanson ◽  
Chong Yap Seng ◽  
Anne Bardsley
Keyword(s):  
Antioxidant Enzymes ◽  
Breast Milk ◽  
Maternal Health ◽  
Fetal Development ◽  
Essential Element ◽  
Mixed Diet ◽  
Disease States ◽  
Neurotoxic Effects ◽  
Pregnancy And Lactation ◽  
In Pregnancy

Manganese is both an essential element and a potent neurotoxin. It is involved in cellular metabolic processes and is a component of antioxidant enzymes. Uptake and efflux of manganese is tightly regulated, as both deficiency and excess can result in disease states. Manganese has essential functions in maternal health and fetal development, and in healthy women adequate amounts can be obtained from a mixed diet of grains, cereals, and fruits. Supplements containing manganese should be used with caution, as excess intake can have neurotoxic effects on the developing brain. Maternal intake in pregnancy and lactation is not likely to be a worry in most cases, as transfer of manganese to the fetus and into breast milk is limited.

scholarly journals Perinatal Use of Melatonin for Offspring Health: Focus on Cardiovascular and Neurological Diseases

2019 ◽  
Vol 20 (22) ◽  
pp. 5681 ◽  
Author(s):  
Chien-Ning Hsu ◽  
Li-Tung Huang ◽  
You-Lin Tain
Keyword(s):  
Fetal Development ◽  
Animal Studies ◽  
Neurological Diseases ◽  
Later Life ◽  
Developmental Programming ◽  
Biologically Active ◽  
Pregnancy And Lactation ◽  
Health And Disease ◽  
Offspring Health ◽  
In Pregnancy

Cardiovascular and neurological diseases can originate in early life. Melatonin, a biologically active substance, acts as a pleiotropic hormone essential for pregnancy and fetal development. Maternal melatonin can easily pass the placenta and provide photoperiodic signals to the fetus. Though melatonin uses in pregnant or lactating women have not yet been recommended, there is a growing body of evidence from animal studies in support of melatonin as a reprogramming strategy to prevent the developmental programming of cardiovascular and neurological diseases. Here, we review several key themes in melatonin use in pregnancy and lactation within offspring health and disease. We have particularly focused on the following areas: the pathophysiological roles of melatonin in pregnancy, lactation, and fetal development; clinical uses of melatonin in fetal and neonatal diseases; experimental evidence supporting melatonin as a reprogramming therapy to prevent cardiovascular and neurological diseases; and reprogramming mechanisms of melatonin within developmental programming. The targeting of melatonin uses in pregnancy and lactation will be valuable in the prevention of various adult chronic diseases in later life, and especially cardiovascular and neurological diseases.

The Influence of the Food and Drug Administration Pregnancy and Lactation Labeling Rule on Drug Information Resources

2020 ◽  
pp. 106002802095665
Author(s):  
John Brock Harris ◽  
Amy P. Holmes ◽  
Lea S. Eiland
Keyword(s):  
Drug Administration ◽  
Health Care Providers ◽  
Drug Information ◽  
Food And Drug Administration ◽  
The United States ◽  
Primary Objective ◽  
Information Resources ◽  
Care Providers ◽  
Pregnancy And Lactation ◽  
In Pregnancy

Background Drug information resources are commonly used by health-care providers answering pregnancy-related medication questions. In 2015, the United States Food and Drug Administration approved a new pregnancy and lactation medication labeling content and format, removing the pregnancy category, and using a narrative. Despite labeling requirements changing, it is unknown if drug information resources updated monographs to reflect these changes. Objective The primary objective was to evaluate if commonly used drug information resources provide pregnancy information listed similar to the requirements of the Pregnancy and Lactation Labeling Rule (PLLR). Secondary analyses included evaluating the references and inclusion of the pregnancy category rating. Methods Pregnancy recommendations for 23 medications were evaluated in 9 drug information resources (Clinical Pharmacology, Drugs in Pregnancy and Lactation, Epocrates®, First Databank, LexiComp® Online, LexiComp® Online Pregnancy & Lactation, In-Depth, Medi-Span®, Micromedex®, and Multum®). The number of references per drug monograph and most recent reference publication year was obtained. Results LexiComp® Online Pregnancy & Lactation, In-Depth mimics the new PLLR structure and consistently had the highest number of and most recent references when the medication was included. Drugs in Pregnancy and Lactation was the next most similar in content with the PLLR and second in most references per monograph; however, the most recent reference was the textbook publication year. Conclusion and Relevance LexiComp® Online Pregnancy & Lactation, In-Depth and Drugs in Pregnancy and Lactation provided pregnancy information in a format most similar to the PLLR. However, several drug information resources contained pregnancy categories ratings that were to be removed from medication labeling per the PLLR.

Medication use in pregnancy and the pregnancy and lactation labeling rule

2016 ◽  
Vol 100 (1) ◽  
pp. 23-25 ◽  
Author(s):  
L Sahin ◽  
SC Nallani ◽  
MS Tassinari
Keyword(s):  
Medication Use ◽  
Pregnancy And Lactation ◽  
In Pregnancy

Haematology

2020 ◽  
pp. 307-362
Author(s):  
Charlotte Frise ◽  
Sally Collins
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Fetal Development ◽  
Biochemical Markers ◽  
Physiological Changes ◽  
Antithrombotic Drugs ◽  
Pregnancy And Lactation ◽  
Potential Risks ◽  
Haematological Disorders ◽  
In Pregnancy

This chapter begins by describing the normal haematological and physiological changes that occur in pregnancy, and biochemical markers at different trimester stages. It then covers the diagnosis, management, and complications for a range of haematological disorders, which may either pre-exist (such as sickle cell disease, thalassaemia, and other inherited conditions) or develop in pregnancy, including their potential risks to fetal development. Blood products and antithrombotic drugs in both pregnancy and lactation are described.

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