"Safety Medicine 100 Lecture Lesson 5"

Drugs during pregnancy are directly related to the physical and mental health of the next generation.The physiological and pharmacological characteristics of women during pregnancy, and the sensitivity to the drug during the entire pregnancy, make the problem of drug safety during pregnancy a focus of attention.Pregnancy is a special stage. When taking medicine for pregnant women, we must consider both maternal and infants to weigh the advantages and disadvantages to prevent improper use of medicines and ensure the safety of maternal and infants.

Drugs that can be used in each pregnancy period are different, and the effects of drugs have different effects on the fetus.During the formation of fetal organs, the impact of drugs is the greatest. After the organs basically grow, the impact of the drug will gradually decrease. Therefore, the medication of pregnant women is closely related to the fetal weeks of the fetus.

1. 1-2 weeks after fertilization (safety period):

The effect of drugs on the embryo during this period is completely or none, that is, there is no effect at all, or it will cause abortion, which will generally not cause fetal malformations.Therefore, when you take drugs before or during pregnancy or during pregnancy, you generally do not have much impact on the fetus, do not have to worry too much, and do not have to abortion because of this.

2. 3-8 weeks after fertilization (that is, 5-10 weeks of menopause, high sensitivity period):

This period is called the teratogenic sensitivity period, and it is also the period of acceleration differentiation of various organ organs. It is easily affected by external factors such as drugs and caused fetal malformations.At this stage, the medication should be strictly controlled, and it is decisive when not in use, including general health products and nourishing drugs.

If you have to take medicine, you must be careful and safe under the guidance of a doctor.If there is a history of taking medicine, you can conduct prenatal diagnosis (including B-ultrasound) at 16-20 weeks of pregnancy, and further understand the growth and development of the fetus and exclude fetal malformations.

3. 9 weeks to 12 weeks of pregnancy (mid -sensitivity period):

This period is also an important period for the formation of fetal organs. It is mainly for the formation of fingers, toes and other parts. Therefore, the medication will not be as great as a period of time, but it should also be treated carefully.

4. In the middle and late pregnancy (low sensitivity period):

This period was basically differentiated by the organs of the fetus and continued to grow.During this time, the possibility of teratogenic teratogenic is greatly reduced, but some drugs may still affect the normal development of the fetus.

5. Before childbirth

Pregnant women should pay great attention to the last week, because when the fetus becomes a newborn baby, the metabolic system in the body is incomplete, and the drug cannot be quickly and effectively eliminated. The drug may accumulate and produce excessive drugs in the baby’s body.


Pregnancy drug risk level (level 5)

Category A: It is safe for pregnant women and fetuses.Most of them are vitamins and minerals, such as B vitamins and calcium tablets.It should be taken in an appropriate amount according to the manual.

Category B: It is safer to pregnant women, and insufficient evidence of the fetus may not be confirmed.Such as stomach recovery, penicillin, and most cephalosporin drugs.

Class C: Animal experiments alone show that fetal malformations or deaths can be caused, but no study data from pregnant women.For example, aspirin, poker sensitivity, earthyamonone, etc., you must carefully consider the potential danger of the fetus when used.

Category D: It is only time to be threatened in the life of pregnant women, or it is not available for time with severe diseases.Including tetracycline, some progesterone and antiepileptic drugs.

Class X: It is clearly stipulated that women who are pregnant or may be pregnant, such as chloramphenicol, meterone, etc.

10 principles for safety during pregnancy:

1. Do a physical examination before pregnancy to strive for pregnancy in a healthy state.

2. The application of any drug must be taken under the guidance of a doctor or pharmacist.

3. If a chronic disease is found before pregnancy, it is necessary to take care of the continuity and safety of medication during pregnancy, and avoid the use of drugs that may endanger the fetus.

4. Try not to take medicine as much as possible in the early pregnancy (within 12 weeks).

5. Try to avoid combined medication.

6. Use the drug with a certain conclusion to avoid using new drugs.

7. Do not use the medicine or listen to the side or the secret recipe to prevent hairdressing accidents.

8. Pay attention to the words of pregnant women on the packaging bag with caution, avoid, and disabled.

9. When using the medicine, try to choose a drug without damage to the fetus or affect small.

TenMost of the instructions for Chinese patent medicines are relatively simple. Many instructions are not provided with precautions for pregnant women. Due to the advantages and disadvantages of pregnant women’s medication, they should be used with caution to ensure the safety of medication.

Treatment of medication during pregnancy:

Do not talk about the color changes. In fact, the probability of drugs is very small after all. Obstetricians need to pay attention to the impact of the disease itself on the fetus and the effect of drugs on the fetus.Sometimes the impact of the disease itself on the fetus is more serious. Doctors’ medication is a process of weighing the pros and cons. Doctors and patients should consider the risk of disease treatment and the risk of non -treatment.The psychological state of maintaining a pleasant psychology during pregnancy is very important for themselves and the fetus.

In short, there is almost no treatment for medicine during pregnancy. Therefore, it is necessary to avoid unnecessary medication, especially in early pregnancy.For adverse reactions that may produce medicines, preventive measures are taken as much as possible to reduce the degree of harm of drugs to fetuses and pregnant women.

Pregnant women do not have to completely disable antibiotics:

In addition to the different sensitivity of the fetus to the drug during different periods, the effect of the drug on the fetus depends on the type and medicinal weight of the drug.

From the perspective of the impact of drugs on pregnant women, it can basically be divided into three categories:

The first type of medicine is definitely harmful to pregnant women, such as anti -tumor drugs, sex hormones, anesthesia, certain antibiotics (erythromycin, rinomycin, chloramphenicol, etc.);

The second category is possible, such as some antibiotics (galcinin, scalidin, tetracycline);

The third category is definitely harmless, refers to some pregnant women’s special medicines, such as the appropriate amount of trace elements, and vitamins.

Whether all kinds of drugs will cause fetal malformations depends on the dosage of the drug, the physical fitness of pregnant women, and the sensitivity to the drug.

Pregnant women should drink plenty of water, pay attention to rest and indoor ventilation.If you have a fever, you should go to the hospital for treatment. Under the guidance of a doctor, choose some antibacterial drugs of penicillin and cephalosporin.

■ contraceptives have not increased fetal malformation rate

In response to the problem of harming the child by worrying about emergency contraceptives, studies have shown that the incidence of natural miscarriage in pregnant women who use emergency contraceptive contraceptives and fetal malformations are not significantly different from pregnant women who do not take emergency contraceptives.The conclusion is that taking emergency contraceptives will not increase the incidence of fetal malformations, nor will it significantly increase the occurrence of adverse pregnancy ending.

■ Chinese medicine and plant medicine:

Pregnant women use caution and disable the disable when choosing Chinese medicine: the drugs include peach kernels, safflower, saffron, bulls, rhubarb, aconite, cinnamon, ginger, and woody;Shang Lu, Musk, etc.Some of these traditional Chinese medicines have strong toxicity, such as aconite and cinnamon; some have the effects of promoting blood circulation, such as peach kernels and safflowers, which can accelerate the blood circulation of pregnant women, and the fetal gas is not solid.Such as musk, grass fruit, lilacs, scent of incense, etc., the warmth is rushing, which is prone to abortion.

During pregnancy, pregnant women cannot use Chinese medicine at will. Some of them can cause pelvic and uterine congestion, stimulate uterine contraction, easily cause miscarriage, and some drugs are not good for fetal growth.

Whether it is Chinese medicine or western medicine, two principles should be followed: first, it should be actively treated when sick, and do not fear the medication.

■ Medicine during pregnancy is not extreme:

Although the medication needs to be cautious during pregnancy, do not go to extremes.Medication misunderstanding during pregnancy includes:

1. During pregnancy, various diseases need to be treated with medicine and refuse to take medicine to increase the pathogenic conditions.

2. Drug treatment for diseases during pregnancy, and the choice of drugs is unreasonable.

■ Specific dad must also be careful of the influence of the medicine:

Two months before planning to be pregnant, it takes 2 months to slowly mature sperm cells from sperm cells. During this period, drugs may accumulate in semen, but general non -prescription drugs such as cold medicines are very small.If your father’s working environment contains chemical drugs such as heavy metals, organic solvents, pesticides and other chemicals, it is more likely to have adverse effects.

■ 7 drugs, expectant mothers should try to avoid:

1. Antilateral drugs

Antilateral drugs often cause abnormal development of fetal brain, heart, and facial features, and it is easy to have problems in intellectual development after birth.In addition to the effects of drug factors, the disease of epilepsy may also cause abnormalities on the fetus.

2. anticoagulant

There are many types of anticoagulants, and some of the small anticoagulants with smaller molecules will cause fetal abnormalities through the mother placenta.In the early stages of pregnancy, abnormalities in fetal skeletal development will cause abnormalities in the nervous system in the middle and later stages of pregnancy.

When anticoagulants are generally used, it is usually long -term medication because of venous embolism or heart problems.When the husband and wife plan to get pregnant, they will have the discussion with the doctor early to understand whether they need to replace the relevant drugs.

3. Hypertension

Hypertension is a disease that many expectant mothers can get during pregnancy. Most of the hypertension drugs are safe, and expectant mothers do not have to worry too much.

Please pay special attention to the "vascular contraction enzyme inhibitors (ACEI)" in hypertension drugs.This type of anti -hypertension drugs can reduce the amniotic fluid of the fetus, which in turn causes abnormalities in the kidney and respiratory system (such as lungs).Therefore, if you have hypertensive mothers before pregnancy, you need to pay special attention. If you take such drugs on weekdays, remember to replace it as soon as possible during pregnancy.

4. Vitamin A

During pregnancy, expectant mothers will always add some comprehensive vitamins.However, it should be noted that if the dose of vitamin A in intake is too high (more than 5,000 international units), the fetus will be abnormal in facial features, heart and nervous system.

In addition, the pretty expectant mother should pay more attention. Because many skin care products on the market may contain this component, when using or purchasing care products during pregnancy, don’t forget to pay special attention to the A acid content of these products.

5. hormone preparation

Many diseases such as breast cancer, endometriosis, severe allergies, etc. need to use hormone drugs. It is recommended to stop after planning to be pregnant, because most of the hormone preparations will have an impact, which can easily cause fetal external genitaliaabnormal.

6. Anti -cancer chemotherapy drug

Chemical treatment drugs against cancer basically affect mothers.These drugs will be used, usually the mother’s own malignant tumor, this situation needs to be combined with the physical condition of expectant mothers and then do related treatment.

7. Antibiotics

Most of the antibiotics that are usually used are mostly safe.However, tetracycline usually causes abnormalities in the development of fetal teeth, or causes the color of the fetal skin to be yellow or pigmented (gray baby syndrome).

In addition to the above drugs, some antiviral drugs may also have an impact.Therefore, when you are going to be pregnant or are pregnant, mothers can ask doctors to prescribe some drugs that can replace the above types, and pay more attention to the choice of choice.

■ Differential drug disable during pregnancy:

1. Disable medicine within 3 months of pregnancy

Antimamines, anticoagulant, antiepileptic drugs, anticancer drugs, sulfa drugs, etc., such as aminotreate, nitrogen mustard, Minkejing, benzene sodium, etc.

2. Disassembled medicine during the entire pregnancy

Anti -infection drugs such as chaincin, tetracycline, and chloramphenicol; drugs that affect endocrine such as propyate testosterone, hexophenols, cortipoprazole, and adrenal corticosteroid drugs.

3. Disable drugs from late pregnancy to close to childbirth

Macueine new alkali drugs, quinine, Quinine, Barbich drugs, Bluspin, aspirin, morphine and other sedative hypnotic pills.

■ Other drugs that must be carefully used:

1. Gactic diabetes

Because oral insulin drugs may have an impact on mothers, the method of adopting insulin will be changed during pregnancy.

2. thyroid disease

It is commonly divided into two types of young women: one is insufficient thyroid dysfunction, or hyperthyroidism before the thyroid function. It has been surgery and must be replenished for a long time.The thyroid drugs belong to Class A, and there is no problem with safety.

If the pregnant woman itself is hyperthyroidism, it is necessary to use anti -thyroid drugs, and this type of drugs belong to Class D.If the thyroid dysfunction occurs during pregnancy, it is dangerous for the mothers. Sometimes the so -called thyroid hazard will occur, which will cause the metabolic status of the expectant mothers to change rapidly, and in severe cases, there will even be danger to life.

3. asthma

Most of the drugs for treating asthma are anticipidine or steroids. It is necessary to depend on patients when using patients. It can choose relatively safer types of use.Because one -third of the expectant mothers in pregnancy will deteriorate during pregnancy. Without control, acute asthma seizures will also cause life danger.

May all expectant mothers walk through every day of pregnancy easily and happily!

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