Transcript drugs during lactation


PAIN MANAGEMENT DURING PREGNANCY
AND LACTATION
 GI
changes
 Renal function
 Hepatic function
 Drug distribution
 Pr binding
 clearance
 Possible
adverse effect
 Critical period
A
None
B
Acetaminophen,fentanil,oxycodone,oxymorphone
nalbuphine,metadone,meperidine,morphine,iboprofen,
naproxen,indometacin, prednisone ,cafffeine
C
Amitriptyline,Asprin,Ketorolac,Betamethasone,cortisone,codeine
gabapentine,lilidocaine,propranolol,sertaline,fluxitine,bupropion
D
Imipramine,carbamazepine,diazepam,paroxetine,phenobarbital,p
henytoin,valporic acid
X
ergotamine, metotrexate
 ASPRIN
 OPIOIDS
 LOCAL
ANESTHETIC
 STERIODS
 TCA
 SSRIs
 ANTICONVULSANT DRUGS
 ERGOTAMINE
 MATERNAL
FACTORS
 INFANT FACTORS
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Is drug therapy really necessary?
The safest drug must be chosen,such as
acetaminophenrather than Asprin for mild
analgesia
If there is a possibility of risk to the infant,then
one should consider monitoring infant serum
levels of the drug.
Having the mother take the medication just after
she has breast fed the infant or before the infant
is due to sleep can minimize drug exposeure.
Effect on nursing infants is
unknown but may be of concern
Benzodiazepines,TCA,Bupropion,
Fluxetine
Drugs that have been associated
with significant effect and should
be given to nursing infant with
caution
Asprin,Ergotamine
Compatible with breast-feeding
Acetaminophen,Anticonvulsant,B
blochers,LA,NSAIDS,Opioids,steroi
ds,sertaline,paroxetine
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Acetaminophen
Opioids
Prednisone
Anticonvulsant
Antidepssant
Bblochers
Ergotamine