Tài liệu: Sử dụng thuốc trong thai kỳ

FDA phân loại có 5 mức độ ảnh hưởng của dược phẩm trên thai kỳ A, B, C, D, X.Hãy nêu một số thuốc và ảnh hưởng trên thai kỳ đối với các nhóm thuốc:- Kháng sinh- Kháng nấm- Điều trị tăng huyết ápPregnancy Category A Adequate and well-controlled human studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters).Pregnancy Category B Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in...
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Tài liệu: Sử dụng thuốc trong thai kỳ Sử dụng thuốc trong thai kỳFDA phân loại có 5 mức độ ảnh hưởng của dược phẩm trên thai kỳ A, B, C, D, X.Hãy nêu một số thuốc và ảnh hưởng trên thai kỳ đối với các nhóm thuốc:- Kháng sinh- Kháng nấm- Điều trị tăng huyết ápPregnancy Category A Adequate and well-controlled human studies have failedto demonstrate a risk to the fetus in the first trimester of pregnancy (and there is noevidence of risk in later trimesters).Pregnancy Category B Animal reproduction studies have failed to demonstrate arisk to the fetus and there are no adequate and well-controlled studies in pregnantwomen OR Animal studies have shown an adverse effect, but adequate and well -controlled studies in pregnant women have failed to demonstrate a risk to the fetusin any trimester.Pregnancy Category C Animal reproduction studies have shown an adverseeffect on the fetus and there are no adequate and well-controlled studies inhumans, but potential benefits may warrant use of the drug in pregnant womendespite potential risks.Pregnancy Category D There is positive evidence of human fetal risk based onadverse reaction data from investigational or marketing experience or studies inhumans, but potential benefits may warrant use of the drug in pregnant womendespite potential risks.Pregnancy Category X Studies in animals or humans have demonstrated fetalabnormalities and/or there is positive evidence of human fetal risk based onadverse reaction data from investigational or marketing experience, and the risksinvolved in use of the drug in pregnant women clearly outweigh potential benefits.Xin cho vài ví dụ 1 số thuốc hay gặp trên lâm sàng:1. Kháng sinh:- Amoxicilline B- Ampicillin B- Cefuroxime B- Cefotaxim B- Ceftazidime B- Ceftriaxone B- Cefixime B- Imipenem C- Cefepime B- Chloramphenicol C- Ciprofloxacin C- Gentamycin C- Sulfamethoxazole: C nếu gần sinh là D- Tetracycline: D2. Kháng nấm:- Ketoconazole C- Fluconazole C- Amphotericine B: B3. Tăng huyết áp:- Methyldopa: B- Nifedipine: C- Hydralazine: C- Perindopril: C nếu trong 6 tháng cuối là D.- Propranolol: C nếu trong 6 tháng cuối là D.- Amlodipine: C- Irbesartan và Losartan: C nếu trong 6 tháng cuối là D.A: These drugs are the safest. Well-designed studies in people show no risks to thefetus.B: Studies in animals show no risk to the fetus, and no well -designed studies inpeople have been done.ORStudies in animals show a risk to the fetus, but well -designed studies in people donot.C: No adequate studies in animals or people have been done.ORIn animal studies, use of the drug resulted in harm to the fetu s, but no informationabout how the drug affects the human fetus is available.D: Evidence shows a risk to the human fetus, but benefits of the drug mayoutweigh risks in certain situations. For example, the mother may have a life -threatening disorder or a serious disorder that cannot be treated with safer drugs.X: Risk to the fetus has been proved to outweigh any possible benefit.Tham khảo thêm tại: http://www.fda.gov/Drugs/Development.../ucm093310.htm1 số thuốc:a. Kháng sinh: (tham khảo thêm tại :1. http://www.healthwikipedia.com/pregnancy/antibiotics-to-avoid-during-pregnancy.html2. http://www.pregnancybliss.com/antibiotics.html3. http://www.ncbi.nlm.nih.gov/pubmed/16557603)- Chloramphenicol : Gray baby syndrome. In women or fetuses with glucose -6-phosphate dehydrogenase (G6PD) deficiency, the breakdown of red blood cells- Fluoroquinolones (such as ciprofloxacin , ofloxacin , levofloxacin , andnorfloxacin ): Possibility of joint abnormalities (seen only in animals)- Kanamycin: Damage to the fetuss ear, resulting in deafness- Nitrofurantoin : In women or fetuses with G6PD deficiency, the breakdown ofred blood cells- Sulfonamides (such as sulfasalazine and trimethoprim- sulfamethoxazole ):When the drugs are given late in pregnancy, jaundice and possibly brain damagein the newborn (much less likely with sulfasalazine). In women or fetuses withG6PD deficiency, the breakdown of red blood cells- Tetracycline: Slowed bone growth, permanent yellowing of the teeth, andincreased susceptibility to cavities in the baby. Occasionally, liver failure in thepregnant woman khảo thêm tại Thamb/ Điều trị tăng huyết áp:http://www.obmed.org/pdfs/hyperten.pdf- Angiotensin-converting enzyme (ACE) inhibitors: When the drugs are taken latein pregnancy, kidney damage in the fetus, a reduction in the amount of fluidaround the developing fetus (amniotic fluid), and defects of the face, limbs, andlungs- Beta-blockers: When some beta-blockers are ta ...