Instructions for safe medication during pregnancy

Two Types of Extreme Mothers

I often come into contact with two types of pregnant mothers: One is full of worries about medication during pregnancy, Even refusing to take all drugs, For example, patients with long-term chronic diseases such as hypertension, diabetes and asthma, If the disease during pregnancy is not well controlled, Not only does it bring great harm to pregnant mothers, It also poses a great danger to the fetus. Even during pregnancy, Also need to take medicine to control, But also to take medicine under the guidance of professional doctors, Not only need the professional guidance of obstetricians and gynecologists, You also need to receive the guidance of other specialists. So pregnant mothers with this chronic disease, Be sure to see doctors of different specialties at the same time, To control their own diseases. Another group of pregnant mothers choose drugs blindly, Causing irrational use of drugs, Causing fetal malformation or abortion, Bring great harm to one’s body and mind. Pregnant mother is ill, It is up to the doctor to balance the risks and benefits of medication. First of all, Judge whether a disease can heal itself without medication. If not, Whether taking medicine is of great benefit or greater risk to pregnant mothers and fetuses, Then decide what kind of medicine to use. Of course, In the real medical environment, Some doctors are afraid of taking responsibility, Will fall into the mistaken idea of preferring [left] to [right], No medicine is prescribed to pregnant mothers. But in fact, For some sick pregnant mothers, Not taking drugs is not the best choice, Reasonable and safe use of drugs is the best treatment plan. Grasp three points, Avoiding hidden dangers of medication during pregnancy in order to ensure reasonable and safe use of drugs, Pregnant mothers should follow the following three principles in medication: First, during the first 3 months of pregnancy, we should try our best to avoid using any drugs. No drug is absolutely safe for the fetus. Only when the benefits of the drug to the pregnant mother outweigh the risks to the fetus can the drug be considered. In addition, The first 3 months of pregnancy is a sensitive period for fetal development. It is the differentiation stage of various tissues and organs of the fetal body. Most susceptible to drugs, Therefore, we should try our best to avoid using any drugs during this period. Second, When it is necessary to use drugs, As far as possible, safe drugs with long clinical use time should be selected. Emphasis should be placed on drugs [long clinical use time], It is because the effect of drugs on the fetus may be different from that expected to happen to the pregnant mother. This difference can only be discovered after long-term clinical use. For example, thalidomide (commonly known as thalidomide) is a drug. At the beginning of its listing, it was used as an antiemetic for early pregnancy. But it can cause fetal multiple limb malformation. Thalidomide has been used clinically as an antiemetic for a long time. As a result, after a group of babies with hands and feet shaped like seals were born, The teratogenic effect of this drug was discovered. Emphasize [safety], It refers to choosing and using drugs with a pregnancy safety grade of A or B as far as possible as possible as stipulated by the U.S. Food and Drug Administration. At present, the reference for pregnancy medication is mainly based on the pregnancy safety drug grade formulated by the U.S. Food and Drug Administration. The U.S. Food and Drug Administration stipulates that pregnancy safety medication is divided into five grades: Grade A refers to drugs that are safe in both animal and human tests. Class B refers to drugs that are shown to be safe by animal tests, or drugs that are shown to be unsafe by animal tests and safe by human tests; Class C refers to drugs that are unsafe in animal tests and have not been done in human tests. Grade D refers to drugs that human tests show are harmful to the fetus, but can be considered when the pregnant mother has serious diseases. Grade X refers to banned drugs. There are relatively few drugs belonging to Grade A, including levothyroxine, folic acid, multiple vitamins during pregnancy, etc. Class B drugs include penicillins and cephalosporins. More than 60% of drugs are classified into Class C, It belongs to the category that can neither exclude harm, But at the same time the potential benefits outweigh the potential harm of drugs. But for serious diseases, Whether to use Class D drugs during pregnancy should weigh the pros and cons, For example, phenytoin, which is used to treat epilepsy, should be absolutely banned during pregnancy. There are not many such drugs in common use. For example, diethylstilbestrol, a sex hormone once widely used in the past, It was used to treat threatened abortion in the early 1950s. The results showed that some of the girls who gave birth would develop vaginal adenosis or clear cell carcinoma of the vagina during their subsequent growth. Therefore, this medicine is classified as Class X. It can also be seen from here that Pharmacy is a science that is constantly updated and revised. Drugs that have been used routinely before, Its possible hazards can only be found after it has been widely used. This time will be modified in the light of its latest clinical findings, The pregnancy safety classification of this drug will also be revised accordingly. For example, the latest revision made by the U.S. Food and Drug Administration is about magnesium sulfate injection to protect the fetus. According to adverse reaction data collected by the U.S. Food and Drug Administration, Pregnant mothers use magnesium sulfate injection continuously for more than 5 days, It can cause bone damage to the developing fetus. According to this, The U.S. Food and Drug Administration changed the pregnancy safety rating of magnesium sulfate injections from the original fairly safe A level to the teratogenic D level. Third, When using drugs, choose the minimum effective dose and the shortest effective course of treatment. For example, acetaminophen, a drug widely used to reduce fever and relieve pain during pregnancy, In the U.S. Food and Drug Administration’s safe grading for pregnancy, it is Grade B, If the minimum effective dose of this drug is 500 mg per use, At the same time, only when there are symptoms, If you don’t eat without symptoms, It is safe to use it during pregnancy. If you use more than 1,000 milligrams of this drug each time or use it in large quantities for a long time, It may have an impact on the fetus, There are reports in the literature that pregnant mothers take large amounts of acetaminophen for a long time, causing renal failure in newborns. The antibiotics that can be used during pregnancy are not only the drugs that pregnant mothers with long-term chronic diseases need to use under the guidance of doctors mentioned earlier, Some acute infectious diseases during pregnancy sometimes have to use drugs. A netizen on Weibo asked me: [I was 4 months pregnant and coughed with stomachache and asthma when talking. I had to see a doctor and prescribed some medicine (as if called amoxicillin). I said that not taking medicine had an impact on the baby, so I had to listen to the doctor and take it. Now I am worried to death. May I ask Mr. Ji, can I use antibiotics during pregnancy? Does it affect the baby? ] Again, Antibiotics are used to treat the infection of bacteria and mycoplasma and other pathogenic bacteria. If the doctor makes it clear that your disease must be treated with antibiotics, Be sure to tell your doctor that you are pregnant, Ask your doctor to give you antibiotics that you can use during pregnancy. Amoxicillin is a penicillin antibiotic. In the U.S. Food and Drug Administration’s drug safety rating for pregnancy, it was rated B, It is an antibiotic widely used during pregnancy. Apart from penicillin, And cephalosporins. If you’re allergic to penicillin or cephalosporins, The doctor can also consider prescribing azithromycin or clindamycin for you. These two drugs are also Class B antibiotics. Antibiotics that should be avoided during pregnancy. Tetracycline antibiotics should be avoided during pregnancy. The commonly used drug in this antibiotic is doxycycline. This drug passes through the placenta, May gather on the teeth of the fetus, Causing discoloration of the teeth, Therefore, it should be avoided during pregnancy. In addition, Aminoglycoside antibiotics should also be used with caution, These antibiotics mainly include streptomycin, amikacin, etc. They are ototoxic, Damage to fetal auditory nerve, It may lead to deafness in the baby born. Like the deaf-mute dancers in the dance < < Thousand-Handed Guanyin > > we saw at the CCTV Spring Festival Gala, The vast majority of them were deafened by drugs such as streptomycin when they were young. There are also babies whose ear nerves have been damaged and need cochlear implants. The drugs most likely to cause ear nerve damage are aminoglycoside antibiotics.