Over the Counter (OTC) Drugs in Pregnancy
Just because a medication is available in any pharmacy does not necessarily make it safe for use in pregnancy. Following is a list of commonly used drugs and the precautions, warnings and safety during pregnancy. Acetaminophen (Tylenol) When used according to the directions, Tylenol is widely considered safe during pregnancy. It should be used short term only. It would be wise to stay as far below the adult dosage as possible. Tylenol is very hard on the liver, and your baby’s liver is very immature. Any drugs you take will get to the baby in varying degrees. The maximum dose is 4 gm over 24- 48 hours. This would be 8 extra-strength tablets. Many other OTC medications contain acetaminophen also, so read labels. It would be easy to take too much. If you need a pain reliever, try massage, warm compresses, meditation or visualization, ice packs or sitting quietly in a dark room, before reaching for the bottle. Ibuprofen (Advil, Motrin) Two studies have found increased risk of miscarriage with the use of ibuprofen in the first trimester. There are some concerns that early Ibuprofen usage can interfere with the implantation of the baby. The third trimester has the greatest risk for Ibuprofen use. The greatest concern is for the premature closing of the ductus arteriosus (a blood vessel in the baby’s heart) which can lead to high blood pressure in the baby’s lungs. The use of Ibuprofen in late pregnancy can inhibit the start of labor and lead to low levels of amniotic fluid, which increases the risk of fetal distress. It is best to avoid Ibuprofen during pregnancy. Diphenhydramine (Benadryl) Stillbirth has been reported following a combination of diphenhydramine and temazepam (an anti-anxiety drug). Diphenhydramine has been shown to cause uterine contractility or irritability when used in high doses late in pregnancy. Some midwives feel that a small dose of Benadryl can help to stop “false labor” and help a mother sleep. Dosing right before birth could cause excessive sleepiness in the newborn. The manufacturer considers this medication incompatible with breastfeeding. Psuedoephedrine (Sudafed) A handful of studies has shown and increase in birth defects in babies who were exposed to psuedoephedrine in pregnancy, especially when combined with acetaminophen (Tylenol Cold & Sinus). Other studies have found no link. The ACOG recommends avoiding oral decongestants during the first trimester unless the benefit will be large and unique. Cough Syrup Cough syrups containing only the expectorant Guiafenesin are widely considered safe during pregnancy. However, cough syrups containing Dextromethorphan have been shown to cause severe birth defects in chicken and rat embryos. Some researchers have questioned the transferability of this information to humans. As with most things, it is best to try natural remedies first. Alka Seltzer This medicine contains aspirin, sodium bicarbonate (baking soda) and citric acid. Because it contains aspirin, this medicine is not safe during pregnancy. Aspirin can affect blood clotting ability, increase bleeding after birth, and cause problems with labor and delivery. Tums Taking large amounts later in pregnancy can lead to fetal hypomagnesemia, increased deep tendon reflexes and increased muscle tone. Also, the form of calcium in Tums, calcium carbonate, is poorly used by the body. A recent Cochrane review has shown that calcium supplementation has shown to reduce the risk of pre-eclampsia and hypertension disorders. The studies were done using calcium carbonate. Mylanta Mylanta is usually a calcium/magnesium medicine with aluminum hydroxide in it. Aluminum is a heavy metal that has been linked with brain damage and alzheimer’s. Magnesium salts may cause CNS depression and diarrhea.
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