N 340 Women's Health & Illness in The Expanding Family & N345 Clinical Practicum

Module 2: Pharmacology
Medications Commonly Used in Pregnancy and During Lactation

The information presented in this model is an adjunct to what is presented in the text because it seems sketchy. This information is presented by category and is meant to give you some basic guidelines for medications not uncommonly used in pregnancy, while women are nursing, and for the newborn. The use of medications presents legal and ethical decisions that need to be made before medications are administered to either the mother/fetus or the infant (directly or via breast milk). Doses of medications don't usually change in pregnancy unless the amount of medication given is weight dependent.

Drugs are listed by the following categories:

Category: A; Controlled studies in pregnant women do not show risk to the fetus

Category B: No controlled studies in humans, but animal studies don't show any problems.

Category C: Animal studies show there may be risks to fetus. These are used if the potential benefit outweighs the potential risks.

Category D: There is evidence of human fetal risk. Drug may still be given if there is a life threatening situation for the mother.(I.e. lots of the antineoplastics).

Category X: There is a clear risk to the fetus. Benefit doesn't outweigh the risk (I.e. Acutane).
This is a "quick" reference and in no way meant to take the place of looking meds up in the appropriate pharmacology resources.

Name:

1. Match the two lists:
Category of medication:
A. ____ 1. There is evidence of human fetal risk. Drug may still be given if there is a life threatening situation for the mother.

B. ____ 2. Controlled studies in pregnant women do not show risk to the fetus

C. ____ 3. There is a clear risk to the fetus. Benefit doesn't outweigh the risk

D. ____ 4. No controlled studies in humans, but animal studies don't show any problems.

X: ____ 5. Animal studies show there may be risks to fetus. These are used if the potential benefit outweighs the potential risks.

Use the Pharmacology in Pregnancy Website and the OTC Medication Website to answer these questions:

2. Name two medications that should not be used in pregnancy, but can be used in a lactating woman. Why might this be?

3. Name a pain medication that can be used in the first two trimesters of pregnancy, but not in the third. Why not?

4. List two psychotropic medications that can be used in pregnancy and one that can not.

5. How come Valium is listed as a category D drug and yet listed as a medication to be used during a seizure?:

6. You are providing care for a postpartum patient whose baby is in the NICU to rule out a cardiac defect. Your patient is tearful as she took Pepto Bismol for the first three months while she was in India in the Peace Corps. She took it to prevent diarrhea which could quickly she knew could quickly lead to dehydration. She now knows this could be the reason for her child's possible heart problems. Briefly, what would you want to cover with your patient?