1.

pregnancy categories,
Category A

Adequate and well-controlled 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).

Example drugs or substances: levothyroxine, folic acid, liothyronine

Category B

Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no
adequate and well-controlled studies in pregnant women.

Example drugs: metformin, hydrochlorothiazide, cyclobenzaprine, amoxicillin, pantoprazole

Category C

Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate
and well-controlled studies in humans, but potential benefits may warrant use of the drug in
pregnant women despite potential risks.

Example drugs: tramadol, gabapentin, amlodipine, trazodone

Category D

There is positive evidence of human fetal risk based on adverse reaction data from
investigational or marketing experience or studies in humans, but potential benefits may warrant
use of the drug in pregnant women despite potential risks.

Example drugs: lisinopril, alprazolam, losartan, clonazepam, lorazepam

Category X

Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive
evidence of human fetal risk based on adverse reaction data from investigational or marketing
experience, and the risks involved in use of the drug in pregnant women clearly outweigh
potential benefits.

Example drugs: atorvastatin, simvastatin, warfarin, methotrexate, finasteride

Common
Pregnancy Pregnancy-Safe Medications FDA Category Common Side Effects
Complaints

Dizziness

Headache

Diarrhea
Mucinex, Glytuss (guaifenesin)
Category C [3] Skin Rash
expectorant [2]
Hives

Nausea/Vomiting

Stomach Pain

Blurred vision

Confusion, restlessness

Cold, cough, Drowsiness

Robitussin DM, Balminil DM
flu and sore
(dextromethorphan) cough Category C [5] Nausea/vomiting
throat
suppressant [4]
medicines Slowed breathing
during
pregnancy Stomach pain

Shakiness/palpitation [6]

Dizziness

Stomach Upset
Benylin Expectorant (guaifenesin- Drowsiness [8]
Category C
dextromethorphan) [7]
Allergic reactions (skin rash,
itching, swelling of the
face/mouth [9])

Fatigue, dizziness
Benadryl (Diphenhydramine) cough
Category B [11] Headache
suppressant [10]
Dry mouth
 Allergic reactions (skin rash,
itching, difficulty breathing,
swelling of the
face/mouth, lips and tongue
[12]
)

No common side effects have

been reported [14] Contact
Sucrets lozenges (over-the-counter your doctor in case of allergic
Category C
dyclonine) sore throat relief [13] reactions (hives, itching,
breathing difficulty, swelling
of the face/mouth)

No common side effects have

Cough drops [15]
been reported

Skin rash

Hives

Blisters or skin peeling

Itching

Category B oral Difficulty breathing

Pain Tylenol, Panadol, Anacin Aspirin-Free and rectal use Swelling of the face, mouth,
medication (acetaminophen/paracetamol) [16,17] [18]Category C in IV throat, hands and feet
form [19]
A long-term study associated
the use of acetaminophen
(Tylenol) in pregnancy with an
increased risk of having a child
with ADHD. However,
conclusive research is still
required [20].

Fever,
headache and
Tylenol (acetaminophen)
migraine
medicines

Morning Emetrol (phosphoric acid/ Fructose intolerant women

Category C
sickness, fructose/dextrose) [21] may experience
vomiting, Fainting
nausea
medicines for Swelling of face, legs and arms
pregnancy Weight loss

Vomiting

Yellow eyes or skin

Large doses may lead to

abdominal pain and diarrhea
[22]
.

Category
A(assigned to Large doses may cause
category C when clumsiness and numbness or
Oral vitamin B6 [23]
the daily intake is tingling sensation in the hands
higher than the and feet [24]
RDA)

Blurred vision

Drowsiness

Dramamine (over the counter
dimenhydrinate) anti-nausea and
vomiting medicine [23]
Headache, dizziness
Category B Ringing of the ears
Dryness of the mouth

Palpitation

Incoordination [25]

Bloating

Gas
Constipation
medicines and Bitter taste in the mouth
Colace 50mg/100mg (docusate) [15] Category C [26]
stool Stomach pain
softeners
Diarrhea

Rectal irritation
 Throat irritation

Allergic reactions [27]

Minor gas and bloating

Metamucil (psyllium) Category B [28]
Abdominal discomfort [29]

Abdominal fullness and

discomfort

Severe side effects

Not classified
(should be used Allergic reactions (rashes,
Unifiber, Citrucel (methylcellulose) [16] only when itching, breathing problems)
absolutely
necessary) Chest pain

Nausea, vomiting

Difficulty swallowing [30]

Diarrhea

Allergic reactions (rashes,

Ex-Lax Milk of Magnesia (milk of itching, difficulty breathing)
Category A [32]
magnesia) [31]
Appetite loss

Nausea, vomiting

Dizziness

Vomiting

Constipation

Dry mouth
Diarrhea
Imodium (loperamide) Category C[33] Stomach pain
medicine
Serious side effects

Skin rash

Itching

Difficulty breathing
 Not classified; not Constipation
absorbed after
Bloating
oral
Parepectolin (attapulgite oral) administration Flatulence
and therefore is
believed to be Stomach Upset
harmless [34] Nausea [35]

Constipation

Nausea
[36]
Zantac (ranitidine) Category B
Stomach pain

Headache [37]

Nausea

Constipation/diarrhea
Mylanta Headache
Category C [38]
(aluminum/magnesium/simethicone)
Allergic reactions (skin rash,
Heartburn, hives, itching, breathing
acid reflux or difficulty) [39]
acid
indigestion No common side effects have
and upset been reported. Some may
stomach develop allergic reactions
Tums (calcium carbonate) Category C [40]
(skin rash, itching, difficulty
breathing, swelling of the
face/mouth) [41]

Loss of appetite
Riopan (magaldrate-oral) Category C [42]
Diarrhea/constipation [43]

There are usually no side

effects except for constipation
Gaviscon (aluminum/magnesium
Category C [44] or diarrhea [45]. Allergic
trisilicate)
reactions may occur in some
individuals
 No serious side effects have
Gas and
been reported. Contact your
bloating Gas X, Mylanta Gas (simethicone) Category C [46]
doctor in case of any
medications
suspected adverse effects. [47]

Ocean Mist Nasal Spray (OTC No serious side effects have

Category A
intranasal sodium chloride) [48] been reported

Headache

Decongestants Category C [50] in Restlessness

and sinus second and third
trimestersNot Insomnia
medications
Sudafed (pseudoephedrine) [49]
recommended Nausea, vomiting
during the first
trimester Nervousness

Increased blood pressure [50]

Benadryl (Diphenhydramine) [16] Category B

Drowsiness

Dizziness and headache

Sleeplessness
Constipation
and insomnia Unisom Sleep-Aid (Doxylamine
Category B [52]
succinate) [51] Stomach upset

Decreased coordination

Dry mouth [53]

Headache

Drowsiness

Swelling of the feet and ankles

Blood
pressure Methyldopa (prescription medication) Category B [54] Vomiting
medication
Upset stomach

Muscle weakness

Diarrhea
 Dry mouth [55]

Fatigue

Headache and
lightheadedness
Trandate (Labetalol, prescription
Category C [57]
medication) [56] Tingling sensations on the skin

Upset stomach

Stuffy nose [58]

Constipation/diarrhea

Dizziness

Drowsiness

Dry mouth

Chlor-Trimeton (chlorpheniramine, an Headache

Category C [59]
antihistamine) Loss of appetite

Allergy Nausea
medicines
Anxiety
while
pregnant Trouble sleeping

Vomiting [60]

Benadryl (Diphenhydramine, an
Category B
antihistamine)

Headache

Claritin (loratadine, an antihistamine) Category B Fatigue

Dry mouth [82]

Yeast Headache
infection and Monistat-1 (tioconazole) Category C [61] urethral or vaginal
other fungal
pain/burning/itching [62]
infections
(e.g. athletes Headache
foot)
Serious side effects

Burning or irritation in the

Terazol 7 Vaginal (terconazole) Category C [63] vagina

Fever

Stomach pain

unusual vaginal discharge [64]

Burning, swelling, irritation,

redness, pimple-like bumps
and flaking of the treated skin
area
Mycelex 7, Lotrimin AF (Clotrimazole
Category B [65]
vaginal cream) [16] Stomach pain

Fever

Foul-smelling discharge [66]

Irritation, burning, redness

[67]
Topical Mentax (butenafine) Category C and itching of the treated skin
area [68]

Burning sensation after

Anusol HC (hydrocortisone rectal, applicationSensitivity
Category C
prescription) reactions (skin rash, scaly skin)
[69]

Not classified;
should not be
used unless Burning or stinging sensation
Hemorrhoid Tucks (pramoxine)
potential benefits after application [70]
outweigh possible
risks [71]

No serious side effects have

Preparation H
been reported. May lead to
(phenylephrine/mineral Category C[72]
allergic reactions in some
oil/petrolatum)
individuals. [73]
 no serious side effects have
Westhroid, Armour Thyroid (thyroid [76]
Category A been reported apart from hair
desiccated)
Thyroid loss in some individuals [81]
medication
Nausea and hair loss are the
Cytomel, Triostat (liothyronine) Category A [79]
only common side effects [74]

Vitamin B6

Consulting your doctor is

Seizure recommended to assess the
medications potential risks and benefits as
Aptiom (eslicarbazepine acetate) Category C [75]
leaving seizures untreated can
be harmful for both the
mother and baby [77]

Fast breathing

Joint pain
Penicillin V Category B [80]
Lightheadedness

Fever [78]
Antibiotic
Nausea and vomiting
medications
Diarrhea

Amoxicillin Category B [113] Headache

Stomach pain

Vaginal discharge [112]

Medicines to avoid during pregnancy

Use of NSAIDs (nonsteroidal anti-inflammatory drugs), anti-depressants and anxiety medications is not
recommended at any stage of pregnancy unless absolutely necessary.

Name of the
Pregnancy ailment FDA Category Adverse effects during pregnancy
Medication

Treatment of fever, Category C in first and

Fetalcomplications and birth defects
headache, pain and Aspirin second
such as pulmonary hypertension in
inflammation trimestersCategory D in
(NSAIDs) the third trimester [85] the newborn babies

Category C before 30th Complications at the time of delivery

[89, 90]
week of
Advil, Motrin,
gestationCategory D
Nuprin (ibuprofen)
after 30th week of
gestation [83]

Category C before week

Anaprox, Aleve,
30Category D for
Naprosyn
prolonged use after
(naproxen)
week 30 [86]

Pepto-Bismol, Category C in first and Intrauterine growth problems and

Anti-diarrheal Kaopectate second serious birth defects
medicines (bismuth trimestersCategory D in
subsalicylate) third trimester [88] Complications during delivery [84]

Increased risk of congenital defects

when taken in the first trimester
Xanax (alprazolam) Category D [92] Birth defects, developmental
problems and floppy baby syndrome
[94]

Use in early pregnancy can lead to

serious fetal heart defects [91]

Use in third trimester may lead to

Paxil (paroxetine) Category D [87] withdrawal symptoms including
Depression and
anxiety feeding problems, breathing
medications difficulty, muscle stiffness, seizures
and constant crying [97]

Congenital malformations

signs of withdrawal after birth, like

Celexa (citalopram) Category C [95] constant crying, feeding difficulties,
breathing problems, seizures etc
(when used during the third
trimester) [93]

Zoloft (sertraline) Category C [98] Increased risk of persistent

 pulmonary hypertension of the
newborn or PPHN

Use in the last few months are

associated with congenital
complications often requiring
respiratory assistance and tube
feeding [100]

Use in late third trimester may lead

to serious breathing problems,
Prozac (fluoxetine) Category C [96] feeding difficulty, muscle stiffness
and other symptoms of withdrawal
in the newborn baby [99]

Klonopin May lead to serious birth defects and

Category D [102]
(clonazepam) problems in the newborn baby.
Consulting your doctor is
Bipolar disorder recommended if taking the
medications medication for seizure management
Topamax Category D [101] as untreated seizure during
pregnancy is also harmful for both
the mother and baby. [103]

FDA Category X medicines

The medicines included in the following list are not recommended in pregnancy under any
circumstances due to possible fatal outcomes.

Name of
Use Adverse effects
medicine

When taken in the first trimester: Bilateral optic

Anticoagulant or blood thinner
atrophy, bone malformations, nasal hypoplasia and
used to prevent blood clotting
Coumadin learning disabilities (fetal warfarin syndrome)
disorders as well as reduce the [105]
(warfarin) When taken in second and third trimesters: Fatal
risks of stroke and heart attack
[106]
maternal or fetal hemorrhage, microcephaly,
increased risk of miscarriage [104]

Trexall, Management of rheumatoid

Rheumatrex arthritis and psoriasis, Serious congenital deformities and fetal death [107]
(methotrexate) treatments of certain cancers
including the skin, lungs and
 breast cancers [109]

Treatment of severe nodular Spontaneous abortion, premature delivery, birth

Claravis, Sotret acne unresponsive to any other defects, physical deformities, skull malformations,
(isotretinoin) treatment options, including central nervous system and cardiovascular system
antibiotics [108] defects [110]

Treating fibrocystic breast

disease and endometriosis,
Danazol Life threatening congenital defects
preventing hereditary
angioedema attacks [111]

2. Rumus Cockcroft-Gault
CCT terhitung pada laki-laki= {(140-umur) x berat badan} / (72 x kreatinin darah)

CCT terhitung pada perempuan= {(140-umur) x berat badan} / (72 x kreatinin darah)
dikali 0,85
Contoh perhitungan:

Seorang laki-laki (katakanlah bernama Mr. X), berusia 50 tahun, berat badan 60 kg, hasil
pemeriksaan Kreatinin Darah 3 mg/dl, maka perhitungan fungsi ginjalnya adalah:
CCT terhitung = {(140-umur) x berat badan} / (72 x kreatinin darah) = {(140-50) x 60} /
(72 x 3) = 25
Jadi fungsi ginjal Mr. X = 25%.

Sedangkan bila dia adalah seorang perempuan (misalnya Mrs. X) maka perhitungannya:
CCT terhitung pada perempuan = CCT pada laki-laki X 0,85 = {(140-50) x 60} / (72 x 3)
dikali 0,85
= 25 X 0,85 = 21,25
Hasilnya, fungsi ginjal Mrs. X = 21,25%.
3. Koreksi kalium
Rumus = delta K (4,5-nilai kalium)x0,3xBB
Misal seorang lelaki memiliki BB 65kg dengan nilai kalium darah 2,5 mmol/L maka
koreksi kaliumnya?
(4,5-2,5)x0,3x65=39 mEq