Prepared by

Glenda B. Ganzon RM, RN, MAN

MEDICATION
DURING PREGNANCY
During pregnancy, some medications
are safe and some are not. Some
require a higher than usual dose, and
some doses change with the
advancing pregnancy. Drugs should
be given only if the potential
benefit justifies the potential risk to
the fetus."
CATEGORIES
The pregnancy category of a drug
is an assessment of the risk of
fetal injury occurred by that drug.
CATEGORIES
The U.S. Food and Drug
Administration has generated a
grading system for medications
used during pregnancy. The
categories are A, B, C, D, and X.
The significance of these
categories are :-

CATEGORY A
Definitions
Drugs that have been tested for
safety during pregnancy and have
been found to be safe.
CATEGORY A
Clinical Application
For all practical purposes, there are
no Category A drugs. Drugs, and
some multivitamins This includes folic
acid, vitamin B6, and thyroid
medicine classified as Category A.
CATEGORY B
Definitions
Drugs that have been used a lot
during pregnancy and do not appear
to cause major birth defects or other
problems.
CATEGORY B
Clinical Application
Category B drugs include vitamins,
acetaminophen (Napa), famotidine
(famotid), prednisolone (cortan),
insulin (for diabetes), and ibuprofan
(inflam) before third trimester,
ibuprofen should not take during the
last three months of pregnancy.
CATEGORY C
Definitions
Drugs that are more likely to cause
problems for the mother or fetus.
Also includes drugs for which safety
studies have not been finished.
Drugs should be given only if the
potential benefit justifies the
potential risk to the fetus.
CATEGORY C
Clinical Application
There are some reasons to be more
concerned about these drugs than
Category B drugs. If the pregnant
patient will benefit from a Category
C drug, it is generally used. These
drugs include fluconazole (Fluda),
and ciprofloxacin (Xirocip), some
antidepressants are also included
in this group.
CATEGORY D
Definitions
Drugs that have clear health risks for
the fetus. but the benefits from use
in pregnant woman may be
acceptable despite the risk (e.g., if
the drug is needed in a life-
threatening situation or for a
serious disease.)
CATEGORY D
Clinical Application
Category D drugs includes - alcohol,
lithium (used to treat manic
depression), phenytoin (eptoin), and
most chemotherapy drugs to treat
cancer. They should be used during
pregnancy only when no alternatives
available.
CATEGORY X
Definitions
Drugs that have been shown to
cause birth defects and should
never be taken during pregnancy.
The drug is contraindicated in
women who are or may become
pregnant."
CATEGORY X
Clinical Application
Category X drugs should not be used
during pregnancy. This includes drugs to
treat skin conditions like cystic acne
(Accutane), a sedative (thalidomide) etc.
COMMONLY USED DRUGS IN PREGNANCY
AND THEIR CATEGORIES
Drugs Categories
Analgesics and Antipyretics
(zydol)
B and C
Acetaminophen(Napa) B
Phenacetin(vicks) B
Aspirin(Ecosprin) C
Antiemetics(Emistat) B and C
Doxylamine(gestrenol) B
Meclizine(emezin) B
COMMONLY USED DRUGS IN PREGNANCY
AND THEIR CATEGORIES
Drugs Categories
Cyclizine(marezine) B
Dimenhydrinate(pedeamine) B
Antibiotics B, C and D
Penicillin, Ampicillin, Amoxycillin, B
Cloxacillin Cephalosporins B
Erythromycin(erocine) B
Gentamicin(gentin) C
COMMONLY USED DRUGS IN PREGNANCY
AND THEIR CATEGORIES
Drugs Categories
Amikacin(kacin) C/D
Streptomycin D
Sulphonamides(burnsil) B/D
Tetracyclines(tetrax) D
Amoebicides(Filmet)
Anthelmentics
-
COMMONLY USED DRUGS IN PREGNANCY
AND THEIR CATEGORIES
Drugs Categories
Albendazol B
Mebendazole B
Antimalarials C
Antifungals C
Anti TB Drugs B and C
Ethambutol B
INH C
COMMONLY USED DRUGS IN PREGNANCY
AND THEIR CATEGORIES
Drugs Categories
Pyrazinamide C
Vitamins
-
B,C,D,E,folic acid A
Hormones
-
Thyroxin A
Androgens X
Estrogens X
COMMONLY USED DRUGS IN PREGNANCY
AND THEIR CATEGORIES
Drugs Categories
Progestogens
-
Hydroxyprogestrone D
Medroxyprogestrone D
Norethindrone X
Norgestrel X
Bronchodilators C
COMMONLY USED DRUGS IN PREGNANCY
AND THEIR CATEGORIES
Since it is not a complete list,
patients are advised to check the
drug label of each drug before
taking them during pregnancy.
SAFE MEDICATION TO TREAT DURING
PREGNANY
Allergy
Benadryl (diphenhydramine).

Cold and Flu
Tylenol (acetaminophen)
Saline nasal drops or spray
Warm salt/water gargle

Constipation
Colace
Metamucil

SAFE MEDICATION TO TREAT DURING
PREGNANY
First Aid Ointment
Bacitracin
J&J First-Aid Cream
Neosporin
Polysporin.

Rashes
Benadryl cream
Caladryl lotion or cream
Hydrocortisone cream or ointment.



WHAT CAN I EAT IF I AM NOT FEELING
WELL?

Pregnancy symptoms vary.
Some woman may have difficulty
with morning sickness, diarrhea, or
constipation. Here are a few
suggestions on how to deal with
these symptoms.
Morning sickness
For morning sickness, try eating
crackers, before you get out of bed. Eat
small meals more frequently
throughout the day. Avoid fatty, fried
foods.
Constipation
Increase your fiber intake by eating high
fiber and fresh fruits and vegetables.
Also, make sure you are drinking plenty
of water - at least eight glasses per day.
Diarrhea
Increase your intake of foods containing
pectin and gum fiber to help absorb
excess water. Good choices include:
applesauce, bananas, white rice, refined
wheat bread, and smooth peanut butter.

Heartburn
Eat small frequent meals throughout the
day. Try drinking a glass of milk before
your meal. Avoid caffeine. Try not to lie
down after eating a meal.

MEDICATIONS SAFE IN PREGNANCY
Some antibiotics namely Amoxycillin, Ampicillin,
Cephalosporins, Erythromycin.
Levothyroxine.
Acetaminophen.
Folic Acid and Vitamin B6.
Methyl dopa, and hydralazine.
Insulin.
Heparin.
MEDICATIONS CONTRAINDICATED IN
PREGNANCY
Some drugs in category X that are contraindicated
in pregnancy and their effects on the fetus are
listed below:-
Vitamin A and its derivatives -
Accutane(Isotretinoin), can cause Birth defects.
Thalidomide
Seal like limbs and other defects.
MEDICATIONS CONTRAINDICATED IN
PREGNANCY
Diethylstilbestrol
Causes cancer of the vagina or cervix in female
children during their teenage years.
Warfarin (Warin)
Causes multiple birth defects.
Danazol (Danzol)
Causes malformations in sex organs of female fetus.

MEDICATIONS CONTRAINDICATED IN
PREGNANCY
Simvastatin (Avastin)and other statins
Cholesterol is needed for fetal growth and its
reduction by statins could harm the fetus
Finasteride (pronor)
Though finasteride is normally not prescribed
to women, pregnant women should not
handle broken or crushed tablets since it can
get absorbed through the skin and affect the
sex organ.
MEDICATIONS CONTRAINDICATED IN
PREGNANCY
Testosterone (Testanon)
Can cause birth defects.
Oral contraceptives-
Can cause birth defects.
Dutasteride (Urodart)
Affects the sex organ development of the fetus.
Methotrexate (Trexonate)
Causes cleft palate along with multiple defects.
MEDICATIONS CONTRAINDICATED IN
PREGNANCY
Aspirin
Aspirin and other drugs containing
salicylate are not recommended during
pregnancy, especially during the last three
months. Acetylsalicylate, a common
ingredient in many OTC painkillers, may
make a pregnancy last longer and may
cause severe bleeding before and after
delivery.
(PDA)- failure of closure of
ductus Arteriosus usually
present in every fetus before
birth, infants after birth.
NSAIDs causes patent ductus
arteriosus (PDA).
Lithium salts (Lithosan SR)
causes
Ebstein's anomaly
Congenital heart defect in which the opening of the
tricuspid valve is displaced towards the right
Thalidomide
causes
Thalidomide caused
Phocomelia
Folic acid deficiency caused Neural tube
defects.
(Spina bifida,
Encephaly,
Encephalocele)
Valproic acid(epilim) causes decreased
absorption of Folic acid and leads to deficiency
of folic acid which may results in neural tube
defects in the fetus.
Spina bifida
Spina bifida is a
developmental conge
nital disorder caused
by the incomplete
closing of
the embryonic neural
tube Some
vertebrae overlying
the spinal cord are
not fully formed and
remain infused and
open.
Encephaly
Anencephaly (without
brain) is a neural tube
defect that occurs
when the head end of
the neural tube fails
to close, usually
during the 23rd and
26th days of
pregnancy.
Encephalocele
Encephaloceles are
characterized by the
skull that are sac-like
and covered with
membrane. They can
be a groove down the
middle of the upper
part of the skull,
between the forehead
and nose, or the back
of the skull.
Paroxetine (oxat)
(Selective serotonin re-uptake
inhibitor).
Causes cardiac defects.
Paroxetine
causes
cardiac defects
in fetus
Alcohol induced
Fetal Alcohol Syndrome
Fetal alcohol syndrome (FAS) is a pattern of
mental and physical defects that can develop in
a fetus in association with high levels of alcohol
consumption during pregnancy. Alcohol crosses
the placental barrier and can stunt fetal
growth or weight, create distinctive facial
stigmata, damage neurons and brain structures,
which can result in psychological or behavioral
problems, and cause other physical damage.
Valproic acid induced
Fetal Valproate Syndrome
Valproate syndrome include facial
features, tall forehead, medial deficiency
of eyebrows, lat nasal bridge,
broad nasal root.
Valproic acid is contraindicated in
pregnancy, as it decreases the intestinal
reabsorption of folate (folic acid), which
leads to neural tube defects.
If taken by a pregnant mother,
Carbamazepine can cause birth defects that
include:- cardiovascular and urinary tract
anomalies, cleft palate, fingernail
hypoplasia, developmental delays,
and intrauterine growth restrictions.
Phenytoin induced
Fetal Hydantoin Syndrome
Fetal hydantoin syndrome, also
called fetal dilantin syndrome is a
group of defects caused to the
developing fetus by exposure to the
teratogenic effects of phenytoin or
carbamazepine.
Opoid analgesic induced
Drug withdrawal syndromes
Drug withdrawal syndromes
Isotretinoin (Vitamin A derivative)
induced
Fetal defects
Fetal defects
Smoking Induced
Fetal defects like
Cleft palate,
Premature births,
Low birth weight,
Abortions.
Smoking Induced
This Presentation is
Dedicated to
My Mother