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Maulana A. Empitu
Department of Pharmacology
Airlangga University – School of Medicine
m.a.empitu@gmail.com
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Category A: Safest
Adequate, well-controlled studies in pregnant women have
not shown an increased risk of fetal abnormalities
Category X: Contraindicated
Asthma
Asthma:
Asthma complicates approximately 4% of
pregnancies
In some cases, asthma improves during
pregnancy
Those with poorly controlled asthma are at
risk for:
Hyperemesis, uterine hemorrhage, preeclampsia,
placenta previa, hypertension and premature labor
IMPLICATIONS of Pregnancy on Asthma
Under-treating is a frequent occurrence for the pregnant
patient because patients are worried about the medication
effects on the fetus
With a few exceptions, the medications used to treat asthma
during pregnancy are similar to the medications used to treat
asthma at other times during a person's life.
Common Asthma
medications
Inhaled B2 Agonists
Albuterol-Category C
Mild, infrequent episodic
May cause maternal hyperglycemia, tachycardia,
hypotension or neonatal hypoglycemia
Briggs, et al., 2002: study of 1090 infants
exposed to albuterol in 1st trimester-possible
association with polydactyly
No congential defects link in 2nd, 3rd trimester
No adverse effects during lactation
Possible B2Choice-Brethine (category B)
Other Asthma Drugs
Theophylline (Cat C)
Crosses placenta in equal concentrations to mother
Not associated with congenital defects but can cause
jitteriness, cardiac arrythmias, hypoglycemia, feeding
difficulties in infants
Neonates more likely affected
Corticosteroids (Cat C)
Spontaneous abortion, prematurity, cardiac
abnormalities reported in one study
Prednisone <20mg/day safe in lactation
In larger doses, delay nursing 3-4hours after dose
The Common Cold
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