Book of Medical Disorders in Pregnancy - Tintash
Book of Medical Disorders in Pregnancy - Tintash
Book of Medical Disorders in Pregnancy - Tintash
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
Restricted <strong>in</strong>dications:<br />
Anti leprosy drugs:<br />
Cl<strong>of</strong>azim<strong>in</strong>e may cause sk<strong>in</strong> discoloration,<br />
which is reversible dapsone.<br />
Compatible with breast feed<strong>in</strong>g. Monitor<br />
for side-effects (hemolysis and jaundice),<br />
especially if the <strong>in</strong>fant is premature or<br />
less than 1 month old. Avoid <strong>in</strong> <strong>in</strong>fants<br />
with G-6-PD deficiency rifampic<strong>in</strong>.<br />
Compatible with breastfeed<strong>in</strong>g.<br />
Antituberculosis drugs:<br />
General <strong>in</strong>formation:<br />
If the baby develops significant jaundice,<br />
stop or change the drug if possible. If<br />
this is not possible, it may be necessary<br />
to consider feed<strong>in</strong>g the baby artificially.<br />
Ethambutol compatible with breastfeed<strong>in</strong>g.<br />
Monitor the <strong>in</strong>fant for jaundice<br />
isoniazid compatible with breastfeed<strong>in</strong>g.<br />
Monitor the <strong>in</strong>fant for jaundice isoniazid<br />
+ ethambutol compatible with<br />
breastfeed<strong>in</strong>g. Monitor <strong>in</strong>fant for<br />
possible tox-icity pyraz<strong>in</strong>amide<br />
compatible with breast feed<strong>in</strong>g. Monitor<br />
the <strong>in</strong>fant for jaundice rifampic<strong>in</strong><br />
compatible with breastfeed<strong>in</strong>g. Monitor<br />
the <strong>in</strong>fant for jaundice rifampic<strong>in</strong> +<br />
isoniazid Compatible with breastfeed<strong>in</strong>g.<br />
Monitor the <strong>in</strong>fant for jaundice<br />
rifampic<strong>in</strong> + isoniazid + pyraz<strong>in</strong>amide,<br />
Compatible with breast-feed<strong>in</strong>g<br />
rifampic<strong>in</strong> + isoniazid + pyraz<strong>in</strong>amide+<br />
ethambutol. Compatible with<br />
breastfeed<strong>in</strong>g streptomyc<strong>in</strong> Monitor the<br />
<strong>in</strong>fant for thrush and diarrhoea.<br />
Complementary drug: Thioacetazone +<br />
isoniazid (A) Compati-ble with<br />
breastfeed<strong>in</strong>g.<br />
Restricted <strong>in</strong>dications: For drugs used<br />
<strong>in</strong> treatment <strong>of</strong> multidrug resistant<br />
tuberculosis, see section 9 <strong>of</strong> the ma<strong>in</strong><br />
179<br />
text <strong>of</strong> the N<strong>in</strong>th report <strong>of</strong> the WHO<br />
Expert Committee. A woman who is<br />
breastfeed<strong>in</strong>g and has TB should receive<br />
a full course <strong>of</strong> anti TB chemo therapy.<br />
Timely and properly applied<br />
chemotherapy is the best way to prevent<br />
transmission <strong>of</strong> tubercle bacilli to her<br />
baby. All the anti-TB drugs are<br />
compatible with breastfeed<strong>in</strong>g and a<br />
woman tak<strong>in</strong>g them can safely cont<strong>in</strong>ue<br />
to breastfeed her baby. The mother and<br />
baby should stay together and the baby<br />
should cont<strong>in</strong>ue to breastfeed <strong>in</strong> the<br />
normal way. The baby should receive<br />
isoniazid prophylaxis and BCG<br />
immunization. ( Quote from : Maher D,<br />
Chaulet P, Sp<strong>in</strong>aci S, Harries A. Treatment<br />
<strong>of</strong> tuberculosis: Guidel<strong>in</strong>es for<br />
national programmers. 2nd edition 1997<br />
Global tuberculosis Programme, World<br />
Health Organization. Geneva,<br />
Switzerland.).<br />
How drugs affect pregnancy:<br />
Most <strong>of</strong> the "drugs <strong>of</strong> abuse" produce<br />
addiction that is, tolerance, and<br />
dependence. The risk <strong>of</strong> withdrawal syndromes<br />
is very real. The fetus is a non<br />
consent<strong>in</strong>g addict.<br />
Use <strong>of</strong> potent agents such as alcohol,<br />
coca<strong>in</strong>e, and hero<strong>in</strong> is associated with<br />
accidental trauma, respiratory failure and<br />
myocardial <strong>in</strong>farction.<br />
Coca<strong>in</strong>e-<strong>in</strong>duces vasospasm and pulmonary<br />
edema. Uteroplacental blood<br />
flow is affected dur<strong>in</strong>g repetitive use <strong>of</strong><br />
coca<strong>in</strong>e. It contributes to the high<br />
<strong>in</strong>cidence <strong>of</strong> placental <strong>in</strong>sufficiency or<br />
distress. Placental abruption and even<br />
fetal death can occur. Prostitution as a<br />
pr<strong>of</strong>ession encourages sexually<br />
transmitted diseases. The passivity <strong>of</strong><br />
some patients <strong>in</strong> the face <strong>of</strong> serial or