Pregnancy Guide

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Pregnancy Medication Safety Guide ​

Medication during pregnancy requires extra caution because drugs may affect fetal development through the placenta. Understanding the principles of safe medication and drug risk classification can effectively reduce the potential harm of drugs to the fetus.

Basic Principles of Medication During Pregnancy ​

Core Principles ​

  • Avoid Unnecessary Medication: Avoid non-essential drugs as much as possible
  • Medication Under Doctor's Guidance: All drugs should be used under the guidance of a doctor
  • Lowest Effective Dose: Use the lowest effective dose
  • Shortest Treatment Time: Shorten the medication time as much as possible
  • Weigh Pros and Cons: Assess the benefits and risks of medication

Timing Considerations ​

  • First Trimester (1-12 Weeks): Most sensitive period, try to avoid medication
  • Second Trimester (13-28 Weeks): Relatively safe, but still need to be cautious
  • Third Trimester (29-40 Weeks): Pay attention to the impact of drugs on delivery and newborns

FDA Pregnancy Drug Categories ​

Category A: Safe Drugs ​

  • Definition: Adequate studies in pregnant women have failed to demonstrate a risk to the fetus
  • Features: Can be used with confidence
  • Representative Drugs:
    • Vitamins (at recommended doses)
    • Thyroxine
    • Folic Acid

Category B: Relatively Safe ​

  • Definition: Animal studies have failed to demonstrate a risk to the fetus, but there are no adequate studies in pregnant women
  • Features: Relatively safe, can be considered for use
  • Representative Drugs:
    • Acetaminophen (Paracetamol)
    • Penicillin antibiotics
    • Most Cephalosporin antibiotics
    • Insulin

Category C: Risk Unknown ​

  • Definition: Animal studies have shown an adverse effect on the fetus, but there are no adequate studies in humans
  • Features: Need to weigh pros and cons
  • Representative Drugs:
    • Most antibiotics
    • Some antipyretic analgesics
    • Some antihypertensive drugs

Category D: Evidence of Risk ​

  • Definition: There is positive evidence of human fetal risk, but the benefits from use in pregnant women may be acceptable despite the risk
  • Features: Use only when necessary
  • Representative Drugs:
    • Carbamazepine
    • Phenytoin Sodium
    • Warfarin

Category X: Contraindicated ​

  • Definition: Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data
  • Features: Absolutely prohibited
  • Representative Drugs:
    • Vitamin A (high dose)
    • Isotretinoin
    • Tamoxifen
    • Methotrexate

Medication Guidance for Common Diseases ​

Cold and Fever ​

Safe Drug Selection ​

  • Antipyretics: Acetaminophen (Tylenol) is the first choice
  • Dosage: 500mg each time, no more than 3000mg per day
  • Avoid Drugs:
    • Aspirin: May increase bleeding risk
    • Ibuprofen: May affect ductus arteriosus closure
    • Compound cold medicines: Contain multiple ingredients, risk unknown

Symptom Relief ​

  • Nasal Congestion: Saline nasal drops
  • Cough: Honey lemon water
  • Sore Throat: Salt water gargle

Digestive System Diseases ​

Nausea and Vomiting ​

  • Vitamin B6: 10-25mg each time, 3-4 times a day
  • Doxylamine: Better effect when combined with Vitamin B6
  • Avoid: Metoclopramide

Heartburn ​

  • Antacids: Calcium carbonate, Aluminum hydroxide
  • H2 Receptor Antagonists: Ranitidine (relatively safe)
  • Proton Pump Inhibitors: Omeprazole (Category B, use with caution)

Constipation ​

  • Dietary Fiber: Increase fruit and vegetable intake
  • Osmotic Laxatives: Lactulose (relatively safe)
  • Avoid: Stimulant laxatives

Pain Management ​

Headache ​

  • First Choice: Acetaminophen
  • Dosage: Use according to instructions, avoid overdose
  • Note: Frequent headaches need medical examination

Musculoskeletal Pain ​

  • Topical Medication: Topical analgesic patch, ointment
  • Physical Therapy: Heat compress, massage
  • Avoid: Oral painkillers

Allergic Diseases ​

Antihistamines ​

  • First Generation: Diphenhydramine (Category B)
  • Second Generation: Loratadine, Cetirizine (Category B)
  • Note: Avoid Terfenadine

Nasal Medication ​

  • Saline: Nasal irrigation
  • Corticosteroid Spray: Relatively safe
  • Decongestants: Avoid use

Infectious Diseases ​

Bacterial Infection ​

Penicillins

  • Representative Drugs: Amoxicillin, Penicillin V
  • Safety: Category B, relatively safe
  • Note: Contraindicated for those allergic to penicillin

Cephalosporins

  • Representative Drugs: Cephalexin, Cefuroxime
  • Safety: Category B, relatively safe
  • Note: Use with caution for those allergic to penicillin

Macrolides

  • Representative Drugs: Erythromycin, Azithromycin
  • Safety: Category B, relatively safe
  • Note: Erythromycin may cause neonatal jaundice

Antibiotics to Avoid ​

  • Tetracyclines: Affect tooth and bone development
  • Aminoglycosides: May damage fetal hearing
  • Quinolones: May affect cartilage development
  • Sulfonamides: May cause kernicterus in the third trimester

Skin Diseases ​

Fungal Infection ​

  • Topical Drugs: Clotrimazole, Miconazole (relatively safe)
  • Oral Drugs: Fluconazole needs doctor's risk assessment

Acne ​

  • Topical Medication: Azelaic acid, Erythromycin gel
  • Avoid Drugs:
    • Retinoids: Tretinoin, Isotretinoin (Category X)
    • Salicylic Acid: High concentration salicylic acid

Traditional Chinese Medicine and Herbal Medicine ​

TCM Medication Principles ​

  • Clear Diagnosis: Use under the guidance of a TCM practitioner
  • Avoid Toxic Drugs: Such as Aconite, etc.
  • Use with Caution: Drugs for promoting blood circulation and removing blood stasis, promoting Qi circulation

TCM to Avoid ​

  • Blood-Activating Class: Safflower, Peach Kernel, Motherwort
  • Purgative Class: Rhubarb, Mirabilite
  • Toxic Class: Aconite, Strychnos

Relatively Safe TCM ​

  • Spleen-Strengthening Class: Yam, Atractylodes, Poria
  • Blood-Nourishing Class: Angelica, White Peony Root, Rehmannia
  • Calming Class: Jujube Seed, Biota Seed

Nutritional Supplements ​

  • Folic Acid: 3 months before pregnancy to early pregnancy
  • Iron: Supplement when anemia or iron deficiency occurs
  • Calcium: Supplement when dietary intake is insufficient
  • Vitamin D: Supplement when sunlight is insufficient

Supplements to be Cautious About ​

  • Vitamin A: Avoid overdose, best obtained from food
  • Vitamin E: High doses may increase bleeding risk
  • Multivitamins: Choose pregnancy-specific formulas

Medication Safety Practice ​

Precautions When Seeking Medical Attention ​

  • Inform Pregnancy: Actively inform pregnancy status when seeing a doctor
  • Provide Complete History: Including allergy history, medication history
  • Ask for Alternatives: Ask if treatment can be delayed or other options chosen

Precautions for Self-Medication ​

  • Read Instructions Carefully: Check pregnancy medication information
  • Choose Smallest Package: Avoid long-term large-scale use
  • Note Medication Time: Try to avoid the first trimester

Drug Storage ​

  • Keep Out of Reach of Children: Avoid accidental ingestion
  • Keep Original Packaging: Keep drug instructions
  • Regular Cleanup: Dispose of expired drugs in time

Medication in Special Situations ​

Chronic Disease Patients ​

Diabetes ​

  • Insulin: First choice, high safety
  • Oral Hypoglycemic Agents: Most drugs are relatively safe
  • Blood Sugar Control: Pregnancy blood sugar control targets are stricter

Hypertension ​

  • Methyldopa: First choice drug
  • Nifedipine: Category B, can be used
  • ACEIs: Contraindicated

Thyroid Disease ​

  • Hypothyroidism: Levothyroxine sodium tablets
  • Hyperthyroidism: PTU is relatively safe

Emergency Medication ​

  • Acute Asthma Attack: Salbutamol inhaler
  • Severe Allergy: Epinephrine (weigh pros and cons)
  • Seizure: Diazepam, Phenytoin Sodium

Medication Risk Assessment ​

Risk Assessment Factors ​

  • Medication Time: Greatest risk in the first trimester
  • Medication Dose: The larger the dose, the higher the risk
  • Medication Duration: Long-term medication increases risk
  • Individual Differences: Different sensitivity

Risk Communication ​

  • Doctor Notification: Fully inform medication risks
  • Patient Informed: Understand benefits and risks
  • Shared Decision Making: Doctor and patient decide treatment plan together

Friendly Reminder: Medication safety during pregnancy is very important. Any medication should be used under the guidance of a doctor. If you have any questions about medication, please consult an obstetrician or pharmacist in time. Do not buy and use drugs on your own, and do not believe in unverified folk remedies.