Drugs Associated

with Pregnancy,
Labor and Delivery,
and Lactation
Drugs are not routinely tested for pregnant and
lactating women. It is also important to note that
fetal organs are formed by the 8th week and drug
effects may be more significant at this time.

Nursing
notes:
During the first 8th Moreover,
week, it is most crucial Nurses should be
that mothers do not extra careful when it
come in contact with comes to medications
medications that may especially during the
cause alterations. first trimester of the
mother.

TORCH
infections
Toxoplasmosis,
rubella,
cytomegalovirus,
HIV, herpes simplex
virus, syphilis Keys terms to
causes teratogenic remember:
to pregnant Teratogenic
women and the Fetotoxic
end result would Abortifacient
be anomalies in Oxytocic
babies. Tocolytic

Teratogenic
- also known as fetotoxic. These are
substances that have a potential to
alter or cause a problem in the
development of the embryo/fetus
inside the mother. This can cause
gross deformity and malformations.

Abortifacient
- have the capacity to cause an abortion before
term. They don't necessarily cause malformation
in the development of the growing fetus, it will
just cause spontaneous delivery.
MARY YVONNE C. SERASPE
 Oxytocic
- it has oxytocin like
Tocolytic
properties that causes - drugs that would
contraction of the cause the contraction
uterus and hasten the to relax. It relaxes the
dwelling process. smooth muscles of
the uterus.

Thalidomide babies
- they are babies are born
without arms dues to
medications their mother used
for nausea and vomiting. It is a
birth defects caused by a
'harmless' pill 60 years ago

MAJOR CLASSIFICATIONS
OF DRUGS
DRUGS USED IN PREGNANCY

ANTI-HYPERTENSIVE
LAXATIVES ORAL MEDICATIONS
Psyllium - bulking agents and are 1. Methyldopa - drug of choice
preferred because they are not 2. Hydralazine - diuretics
absorbed in the circulatory system. This 3. Hydrochlorothiazide - diuretics
is the preferred laxative for pregnant 4. Nifedipine
women.
Docusate - a stool softener which may VIA INTRAVENOUS
also be prescribe. 1. Magnesium sulfate - a central nervous
system depressant, is initiated. This
may act as a vasodilator and/or
protector of the blood–brain barrier
GROUP B STREPTOCOCCAL INFECTION from edema.
Penicillin G - is the drug of choice.
Clindamycin is an alternative in those - These antihypertensive drugs cause
women who are allergic to penicillin. vasodilation (opening of blood vessels).

Common Conditions Arising NURSING

in Pregnancy CONSIDERATIONS
THE COMBINATION OF
Constipation DELAYED-RELEASE
DOXYLAMINE
Diabetes Mellitus
SUCCINATE AND
Heartburn PYRIDOXINE
HYDROCHLORIDE IS
Nausea and Vomiting THE ONLY
PHARMACOLOGICAL
Hypertension - most common TREATMENT TO
RECEIVE FDA
maternal complication PREGNANCY
CATEGORY A STATUS,
Group B Strep Infection UNDER THE PREVIOUS
Human Immunodeficiency FDA PREGNANCY
CATEGORIES.
Neoplastic Disease BECAUSE HIV CAN BE
TRANSMITTED
THROUGH
BREASTMILK,
BREASTFEEDING IS
NOT RECOMMENDED
FOR INFECTED
MOTHERS.

MARY YVONNE C. SERASPE

 DRUGS USED DURING LABOR

OXYTOCICS
TOCOLYTICS - that would cause strong contraction
- these are drugs that relaxes the smooth to help deliver the child. It somehow
muscle contraction of the uterus helps maintain the tone of the uterus
so that the mother will not bleed to
death after delivery.

Beta-sympathomimetics
Misoprostol
- used for asthma. One of the nursing
- inserted intravaginally because it
responsibility is to go back and check the
causes cervical ripening.
heart rate because it causes an elevation
of the heart rate. Dinoprostone
Oxytocin
- given intravenously because it
Magnesium Sulfate strengthens the contractions. This
- is the drug most widely prescribed for shouldn't be given within 4 hours or
preterm labor because its side effects are before. This is given when pregnancy
relatively mild. It is the drug choice of is not progressing or after delivery.
preeclampsia. This drug control the blood
pressure of the mother and it effectively
stops uterine contractions
ANALGESICS/ANESTHESIA
- these drugs will be given so that the
mother will not suffer so much pain
during labor and delivery. Some drugs
Calcium channel blockers are butorphanol, nalbuphine, fentanyl.

ADJUNCT MEDICATIONS
Prostaglandin inhibitors - these medications such as
betamethasone and dexamethasone
- it is an anti-inflammatory drug that
are given to hasten the development
inhibits prostaglandins which in a way
or the production of lung surfactant so
can cause and stimulate uterine
that the baby born prematurely will
contractions. An example of this is
have a better chance to breathe.
indomethacin. This is only used if the
woman has premature contractions
below 32 weeks.

DRUGS USED IN POSTPARTUM PAIN MEDICATIONS

Oxytocin
Methylergon Mefenamic
ovine acid - for
after pains
These drugs are Tramadol -
used to contract for higher
uterus and pain reliever
prevent
mother's from
bleeding out.

BREASTFEEDING AND MEDICATIONS GENERAL GUIDELINES

Most drugs appear in breastmilk to some degree
Levels of most drugs in breastmilk do not usually exceed
1%-2% of ingested maternal dosage
Milk/plasma ratio and active metabolites < 1:1, it is usually
safe.
If infant dose is less than 10% of maternal dose, it is usually
safe to breastfeed

MARY YVONNE C. SERASPE

 Determinants of Medication
Pharmacokinetics in Breastmilk

Lipid solubility
Molecular size
Blood level
Protein binding
Oral bioavailability
Half-life

“Very few drugs are contraindicated

during lactation.”
CONSIDER TIMING OF TAKING MEDS
SHORTER HALF-LIFE IS BETTER
FEED INFANT BEFORE TAKING MEDS (ORAL)
APPLY OINTMENTS AFTER (TOPICAL)
KNOW ALTERNATIVE DRUGS
BE WARY OF DRUGS THAT AFFECT SUPPLY
(E.G BROMOCRIPTINE, ERGOTAMINES,
ESTROGEN, ANTIHISTAMINES,CAFFEINE)

To check for breastfeeding and

drug compatibility you may go
to the following websites

http://www.e-lactancia.org
LactMed
(https://www.ncbi.nlm.nih.gov/books
/NBK501922/toc/?report=reader)
Nice Breastfeeding
(www.nicebreastfeeding.com)

References:
Chapter 12 of Nursing Pharmacology by Smith
(www.dw.com), D. W. (n.d.). Thalidomide babies: Birth defects caused by a
'harmless' pill 60 years ago: DW: 27.11.2021. DW.COM. Retrieved December 1, 2021,
from https://www.dw.com/en/thalidomide-babies-birth-defects-caused-by-a-
harmless-pill-60-years-ago/a-59952155.

MARY YVONNE C. SERASPE