Drugs and Pregnancy: A Handbook (A Hodder Arnold Publication)

385 Pages·2006·4.81 MB·english

by  Bertis B. Little

DRUGS AND PREGNANCY
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DRUGS AND
PREGNANCY
A HANDBOOK
Bertis B Little PhD
Associate Vice-President for
Academic Research and Professor
Tarleton State University
Stephenville, Texas
USA
Texas A&M University System

Hodder Arnold
AMEMBER OF THE HODDER HEADLINE GROUP
First published in Great Britain in 2006 by
Hodder Arnold, an imprint of Hodder Education and a member of the Hodder Headline Group,
338 Euston Road, London NW1 3BH
http://www.hoddereducation.com
Distributed in the United States of America by
Oxford University Press Inc.,
198 Madison Avenue, New York, NY10016
Oxford is a registered trademark of Oxford University Press
© 2006 Bertis B Little
All rights reserved. Apart from any use permitted under UK copyright law, this publication may
only be reproduced, stored or transmitted, in any form, or by any means with prior permission in
writing of the publishers or in the case of reprographic production in accordance with the terms
of licences issued by the Copyright Licensing Agency. In the United Kingdom such licences are
issued by the Copyright licensing Agency: 90 Tottenham Court Road, London W1T 4LP.
Hodder Headline’s policy is to use papers that are natural, renewable and recyclable products
and made from wood grown in sustainable forests. The logging and manufacturing processes are
expected to conform to the environmental regulations of the country of origin.
Whilst the advice and information in this book are believed to be true and accurate at the date of
going to press, neither the author[s] nor the publisher can accept any legal responsibility or
liability for any errors or omissions that may be made. In particular, (but without limiting the
generality of the preceding disclaimer) every effort has been made to check drug dosages;
however it is still possible that errors have been missed. Furthermore, dosage schedules are
constantly being revised and new side-effects recognized. For these reasons the reader is strongly
urged to consult the drug companies' printed instructions before administering any of the drugs
recommended in this book.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging-in-Publication Data
A catalog record for this book is available from the Library of Congress

ISBN-10 0 340 809 175
ISBN-13 978 0 340 809 174
1 2 3 4 5 6 7 8 9 10
Commissioning Editor: Sarah Burrows
Project Editor: Francesca Naish
Production Controller: Joanna Walker
Cover Design: Amina Dudhia
Indexer: Laurence Errington
Typeset in 9/12 pt Sabon by Phoenix Photosetting, Chatham, Kent
Printed and bound in Spain by Graphycems
What do you think about this book? Or any other Hodder Arnold title? Please see our
website at www.hoddereducation.com
Dedication
Dr. Gilstrap and I dedicated Drugs and Pregnancy second edition to our mothers. Dr.
Yonkers and I dedicated Treatment of Psychiatric Disorders in Pregnancy to our
spouses. Present and past generations were thus recognized. Accordingly, Drugs and
Pregnancy – A Handbookis dedicated to the future generation:
Christian Carroll
Ian Carroll
Lauren DelHomme
Leslie DelHomme
Luke DelHomme
Catherine DelHomme
Madeline DelHomme
Nicole Hery, Pharm.D. (Candidate)
William Hery
B. Britt Little, II
Alexis Reynolds
Zachary Reynolds
Christa Little White, R.N.

Raven Little White
Savannah White
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Contents
Preface ix
Acknowledgements xi
1 Introduction to drugs in pregnancy 1
2 Antimicrobials during pregnancy: bacterial, viral, fungal, and 22
parasitic indications
3 Cardiovascular drugs during pregnancy 51
4 Endocrine disorders, contraception, and hormone therapy during 75
pregnancy: embryotoxic versus fetal effects
5 Antiasthma agents during pregnancy 101
6 Anesthetic agents and surgery during pregnancy 114
7 Antineoplastic drugs during pregnancy 126
8 Analgesics during pregnancy 149
9 Anticonvulsant drugs during pregnancy 165
10 Psychotropic use during pregnancy 181
11 Antihistamines, decongestants, and expectorants during pregnancy 206
12 Nutritional and dietary supplementation during pregnancy 216
13 Use of dermatologics during pregnancy 240

14 Drug overdoses during pregnancy 254
15 Miscellaneous drugs during pregnancy: tocolytics and 279
immunosuppressants
16 Substance abuse during pregnancy 296
Appendix – Drug names 333
Index 352
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Preface
The purpose of this volume was originally to condense and update Drugs and Pregnancy
second edition. However, the book has evolved into a larger project since its inception
in 2000. The total length of the original typescript was approximately three times the
number of pages for which the publisher contracted. First strategy suggested was to
eliminate the large number of references, but this was not acceptable. The final compro-
mise developed was to post the full bibliography and supporting materials on a website
for the book – http://www.drugsandpregnancy.com.
It is intended for the content of this book to be updated and corrected – as necessary
– approximately four times per year. These additions to the book will be posted to the
website above, which will be maintained by the publisher. In addition, a searchable
index of proprietary and generic names is provided on the website.
In addition, a link to TERIS is provided on the website, and the reader is strongly
encouraged to use TERIS in counseling patients who have been exposed to a medication
during pregnancy. The information in TERIS has been vetted by leading authorities in
the field, and is tantamount to high quality peer reviewed literature. It was through
working on the development of TERIS (writing agent summaries, knowledgebase
design) from 1985 to 1989 that I became deeply interested in human teratology.
Links to other sites that may be of use to readers of this book will also be included on
the website. A feature under development for http://www.drugsandpregnancy.com is a
current literature alert window. We have developed an automated search agent that will
identify new publications (journal articles, books, etc.) relevant to human teratology,
and will post those to the website under CURRENT LITERATURE ALERTS. This will
assist the reader in main taining access to up-to-date information. The main advantage
of having a website accompany the published book is currency of information. Books
usually take a year or longer to reach the reader after the author has completed the type-
script, and may already be out-of-date by the time of release.
I thank the publisher for providing this option to (1) maintain scholarly references for
the book’s content, (2) provide readers the most recent information available, and (3)
refer readers to other authoritative sources such as TERIS.
BBL
July 2006