Penatalaksanaan Asma Selama Kehamilan
| Therapy | Comments |
|---|---|
| Desensitization or immunotherapy (“allergy shots”) | Ongoing therapy can be continued. However, skin testing, initiating treatment, and increasing therapy should be avoided. Reducing exposure to environmental irritants and allergens remains important. |
| Antihistamines (chlorpheniramine and tripelennamine preferred and nonsedating agents used when sedation must be minimized) | More information is available for older antihistamines. Recommendations for newer agents, with less sedation, are based on limited animal and human data. |
| Disodium cromoglycate and nedocromil | Less than 10% of the drug is absorbed. No reported adverse effects from use during pregnancy. |
| Theophylline | Distribution and clearance are altered during pregnancy, and levels should be checked monthly. It crosses the placenta; rarely, neonatal toxicity has been reported despite therapeutic maternal levels. |
| β -Agonists (albuterol, metaproterenol, terbutaline; no data on salmeterol) | Use is safe during pregnancy. Rare reports of tocolytic effects. |
| Inhaled ipratropium | Little data on use during pregnancy, although it is probably safe. |
| Antileukotriene (zafirlukast, montelukast, zileuton) | No human information; zileuton had adverse effects in animal studies and is not recommended for use during pregnancy. |
| Inhaled corticosteroids (beclomethasone and budesonide best studied) | Regular use reduces asthma exacerbations during pregnancy. |
| Oral corticosteroids | May be used safely when indicated. Ninety percent of prednisone is inactivated by the placenta, thus reducing fetal exposure. Betamethasone does not undergo placental 11-oxidation and is the preferred corticosteroid when promoting fetal lung maturation. |
Referensi:
Cecil Medicine 23rd Edition (Saunders) 2008
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