Featured Books


Drug Treatment Of Asthma During Pregnancy

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.

Cecil Medicine 23rd Edition (Saunders) 2008

Download table

Copyright 2010 ReadingFirst | Digital Bookstore - All Rights Reserved.
Designed by Web2feel.com | Bloggerized by Lasantha - Premiumbloggertemplates.com | Affordable HTML Templates from Herotemplates.com.