Asthma treatment during pregnancy - What can be safely taken?

被引:18
作者
Schatz, M [1 ]
机构
[1] KAISER PERMANENTE MED CTR, DEPT ALLERGY IMMUNOL, SAN DIEGO, CA 92111 USA
关键词
D O I
10.2165/00002018-199716050-00005
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
'Safe' pharmacological therapy for gestational asthma is defined. as therapy during which the apparent risks of the drug appear to be lower than the maternal and potential fetal risks of uncontrolled asthma that could result if the drug were not used. Major malformations occur in 2 to 4% of all newborns, 1% of which can be attributed to medication in general. Information regarding the effects of drugs administered during pregnancy may come from animal studies, human case reports, and prospective cohort studies. Based on a review of the available information, it is recommended that mild asthma during pregnancy be managed with inhaled beta 2-agonists, as required; step therapy for moderate asthma would include inhaled sodium cromoglycate (cromolyn sodium), inhaled beclomethasone dipropionate and oral theophylline. Severe gestational asthma should be treated with oral corticosteroids at the lowest effective dosage. The pharmacological management of acute asthma during pregnancy should include nebulised beta 2-agonists and ipratropium bromide, and intravenous methylprednisolone, intravenous aminophylline would not generally be recommended,unless the patient requires hospitalisation. Optimal medical practice and medicolegal considerations demand that the patient's informed consent be obtained for the recommended gestational management programme.
引用
收藏
页码:342 / 350
页数:9
相关论文
共 28 条
[1]  
ABRAMS RS, IN PRESS ASTHMA IMMU
[2]  
Briggs GG., 2008, DRUGS PREGNANCY LACT, P431
[3]  
CHOW AW, 1987, WESTERN J MED, V146, P761
[4]  
FERN FH, IN PRESS ASTHMA IMMU
[5]  
FRANCIS NATHAN, 1941, JOUR ALLERGY, V12, P559, DOI 10.1016/S0021-8707(41)90203-4
[6]   LONGITUDINAL EFFECTS OF PREGNANCY ON THE PHARMACOKINETICS OF THEOPHYLLINE [J].
GARDNER, MJ ;
SCHATZ, M ;
COUSINS, L ;
ZEIGER, R ;
MIDDLETON, E ;
JUSKO, WJ .
EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY, 1987, 32 (03) :289-295
[7]   UNCONTROLLABLE LIFE-THREATENING STATUS-ASTHMATICUS - AN INDICATOR FOR TERMINATION OF PREGNANCY BY CESAREAN-SECTION [J].
GELBER, M ;
SIDI, Y ;
GASSNER, S ;
OVADIA, Y ;
SPITZER, S ;
WEINBERGER, A ;
PINKHAS, J .
RESPIRATION, 1984, 46 (03) :320-322
[8]   FETAL MORBIDITY FOLLOWING POTENTIALLY ANOXIGENIC OBSTETRIC CONDITIONS .7. BRONCHIAL ASTHMA [J].
GORDON, M ;
NISWANDER, KR ;
BERENDES, H ;
KANTOR, AG .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1970, 106 (03) :421-+
[9]  
Heinonen O, 1977, BIRTH DEFECTS DRUGS
[10]  
LEE F, 1982, OBSTET GYNECOL, V60, P314