Pharmacy Times 2008 OTC Products - (Page 54) Safety of OTC Medications in Pregnant Women Kristin E. Weaver, BA, and Hannah R. Howell, PharmD Ms. Weaver is a pharmacy student and Dr. Howell is an assistant professor of pharmacy practice at Lake Erie College of Osteopathic Medicine School of Pharmacy, Erie, Pennsylvania. pregnant women is acetaminophen.3 Studies have not shown an increase in birth defects associated with occasional use of acetaminophen at any time during pregnancy; however, it is important to caution all patients about using the appropri ate dose only when needed, because of hepato toxicity and, rarely, nephrotoxicity associated with overuse in the general public.2 Most nonsteroidal antiinflammatory drugs (NSAIDs), including aspirin, ibuprofen, and naproxen, are not recommended unless pain is intolerable and cannot be relieved with acetami nophen.2 NSAIDs can potentially cause premature closure of the fetal ductus arteriosus and should be avoided in the third trimester.5 8 Ac w h ie vem e n t A Analgesics The OTC medication most commonly used by REC O ar ore than 80% of women use medica tions during pregnancy, most of which are sold OTC.1,2 Medical and pharmacy records often lack documentation of nonpre scription medication use, which makes it more difficult to detect an association between OTC medications and specific birth defects.3 Because the teratogenic effects of most medica tions are unknown, many health care professionals refrain from prescribing or recommending medica tions for pregnant women.4 This practice could be dangerous and lead to inappropriate use of self administered OTC medications.2 The objective of this review is to provide phar macists with the most current information on the effects of OTC medications on pregnant women and the fetus, in order to be able to advise preg REC O IS T M M AC nant patients on how to safely alleviate specific symptoms. Table 1 highlights treatment for spe SINCE cific symptoms in pregnant women. 1997 EN M Cold Medications Cold relief products often contain several dif ferent types of medications and do not actually shorten the length of the cold; therefore, it is recommended that they are used only for serious discomfort.2 Nonpharmacologic remedies that can relieve symptoms include increasing fluid intake, using a humidifier, resting for an adequate time, and elevating the head while sleeping.6 If the patient is still severely congested, pseu doephedrine is the oral decongestant drug of choice for pregnant women.2,6 Shortacting formulations and low doses should be recommended.2 Oxymetazoline, a nasal decongestant spray, continued on page 56 • PH AR M D ED • M M PH AR PH AR d 8 Ac w h ie vem e n t A 8 ar Ac Toothpaste—Sensitive M AC w h ie vem e n t A ar d M PH AR PH AR d ar Number of pharmacist recommendations per month: 223,020 ar d 20 d 0 AC IS T M M AC IS T REC O M OTCs Pharmacists Recommend E E EN M EN D ED D ED 20 20 20 0 0 0 Wound Care Product % of Pharmacist Recommendations Sensodyne Crest Sensitive Colgate Sensitive 8 w 8 Ac w Ac h ie vem e n t A h ie vem e n t Mentadent Sensitive A Rembrandt for Sensitive Teeth Other EN EN AC IS T REC O M M Product D ED IS T REC O M M % of Pharmacist Recommendations 68.1 9.7 7.6 4.9 3.5 6.2 Neosporin Polysporin Betadine Bacitraycin A&D Original Ointment Bactine Other 74.0 13.0 4.0 2.0 1.0 1.0 5.0 D ED OTC Supplement 2008 20 0 Number of pharmacist recommendations per month: 800,100 54 Pharmacy Times
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