Cardiac disease in pregnancy and drug therapy: Difference between revisions
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*[[ACE inhibitors]] | *[[ACE inhibitors]] | ||
*[[Angiotensin receptor blockers]] ([[ARBs]]s) | *[[Angiotensin receptor blockers]] ([[ARBs]]s) | ||
*[[Aldosterone]] antagonists cause antiandrogenic effects in the first trimester and should be avoided. | |||
*[[Warfarin]] is [[teratogenic]] | |||
==Drugs to be Avoided== | ==Drugs to be Avoided== |
Revision as of 01:01, 11 October 2012
Cardiac disease in pregnancy Microchapters |
Diagnosis |
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Treatment |
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Cardiac disease in pregnancy and drug therapy On the Web |
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Risk calculators and risk factors for Cardiac disease in pregnancy and drug therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
ACE inhibtors, Angiotensin receptor blockers (ARBss), and warfarin should be avoided in pregnancy.
Contraindicated Drugs
- ACE inhibitors
- Angiotensin receptor blockers (ARBss)
- Aldosterone antagonists cause antiandrogenic effects in the first trimester and should be avoided.
- Warfarin is teratogenic
Drugs to be Avoided
- Atenolol
- Carvedilol
- Thrombolytics efficacy and safety is mostly untested
- Greatest experience in massive pulmonary embolism
- Streptokinase does not cross placental membrane in animals, but Ab found in neonatal spinal cord fluid
- Urokinase not teratogenic in mice/rats
- Risk for maternal hemorrhage (1 case of placental abruption reported); increased risk when given at time of delivery
- Delivery best delayed at least 2-3 weeks
Acceptable Drugs
- ASA - low dose
- Nitrates – use low dose to prevent fetal distress
- Hydralazine
- Beta-1 selective Beta-blockers like lopressor, metoprolol.
- Magnesium
- Morphine sulfate
- Diuretics can reduce placental perfusion and should be used sparingly