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 Guaifenesin, dextromethorphan safe

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تاريخ التسجيل : 23/02/2008

مُساهمةموضوع: Guaifenesin, dextromethorphan safe   الإثنين فبراير 25, 2008 4:29 am

Breast-Feeding
The majority of prescription and nonprescription medications are not found in breast milk after ingestion.[2] However, there are several recommendations that can be given to the concerned mother.[2] First, she should be encouraged to avoid medications whenever possible and to explore the option of nonpharmacological therapies. Second, she should be advised to take oral medications immediately after nursing the infant and preferably before the babylongest sleep period. This will help prevent the baby from encountering medications by avoiding peak plasma and breast-milk levels. Third, the mother should take the regular-strength versions of a nonprescription product, rather than extra strength, maximum-strength, or long-acting versions. The mother should rely on single-entity medications instead of combinations, and she should be alert for the first sign of an adverse event in order to notify the pediatrician as early as possible.
Analgesics
Aspirin, magnesium salicylate, and bismuth subsalicylate can enter breast milk; they can cause adverse effects and lead to Reye's syndrome.[2] Aspirin in breast milk can also cause rashes, platelet abnormalities, and bleeding.[5] Combination analgesic products containing diphenhydramine, phenyltoloxamine, caffeine, salicylamide, and other ingredients should be avoided. Safer alternatives are ibuprofen and acetaminophen.
Antihistamines and Decongestants
Clemastine may produce drowsiness and irritability in the breast-fed infant.[2] Other antihistamines may also cause drowsiness. Experts advise ingesting the antihistamine after the last nighttime feeding, just prior to bedtime.[2] Pseudoephedrine passes poorly into breast milk (0.5% of the oral dose), although it may decrease the volume of breast milk.[2,7] Oxymetazoline can decrease milk supply.[2] Phenylephrine has a shorter duration of action and might be preferable as a topical nasal decongestant, although mothers should carefully monitor the volume of breast milk to ensure that it does not undergo appreciable reduction in volume.[2]
Cough and Sore Throat Products
Guaifenesin, dextromethorphan, menthol, dyclonine, and benzocaine are reportedly safe for use by breast-feeding mothers.[2] Although codeine does reach breast milk in detectable amounts, dextromethorphan is a safer antitussive.
References
1. Kyle PM. Drugs and the fetus. Curr Opin Obstet Gynecol. 2006;18:93-99.
2. Nice FJ, Snyder JL, Kotansky BC. Breastfeeding and over-the-counter medications. J Hum Lact. 2000;16:319-331.
3. Della-Giustina K, Chow G. Medications in pregnancy and lactation. Emerg Med Clin North Am. 2003;21:585-613.
4. Lee E, Maneno MK, Smith L, et al. National patterns of medication use during pregnancy. Pharmacoepidemiol Drug Saf. 2006;15:537-545.
5. Final rule for professional labeling of aspirin, buffered aspirin, and aspirin in combination with antacid drug products. Fed Reg. 1999;64:49652-49655.
6. McCarter-Spaulding DE. Medications in pregnancy and lactation. MCN Am J Matern Child Nurs. 2005;30:10-17.
7. Hale TW. Medications in breastfeeding mothers of preterm infants. Pediatr Ann. 2003;32:337-347.
8. Fast facts about medication use during pregnancy and while breast feeding. Centers for Disease Control and Prevention. Available at: www.cdc.gov/ncbddd/meds/fast.htm. Accessed August 2, 2007.
9. Marcus DM, Snodgrass WR. Do no harm: Avoidance of herbal medicines during pregnancy. Obstet Gynecol. 2005;105:1119-1122.
10. Kuczkowski KM. Labor analgesia for the parturient with herbal medicines use: What does an obstetrician need to know? Arch Gynecol Obstet. 2006;274:233-239.
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Guaifenesin, dextromethorphan safe
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