Fe Calcium B complex folic acid Lactulose

1. DRUGS USED IN PREGNANCY
Sharon Treesa Antony
First Year M.Sc Nursing

2. FOLIC ACID
 Needed for erythropoiesis
 Prevents neural tube defects
 2-5mg/day (therapeutic dose)
 0.5mg/day (prophylactic dose)
 Carbamazepine increases need for folic acid
 Methotrexate reduces folate levels
 Urine bright yellow

3. NATIONAL ANAEMIA CONTROL PROGRAM
 T. Folifer * 100 days during pregnancy, to be
continued till 100 days postpartum
WHO recommendations
 60 mg Fe + 400 mcg folic acid * 6months during
pregnancy, to be continued till 3 months postpartum
National iron plus initiative
 T. Folifer * 100 days during pregnancy from 2nd
trimester and for 100 days in postpartum

4. FERROUS SULPHATE
 Replaces iron stores needed for RBC development
as well asO2 transport and use
 Used in iron deficiency anaemia, prophylaxis of iron
deficiency anaemia in pregnancy, and as nutritional
supplementation
 100 mg elemental iron daily
 Nausea, vomiting, constipation, epigastric pain,
black tarry stools, diarrhea, temporarily discoloured
teeth and eyes

5.  Vitamin C increases action of iron preparation
 Caffeine, egg and dairy products reduces absorption

6.  Swallow tables whole
 With Juice
 between meals
 Liquid preparations through straw
 I hour before bedtime
 Avoid reclining position for 15-30 minutes
 Iron toxicity: nausea, vomiting, dirrhea ( green &
then tarry)

7. VITAMIN C
 General growth and development
 Involved in pathway of Hb synthesis
 500mg OD

8. B COMPLEX
 Niacinamide
 Pyridoxine
 Riboflavin
 Thiamine

9.  Niacin: conversion of fats, proteins and
carbohydrates ( vasodialation)
 Pyridoxine: fat, protein and carbohydrate
metabolism
 Thiamine : Pyruvate metabolism,
 Riboflavin: respiratory reactions

10. CALCIUM CARBONATE
 Fetus absorb 28g calcium from mother
 RDA : 1000- 1500 mg
 Dosage: 500mg daily

11. TETANUS TOXOID
 Formaldehyde treated exotoxin
 1st dose : 1st visit in 1st trimester
 2nd dose : 1 month apart & at least 2 weeks prior to
delivery

12.  Govt of India
 2 doses in 2nd trimester 4 weeks apart
 If again pregnant within 3 years, single dose is
enough
 WHO
 1st dose: 1st visit in 1st trimester
 2nd dose: 4 weeks later
 3rd dose : after 6 months

13. LACTULOSE
 Synthetic disaccharide of galactose and fructose
 Hydrolized in the large intestine
 Draws water into the intestine
 Effect seen only after 24-48 hours
 15- 30ml at night
 Antacids 1 hour before/after lactulose

14. DOXYLAMINE SUCCINATE
 First generation H1 receptor antagonist
 Peak action at 2-4 hours
 20mg PO at bed time/ 5-10mg more may be given
in the morning and afternoon

15. H2 RECEPTOR ANTOGONIST
 Reduces acid production
 Used in heart burn, GERD, for prevention of stress
ulcer
 150-300mg TDS or HS PO
50mg IM/ slow IV
o Constipation, Diarrhoea, Headache, Fatigue

16. PROTON PUMP INHIBITORS
 Suppress gastric acid secretion by irreversible
blockade of hydrogen-pottassium ATPase
 GERD, Erosive esophagitis, gastric and duodenal
ulcers
 Contraindicated in severe hepatic disease
 OMEZ:20-40mg OD
 PANTOP: 40mg OD

17. URSODEOXYCHOLIC ACID
 Hydrophilic dehydroxylated bile acid
 Alters the relative concentrations of bile acids&
reduces the cholesterol content of bile
 Protective of hepatocytes
 Used in Intrahepaytic Cholestasis of pregnancy
 13-15mg/kg in 2 divided doses