perinatology.com
   Prescription Drugs of Choice During Pregnancy


Home > Reference >Prescription Drugs of Choice During Pregnancy
Condition Medication Reference(s)
Asthma Albuterol is rescue therapy of choice
Budesonide is the preferred inhaled corticosteroid
Long-acting b2-agonists salmeterol  is the preferred add-on controller therapy
1
Bacterial Vaginosis Treatment is recommended for all pregnant women with symptoms.
Metronidazole OR
Clindamycin
2
Chlamydia Azithromycin 2
Cholestasis of pregnancy Ursodeoxycholic acid (UDCA) 14
Chronic hypertension Labetalol OR / AND
Methyldopa 
OR / AND
Nifedipine slow-release preparation
3.
Depression , mild Psychotherapy such as cognitive-behavioral therapy (CBT) OR interpersonal therapy 18
Depression , severe Psychotherapy AND fluoxetine.
Alternative medications: sertraline or  tricyclic antidepressant
18
Depression with psychosis Electroconvulsive therapy OR
Haloperidol AND antidepressant as above
18
Depression mild, postpartum while breast-feeding Psychotherapy with or without antidepressant (sertraline or paroxetine) 18
Depression severe, postpartum while breast-feeding Supportive services AND sertraline
Alternative medication: Paroxetine
18, 19
Diabetes Insulin 4
Gonorrhea; uncomplicated genital, rectal, and pharyngeal

Ceftriaxone 250 mg as a single intramuscular dose, plus either azithromycin 1 g orally in a single dose

5.
Herpes Acyclovir OR
Valacyclovir
6.
Hypothyroidism Levothyroxine 7,15
Hyperthyroidism Propylthiouracil (PTU). in the first trimester of pregnancy.
Methimazole  after first trimester
Beta adrenergic blocking agents, such as propranolol  may be used for controlling hypermetabolic symptoms.
7

 

Idiopathic thrombocytopenic purpura (ITP) Prednisone.
IVIg may be used with corticosteroids when a more rapid increase in platelet count is required, or corticosteroids are contraindicated [
8.
Malaria Chloroquine , hydroxychloroquine
For chloroquine-resistant P. falciparum infection, treat with either mefloquine or a combination of quinine sulfate and clindamycin
16,17
Nausea and vomiting of pregnancy Diclegis (doxylamine succinate and pyridoxine hydrochloride)
Refractory cases add promethazine or dimenhydrate . If still no response add metoclopromide .
9.
Pediculosis Pubis Permethrin 1% cream  OR
Pyrethrins with piperonyl butoxide
2,
Pyelonephritis
  • Cefriaxone  OR
  • Ampicillin AND  genatmicin OR
  • Cefazolin  OR
  • Cefotetan  OR
  • Aztreonam
    (Several other regimens are also acceptable )
  • 10,11

     

    Scabies Permethrin cream 5% 2
    Syphilis Benzathine penicillin 2
    Trichomoniasis Metronidazole 2
    Ulcer Sucralfate
    Ranitidine
    13
    Urinary tract infection Nitrofurantoin ( Avoid in first trimester)
    Cephalexin
    11
    Venous thromboembolism (VTE) Low Molecular Weight Heparin
    Enoxaparin  OR
    Dalteparin   OR
    Tinzaparin
    12.
    Vulvovaginal Candidiasis  Only topical azole therapies, applied for 7 days, are recommended
    Terconazole 0.4% cream
    2

    REFERENCES

    1.ACOG practice bulletin: clinical management guidelines for obstetrician-gynecologists number 90, February 2008: asthma in pregnancy.Dombrowski MP, Schatz M; ACOG Committee on Practice Bulletins-Obstetrics. Obstet Gynecol. 2008 Feb;111(2 Pt 1):457-64. PMID: 18238988
    2.
    CDC Sexually Transmitted Diseases Treatment Guidelines , 2010 December 17, 2010 / Vol. 59 / No. RR-12 Morbidity and Mortality Weekly Report PMID: 21160459
    3.
    Chronic hypertension in pregnancy. Practice Bulletin No. 125. American College of Obstetricians and Gynecologists. Obstet Gynecol 2012;119:396407.
    4. Pregestational diabetes mellitus. ACOG Practice Bulletin No. 60. American College of Obstetricians and Gynecologists. Obstet Gynecol 2005;105:67585.
    5.
    Update to CDC's Sexually transmitted diseases treatment guidelines, 2010: oral cephalosporins no longer a recommended treatment for gonococcal infections. Centers for Disease Control and Prevention (CDC).MMWR Morb Mortal Wkly Rep. 2012 Aug 10;61(31):590-4.PMID: 22874837
    6.
    Management of Herpes in Pregnancy. ACOG Practice Bulletin No. 82. American College of Obstetricians and Gynecologists. Obstet Gynecol 2007; 109:123348.
    7.
    Stagnaro-Green A, ert al. American Thyroid Association Taskforce on Thyroid Disease During Pregnancy and Postpartum.Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid. 2011 Oct;21(10):1081-125. doi: 10.1089/thy.2011.0087. PMID: 21787128
    8.
    Neunert C, et al., The American Society of Hematology 2011 evidence-based practice guideline for immune thrombocytopenia. Blood. 2011 Apr 21;117(16):4190-207. Epub 2011 Feb 16. PMID: 21325604
    9.
    Nausea and vomiting of pregnancy. ACOG Practice Bulletin No. 52. American College of Obstetricians and Gynecologists. Obstet Gynecol 2004;103:80315
    10.
    Jolley JA, Wing DA.Pyelonephritis in pregnancy: an update on treatment options for optimal outcomes.
    Drugs. 2010 Sep 10;70(13):1643-55. PMID: 20731473
    11.
    Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Renal and Urinary Tract Disorders. In: Williams obstetrics. 23rd ed. New York: McGraw-Hill, 2010:7 1035-1037
    12.
     Inherited thrombophilias in pregnancy. Practice Bulletin No. 124 American College of Obstetricians and Gynecologists. Obstet Gynecol 2011;118:730-40.
    13. Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Renal and Urinary Tract Disorders. In: Williams obstetrics. 23rd ed. New York: McGraw-Hill, 2010:7 1053
    14. Bacq Y, Efficacy of Ursodeoxycholic Acid in Treating Intrahepatic Cholestasis of Pregnancy: A Meta-analysis.Gastroenterology. 2012 Aug 11. doi:pii: S0016-5085(12)01187-0. 10.1053/j.gastro.2012.08.004. PMID: 22892336
    15. Thyroid disease in pregnancy. ACOG Practice Bulletin No. 37. American College of Obstetricians and Gynecologists. Obstet Gynecol 2002;100:387396
    16. Griffith KS, et al. Treatment of malaria in the United States: a systematic review. JAMA. 2007 May 23;297(20):2264-77. PMID: 17519416
    17. Centers for Disease Control and Prevention. Treatment of Malaria: Guidelines For Clinicians (United States) .Part 3: Alternatives for Pregnant Women and Treatment of Severe Malaria
    http://www.cdc.gov/malaria/diagnosis_treatment/clinicians3.html. Accessed 10/27/20
    18. Altshuler LL, et al., Treatment of depression in women: a summary of the expert consensus guidelines.
    J Psychiatr Pract. 2001 May;7(3):185-208. PMID: 15990522
    19. Berle JO, Spigset O.Antidepressant Use During Breastfeeding. Curr Womens Health Rev. 2011 Feb;7(1):28-34. PMID: 22299006

     

    Home | About | Disclaimer | Privacy | Contact
    Copyright 2013 by Focus Information Technology.
    All rights reserved