Understand the classification of drugs to ensure the safety of medication during pregnancy.

Whether pregnant or pregnant women, improper medication may cause harm to the fetus. Knowing the safety classification system of drugs can avoid the regret that "pregnant women take drugs and the fetus is hurt"! Careless medication during pregnancy does not always tell pregnant women: "one person takes it, two people make it up", but when it comes to medication, if pregnant mommy uses the wrong medicine, it is likely to become "pregnant women take medicine, and the fetus suffers". Dr. Huang Shangyu from the Department of Obstetrics and Gynecology of Chang Gung Memorial Hospital in Linkou said that pregnant mothers often ask, "I don't know if taking cold medicine during pregnancy will have adverse effects on the baby?" ","I was sick during pregnancy, can't I take medicine? This shows that most pregnant mothers know that they can't take medicine indiscriminately during pregnancy, but they know little about the safety of medication during pregnancy. The reason why pregnant women especially need to abide by the principle of drug safety is that most drugs will enter the fetus through the placenta, which may cause serious damage or deformity to the fetal heart system, nervous system, brain, facial features and limbs. Dr. Huang Shangyu reminded that pregnant women and women who are preparing to get pregnant must inform the doctor in advance when they seek medical treatment due to illness, so that the doctor can prescribe appropriate drugs after diagnosis and truly follow the doctor's advice. Don't buy proprietary Chinese medicines or take medicines from unknown sources. If pregnant mommy has any questions, she can give the medicine she has eaten to an obstetrician or pharmacist for judgment. The harm of improper medication in the first pregnancy Dr. Huang Shangyu explained that the first three months of pregnancy is a critical period for the formation of embryonic structure. During this period, the fetus will gradually develop important organs such as hands, feet, organs and nerves. When the fetus absorbs the drugs taken by pregnant mommy through the placenta, it may lead to fetal malformation, growth retardation or neural tube defects, which is the most dangerous. In addition, we must pay attention to the safety of medication during pregnancy. Any medication must be evaluated by a doctor or pharmacist for its benefits and risks! What should I do if I accidentally took drugs during pregnancy? Dr. Huang Shangyu said that fertilized eggs will not begin to communicate with maternal blood before implantation. If you take medicine before implantation, you generally don't have to worry too much. If pregnant mommy has any questions, she can give the medicine to an obstetrician or pharmacist for judgment. If it is found that there is a possibility of teratogenesis or great harm to the fetus, the doctor will discuss with the prospective parents whether to terminate the pregnancy. However, since he became a doctor, Dr. Huang Shangyu has never encountered a case of termination of pregnancy by taking drugs by mistake during unknown pregnancy. One of the reasons is that the drugs taken by pregnant women are mainly cold medicines, which have little effect on the fetus; Secondly, if the drugs taken are harmful, embryos will usually be naturally eliminated. If it can continue to develop to the stage of heartbeat measurement, it means that the fetus has passed the test of drugs. To understand the classification of drug use risk during pregnancy, the current classification standard of drug use during pregnancy in Taiwan Province Province mainly refers to the "classification of drug use risk during pregnancy" formulated by the US Food and Drug Administration (FDA). According to the data of drug experiments and clinical diagnosis and treatment, the degree of danger caused by drugs to the fetus is divided into five grades: A, B, C, D and X. Classification definition of drugs Safety evaluation A According to human clinical trials, there is no evidence that the drug may cause harm to the fetus in the early and late pregnancy. Safe. B animal experiments show that there is no danger to the fetus, but there is no experimental data of pregnant women; In other words, although animal experiments have adverse reactions to the fetus, human clinical experiments cannot confirm that there are adverse reactions to the fetus in the early and late pregnancy. It may be safe. C animal experiments have proved that it is harmful to fetus, but there is no experimental data of pregnant women; There is no research data on animals and pregnant women, and the danger is not ruled out. Use should be avoided unless the therapeutic benefits outweigh the potential risks. D Human experiments have proved that the drug is dangerous to the fetus, but it can still be used for a short time when pregnant women are in fatal danger or other safer drugs cannot be effectively controlled. Avoid using it, and it can be used for a short time under special circumstances. Studies on animals and humans have confirmed that X can cause fetal malformation, which is prohibited for pregnant women or potential pregnant women. It has teratogenic effect and is absolutely forbidden for pregnant women. Controversy on drug classification Although most drugs are marked with the safety level of drugs used during pregnancy, whether drugs used during pregnancy will harm the fetus and the degree of harm is still a probability problem. From the grading alone, it seems that the safety is A > B > C > D > X, but in fact, we still need to refer to the nature, dosage, duration, which pregnancy to take, toxicity, placental permeability and fetal response to drugs. At present, except for Class X drugs that have been proved to have adverse effects on the fetus, most drugs cannot give absolutely safe or dangerous answers, because it is difficult to conduct human experiments on pregnant women. Dr. Huang Shangyu said that although pregnant women should give priority to class A and B drugs in theory, the cost-benefit ratio of cure should be considered. If the benefits of controlling the mother's illness outweigh the possible harm to the fetus, class C and D drugs can still be used as appropriate. Medication for pregnant women is the first priority, and both internal and external use should be cautious. "Should I take medicine when I am sick during pregnancy?" This problem has plagued many pregnant mothers for a long time. For the sake of the baby in the womb, most of them will choose not to take medicine. However, Dr. Huang Shangyu said that not taking medicine during pregnancy is the best principle. If the condition does not recover, it may affect the fetus. It is suggested that pregnant mothers should seek medical treatment if they are sick, so as not to aggravate their illness. Common diseases during pregnancy: Cold is the most common problem of pregnant mommy during pregnancy. If a cold is not cured for a long time, it will not only affect the life and mood of pregnant mommy, but also easily lead to other complications, such as bronchitis and pneumonia, and may also affect the fetus because of the expansion of the invasion of cold virus, so the condition can not be ignored. Dr. Huang Shangyu pointed out that the common cold medicines prescribed by doctors are symptomatic medicines, such as antipyretic and analgesic medicines for nasal congestion and antihistamines. This kind of drugs are usually within B and C levels, so long as the time and dosage are well controlled, it will not cause harm to the fetus. Bacterial infections, such as acute otitis media, sinusitis, bacterial pneumonia and toothache, need to be treated with appropriate and sufficient antibiotics. The medicine prescribed by doctors for pregnant mothers is usually Class A penicillin. If pregnant mothers have allergic or uncomfortable symptoms, they will choose class B safe antibiotics. As for sulfonamides, tetracyclines and chloramphenicol, they belong to Class C and Class D drugs, which are risky. At present, pregnant mothers are prohibited from taking them. During pregnancy, the skin is itchy. Due to physical changes, many pregnant mothers will have itchy skin. If itching has seriously affected their lives, the doctor will prescribe a combination of B-class antibiotics and steroids, which can relieve the discomfort after about 3 days. Topical drugs also carry risks. Any drug that promotes therapeutic effects, whether oral or external, may cause harm to the fetus. Pregnant mommy should never think that it will not cause problems if it is only used on the skin. Any drugs used during pregnancy must be evaluated by professional medical personnel before use. Dr. Huang Shangyu pointed out that the drugs commonly used to treat acne at present, such as A-acid, salicylic acid and tetracycline, are all Class X drugs with teratogenic risks and are dangerous drugs that pregnant mothers must ban. In addition, many sore ointments and patches contain diclofenac (commonly known as "pink round"), which may lead to premature closure of fetal arterial duct in the third trimester of pregnancy, which may cause fetal hypoxia and neonatal pulmonary hypertension. Pregnant mommy should not use it. Pregnant women take painkillers, is the baby afraid to move more? ! Recently, a news report pointed out that Tylenol painkillers often prescribed by doctors for pregnant women may hinder the hormone secretion of fetal brain development, leading to ADHD symptoms in the future. Dr. Huang Shangyu pointed out that this was a study done in Denmark from 65438 to 0950-2002. In the study, 56% of pregnant women took Tylenol painkillers during pregnancy, and about 30% of them gave birth to babies with severe ADHD, 7% higher than the average person. Dr. Huang Shangyu said that this study is not the result of human trials, and other studies are needed to support this theory, and it is necessary to consider whether there is a problem of abuse of patented drugs, whether it is caused by taking drugs for too long and taking too high a dose, so the general public need not panic too much. Instructions for medication during pregnancy: Improper medication or smearing by pregnant mommy may have an impact on the fetus. Dr. Huang Shangyu reminded that in addition to following the doctor's advice, we should adhere to the principle of "checking more, listening more and asking more questions" for any medicine to avoid blind medication! Five reminders for pregnant women 1. A woman who is pregnant after being reused by a doctor or pharmacist and has a pregnancy plan must inform her of the fact of pregnancy when she goes to see a doctor, and ask the doctor to assess the needs of her illness and prescribe appropriate mild drugs. 2. Be sure to follow the doctor's instructions. When you need to take medicine because of illness, you must take medicine according to the doctor's instructions. It is very dangerous to increase or decrease drugs, not take drugs on time or stop taking drugs without authorization; Except for oral and injectable drugs, any external drugs, plugs and drops must be used under the guidance of a doctor. 3. It is more complicated to avoid taking Chinese patent medicines on the market. The general public may not know whether it is harmful to the fetus from the drug instructions alone. If there is a need for medication, it is recommended to consult a doctor, Yamatonokusushi, to evaluate the medication situation. 4. Use Chinese medicine and nutritious food with caution. Many pregnant mothers will take traditional Chinese medicine or nutritious food to supplement their nutrition during pregnancy, which may still have an impact on the fetus if taken improperly. Before taking Chinese medicine, you should first ask a qualified Chinese medicine doctor for diagnosis, and you should not listen to the folk prescription and go to the Chinese pharmacy to get the medicine yourself. The dosage of vitamin and mineral supplements should not exceed the daily requirement, otherwise it will still be harmful. 5. Make good use of the information in the medicine bag. When you get the medicine bag after seeing a doctor, you should first check the type, quantity and usage of the medicine. Read all instructions before taking the medicine; If there are any side effects after taking the medicine, you should follow the instructions of the medicine bag or consult the medical staff; You can keep the medicine bag for a period of time after recovery, and it can be used as the basis for medication consultation when you are pregnant unexpectedly or have a pregnancy plan. Precautions for long-term medication Dr. Huang Shangyu mentioned that the best way to avoid the harm of drugs to the fetus is planned pregnancy, especially some chronic diseases and genetic diseases, such as asthma, hypothyroidism, lupus erythematosus, epilepsy, hypertension and diabetes. Because this kind of disease can not be stopped or drugs can not be increased or decreased rashly, it is suggested that patients should wait until their condition is stable before considering pregnancy plan; When you find an unexpected pregnancy, you should immediately discuss with your doctor and switch to a more suitable drug. Miss Jane, who was pregnant for 7 months, suffered from side effects of drugs. One day, she urinated with burning pain and was diagnosed as cystitis. The obstetrician prescribed her antibiotics, which she could take during pregnancy. Unexpectedly, on the fifth day after taking the medicine, Miss Jane's skin appeared red rash, itching, blisters, broken skin and oral ulcer. After the follow-up visit, it may be caused by drug allergy. The doctor arranged for Miss Jane to live in the burn intensive care unit for treatment. During the hospitalization, Miss Jane successfully gave birth to the baby. After leaving the hospital, he applied to the "Consortium Legal Person Drug Injury Relief Foundation" according to the doctor's advice, and paid the relevant medical expenses of about 90,000 yuan after the inspection conditions met. The consortium legal person drug injury relief fund said that as long as legal drugs are used but side effects occur, resulting in serious diseases, obstacles or deaths, they can apply to the foundation for drug injury relief within three years of drug injury and get immediate relief. Huang Shangyu Education: Interview with Attending Physician of Obstetrics and Gynecology in Linkou Chang Gung Memorial Hospital/Wu Xiaolan Planning Editor/Wu Huimin Consulting/Information provided by Huang Shangyu, Attending Physician of Obstetrics and Gynecology in Linkou Chang Gung Memorial Hospital/Foundation for Drug Rehabilitation of Consortium/Xiaojiang * For more details, please refer to: Baby and Mom No.2065438+April 2005. Mababy/ subscribe to the healthy Aloha audio-visual channel, read health knowledge more easily, and pay attention to your health every day! Line @ ID: @:/supply/article/14768/Understand the classification of drugs to ensure the safety of medication during pregnancy Key words: pregnant women, drugs, nutritious food, Huang Shangyu, Department of Obstetrics and Gynecology, Chang Gung University.