Drugs During Pregnancy and Lactation
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Drugs During Pregnancy
and Lactation
Treatment options and
risk assessment
Second edition
Edited by
Christof Schaefer, Paul Peters, and Richard K. Miller
AMSTERDAM • BOSTON • HEIDELBERG • LONDON • NEW YORK • OXFORD
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First edition 2001
Second edition 2007
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07 08 09 10 11
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Contents
List of contributors
Preface
Notice
1
xxii
xxiv
xxvii
General commentary on drug therapy and drug risks in
pregnancy
Richard K. Miller, Paul W. Peters, and Christof E. Schaefer
1.1
1.2
1.3
1.4
1.5
1.6
1.7
1.8
1.9
1.10
1.11
1.12
1.13
1.14
1.15
1.16
2
Introduction
Development and health
Reproductive stages
Reproductive and developmental toxicology
Basic principles of drug-induced reproductive and developmental
toxicology
Effects and manifestations
Pharmacokinetics in pregnancy
Passage of drugs to the unborn and fetal kinetics
Causes of developmental disorders
Embryo/fetotoxic risk assessment
Classification of drugs used in pregnancy
Paternal use of medicinal products
Communicating the risk of drug use in pregnancy
Risk communication prior to pharmacotherapeutic choice
Risk communication regarding the safety (or otherwise) of drugs
already used in pregnancy
Teratology information centers
2
3
3
6
9
10
12
13
14
15
19
20
21
22
23
24
Specific drug therapies during pregnancy
2.1 Analgesics and anti-inflammatory drugs
28
Minke Reuvers and Christof Schaefer
2.1.1
2.1.2
2.1.3
2.1.4
2.1.5
2.1.6
2.1.7
Paracetamol (acetaminophen)
Aspirin (acetylsalicylic acid)
Pyrazolone derivatives
Combination analgesic preparations
Opioid analgesics in general
Morphine
Codeine
28
29
32
32
33
33
34
vi
Contents
2.1.8
2.1.9
2.1.10
2.1.11
2.1.12
2.1.13
2.1.14
2.1.15
2.1.16
2.1.17
2.1.18
2.1.19
Pethidine (meperidine)
Fentanyl, alfentanil, remifentanil, and sufentanil
Other narco-analgesics and centrally acting analgesics
Naloxone
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Selective cyclooxygenase-2 (COX-2) inhibitors
Migraine medications
Additional analgesics
Additional antiphlogistics and antirheumatics
Myotonolytics
Gout interval therapy
Gout attack therapy
2.2 Antiallergic drugs and desensitization
34
36
37
38
38
41
42
44
44
47
48
49
57
Margreet Rost van Tonningen
2.2.1
2.2.2
2.2.3
2.2.4
Antihistamines (H1-blocker)
Glucocorticosteroids
Mast cell stabilizers
Immunotherapy
2.3 Antiasthmatic and cough medication
57
60
61
61
63
Hanneke Garbis
2.3.1
2.3.2
2.3.3
2.3.4
2.3.5
2.3.6
2.3.7
2.3.8
2.3.9
2.3.10
2.3.11
2.3.12
Asthma and pregnancy
Selective β2-adrenergic agonists
Corticosteroids
Anticholinergic drugs
Theophylline
Cromoglycate, nedocromil, and lodoxamide
Other mast cell inhibitors
Antileukotrienes
Monoclonal antibodies and other asthma medications
Expectorants and mucolytic agents
Antitussives
Non-selective β-adrenergic agonists
2.4 Antiemetics
63
64
65
67
68
69
70
70
71
71
72
73
78
Lee H. Goldstein and Matitiahu Berkovitch
2.4.1
2.4.2
2.4.3
2.4.4
2.4.5
2.4.6
Nausea and vomiting in pregnancy
Diet manipulations and treatment
Complementary treatment options
Acupuncture and acupressure
Hypnosis
Ginger
78
79
80
81
82
82
Contents
2.4.7
2.4.8
2.4.9
2.4.10
2.4.11
2.4.12
2.4.13
Antihistamines (H1-blockers)
Dopamine antagonists
Pyridoxine (vitamin B6)
Thiamine (vitamin B1)
Serotonin antagonists
Glucocorticoids
Other agents with antiemetic properties
2.5 Gastrointestinal and antilipidemic agents and spasmolytics
vii
83
85
86
87
87
88
89
94
Margreet Rost van Tonningen
2.5.1
2.5.2
2.5.3
2.5.4
2.5.5
2.5.6
2.5.7
2.5.8
2.5.9
2.5.10
2.5.11
2.5.12
2.5.13
2.5.14
2.5.15
2.5.16
2.5.17
2.5.18
2.5.19
2.5.20
2.5.21
2.5.22
2.5.23
2.5.24
2.5.25
2.5.26
Gastritis and peptic ulcer during pregnancy
Antacids and sucralfate
H2-receptor antagonists
Proton-pump inhibitors
Bismuth salts
Additional ulcer therapeutics
Helicobacter pylori therapy
Acids
Atropine and other anticholinergic spasmolytics
Cholinergics
Other prokinetic agents
Constipation during pregnancy
Stool-bulking agents
Hyperosmotic and saline laxatives
Diphenylmethanes
Anthraquinone derivatives
Castor oil
Lubricants and emollient laxatives
Antidiarrheals
Drugs for chronic inflammatory bowel disease
Dimeticon and plant-based carminatives
Chenodeoxycholic acid and ursodeoxycholic acid
Clofibrine acid derivatives and analogs
Cholesterol synthesis-enzyme inhibitors
Cholestyramine and other lipid reducers
Appetite suppressants, obesity and weight loss
2.6 Anti-infective agents
94
95
97
98
99
99
101
102
102
103
104
105
105
105
106
107
107
108
108
109
112
112
113
114
115
116
123
Hanneke Garbis, Margreet Rost van Tonningen, and Minke Reuvers
2.6.1
2.6.2
2.6.3
2.6.4
Penicillins
Cephalosporins
Other β-lactam antibiotics and β-lactamase inhibitors
Macrolide antibiotics
124
125
126
126
viii
Contents
2.6.5
2.6.6
2.6.7
2.6.8
2.6.9
2.6.10
2.6.11
2.6.12
2.6.13
2.6.14
2.6.15
2.6.16
2.6.17
2.6.18
2.6.19
2.6.20
2.6.21
2.6.22
2.6.23
2.6.24
2.6.25
2.6.26
2.6.27
2.6.28
2.6.29
2.6.30
2.6.31
2.6.32
2.6.33
2.6.34
2.6.35
2.6.36
2.6.37
2.6.38
2.6.39
2.6.40
2.6.41
2.6.42
2.6.43
2.6.44
2.6.45
2.6.46
2.6.47
2.6.48
Lincomycin and clindamycin
Tetracyclines
Sulfonamides, trimethoprim, atovaquone, and pentamidine
Quinolones
Nitrofurantoin and other drugs for urinary tract infections
Aminoglycosides
Chloramphenicol
Metronidazole and other nitroimidazole antibiotics
Polypeptide antibiotics
Antimycotics in general
Nystatin
Clotrimazole and miconazole for topical use
Other local “conazole” antimycotics
Other local antimycotics
“Conazole” antimycotics for systemic use
Amphotericin B
Flucytosine
Griseofulvin
Terbinafine
Malaria prophylaxis and therapy in pregnancy
Chloroquine
Proguanil
Mefloquine
Pyrimethamine, sulfadoxine and dapsone
Quinine
Halofantrine
Primaquine
Artemisinin derivatives
Other malarial agents
Tuberculosis and pregnancy
Isoniazid (INH)
Rifampicin
Ethambutol
Pyrazinamide (PZA)
Aminoglycosides in tuberculosis
Para-aminosalicylic acid (PAS)
Quinolones in tuberculosis
Other second-line antituberculous drugs
Dapsone
Aciclovir and other herpes antivirals
Antiviral drugs for influenza
Ribavirin
Other antiviral drugs
HIV prophylaxis and therapy
128
128
129
131
132
133
134
135
136
136
137
137
138
138
139
140
141
142
142
143
144
144
145
146
147
148
148
149
150
151
152
153
153
154
154
154
155
155
156
156
158
158
159
159
Contents
2.6.49
2.6.50
2.6.51
2.6.52
2.6.53
2.6.54
2.6.55
2.6.56
2.6.57
Mebendazole and flubendazole
Pyrviniumembonate
Albendazole and thiabendazole
Niclosamide
Praziquantel
Pyrantel
Ivermectin and diethylcarbamazine
Hyperthermia
Traveling
2.7 Vaccines and immunoglobulins
ix
162
163
164
164
165
165
166
166
168
178
Paul Peters
2.7.1
2.7.2
2.7.3
2.7.4
2.7.5
2.7.6
2.7.7
2.7.8
2.7.9
2.7.10
2.7.11
2.7.12
2.7.13
2.7.14
2.7.15
2.7.16
2.7.17
2.7.18
Vaccination and pregnancy
Cholera vaccine
Hemophilus influenza b (HIB) vaccine
Hepatitis A vaccine
Hepatitis B vaccine
Human Papilloma Virus (HPV) vaccine
Influenza vaccine
Measles and mumps vaccines
Meningococcal meningitis vaccine
Pneumococcal vaccination
Poliomyelitis vaccine
Rabies vaccine
Rubella vaccine
Tetanus and diphtheria vaccines
Typhoid vaccine
Varicella vaccine
Yellow fever vaccine
Immunoglobulins
2.8 Heart and circulatory system drugs and diuretics
179
180
180
180
181
182
182
183
184
184
184
185
186
187
187
188
189
189
193
Corinna Weber-Schöndorfer
2.8.1
2.8.2
2.8.3
2.8.4
2.8.5
2.8.6
2.8.7
2.8.8
2.8.9
2.8.10
2.8.11
Arterial hypertension and pregnancy
α-methyldopa
β-adrenergic receptor blockers
Hydralazine and dihydralazine
Nifedipine and other calcium antagonists
ACE inhibitors
Angiotensin-II receptor antagonists
Clonidine
Diazoxide
Magnesium sulfate
Nitroprusside
194
195
196
198
200
203
205
207
208
208
209
x
Contents
2.8.12
2.8.13
2.8.14
2.8.15
2.8.16
2.8.17
2.8.18
2.8.19
2.8.20
2.8.21
2.8.22
2.8.23
2.8.24
2.8.25
2.8.26
2.8.27
2.9
Reserpine
Other antihypertensives
Pulmonary hypertension and its medication
Hypotension and antihypotensives
Dihydroergotamine
Adrenergic substances
Cardiac glycosides
Antiarrhythmic therapy of the pregnant woman and
of the fetus
Nitrates and other so-called vasodilators
Cardiovascular drugs
Diuretics
Thiazide diuretics
Furosemide and other high-ceiling diuretics
Aldosterone antagonists
Amiloride and triamterene
Mannitol
Anticoagulant and fibrinolytic drugs
209
210
211
214
215
216
216
217
222
223
224
224
225
226
227
227
237
Minke Reuvers
2.9.1
2.9.2
2.9.3
2.9.4
2.9.5
2.9.6
2.9.7
2.9.8
2.9.9
2.9.10
2.9.11
2.9.12
Pregnancy and coagulation
Heparins
Protamines
Low-dose aspirin (LDA)
Other non-coumarin antithrombotic drugs
Vitamin K antagonists
Vitamin K
Fibrinolysis
Streptokinase
Other fibrinolytics
Inhibitors of fibrinolysis
Volume expanders
2.10 Antiepileptics
237
239
240
241
241
242
246
247
247
248
249
249
254
Elisabeth Robert-Gnansia and Christof Schaefer
2.10.1
2.10.2
2.10.3
2.10.4
2.10.5
2.10.6
2.10.7
2.10.8
2.10.9
Epilepsy and antiepileptic drugs in pregnancy
Benzodiazepines
Carbamazepine
Ethosuximide and other succimides
Oxazolidine anticonvulsants
Phenobarbital and primidone
Phenytoin
Sultiam
Valproic acid
255
257
260
261
262
263
266
268
269
Contents
2.10.10
2.10.11
2.10.12
2.10.13
2.10.14
2.10.15
2.10.16
2.10.17
2.10.18
2.10.19
Felbamate
Gabapentin
Lamotrigine
Levetiracetam
Oxcarbazepine
Pregabalin
Tiagabine
Topiramate
Vigabatrin
Zonisamid
2.11 Psychotropic drugs
xi
273
273
274
276
277
278
278
279
279
280
288
Hanneke Garbis and Patricia R. McElhatton
2.11.1
2.11.2
2.11.3
2.11.4
2.11.5
2.11.6
2.11.7
2.11.8
2.11.9
2.11.10
2.11.11
2.11.12
2.11.13
2.11.14
2.11.15
2.11.16
2.11.17
2.11.18
Tricyclic and tetracyclic antidepressants
Selective serotonin reuptake inhibitors (SSRIs)
Monoaminoxidase inhibitors (MAOIs)
Other antidepressants
Antipsychotic drugs and pregnancy – “classical” or
atypical antipsychotics?
Phenothiazines and thioxanthenes
Butyrophenones
Atypical antipsychotic drugs
Other neuroleptic drugs
Lithium and other mood-stabilizers/antimanic agents
Barbiturates as sedative-hypnotic agents
Benzodiazepines
Zaleplon, zolpidem, and zopiclone
Other anxiolytic drugs
Chloral hydrate
Other sedative-hypnotic drugs
Psychoanaleptic drugs
Parkinson drugs
2.12 Immunomodulators
289
291
296
297
299
300
301
302
304
305
306
307
309
309
310
310
311
312
321
Corinna Weber-Schöndorfer
2.12.1
2.12.2
2.12.3
2.12.4
2.12.5
2.12.6
2.12.7
2.12.8
Immunomodulators in general
Azathioprine
Cyclosporine A
Selective immunosuppressants
Monoclonal antibodies as part of an
immunomodulatory therapy
Interferons
Thalidomide
Other immunomodulators
321
322
323
324
326
327
329
330
xii
Contents
2.13 Antineoplastic drugs
335
Corinna Weber-Schöndorfer and Christof Schaefer
2.13.1
2.13.2
2.13.3
2.13.4
2.13.5
2.13.6
2.13.7
2.13.8
2.13.9
2.13.10
2.13.11
2.13.12
2.13.13
2.13.14
2.13.15
2.13.16
2.13.17
2.13.18
2.13.19
Cancer and pregnancy
Classification of the drugs used for chemotherapy
Vinca alkaloids and structural analogs
Podophyllotoxin derivatives
Nitrogen mustard agents
Nitrogen mustard analogs
Other alkylating agents
Cytotoxic anthracycline antibiotics
Other cytotoxic antibiotics
Folate antagonistic antimetabolites
Purine-derived antimetabolites (purine antagonists)
Pyrimidine-derived antimetabolites (pyrimidine antagonists)
Taxanes
Platin compounds
Other antineoplastic drugs
Enzymes and antibodies exerting antineoplastic effects
Antineoplastic drugs with endocrine effects
Cytostatic drugs of plant origin
Occupational handling of cytostatic drugs
2.14 Uterine contraction agents, tocolytics, vaginal therapeutics,
and local contraceptives
335
338
339
340
340
341
342
343
345
346
349
350
352
352
354
355
357
358
358
368
Herman van Geijn
2.14.1
2.14.2
2.14.3
2.14.4
2.14.5
2.14.6
2.14.7
2.14.8
2.14.9
2.14.10
2.14.11
2.14.12
2.14.13
Prostaglandins
Oxytocin
Ergot alkaloids (see also Chapter 2.1)
Tocolytics in general
β2-sympathomimetics
Calcium antagonists
Magnesium sulfate
Oxytocin receptor antagonists
Prostaglandin antagonists
Other tocolytics
Vaginal therapeutics
Spermicide contraceptives
Intrauterine devices
2.15 Hormones
368
371
372
372
373
373
374
375
375
375
376
377
377
381
Elvira Rodriguez-Pinilla and Corinna Weber-Schöndorfer
2.15.1
2.15.2
Hypothalamic releasing hormones
Anterior pituitary hormones
382
384
Contents
2.15.3
2.15.4
2.15.5
2.15.6
2.15.7
2.15.8
2.15.9
2.15.10
2.15.11
2.15.12
2.15.13
2.15.14
2.15.15
2.15.16
2.15.17
2.15.18
Prolactin antagonists
Posterior pituitary hormones
Thyroid function and iodine supply during pregnancy
Hypothyroidism, triiodothyronine (T3), and thyroxine (T4)
Hyperthyroidism and thyrostatics
Glucocorticoids
Diabetes mellitus and pregnancy
Insulin
Oral antidiabetics
Estrogens
Progestins (gestagens)
Diethylstilbestrol
Androgens and anabolics
Antiestrogens, antiandrogens, and danazol
Mifepristone (RU486)
Clomiphene
2.16 General and local anesthetics and muscle relaxants
xiii
386
387
388
389
390
392
397
399
401
404
405
408
408
409
410
411
423
Asher Ornoy
2.16.1
2.16.2
2.16.3
2.16.4
2.16.5
2.16.6
2.16.7
2.16.8
Halogenated inhalation agents for general anesthesia
Ether (diethyl ether)
Nitrous oxide
Injectable anesthetics
Local anesthetics
Epidural and spinal analgesia/anesthesia in pregnancy
Muscle relaxants
Occupational exposure to inhalation anesthetics
2.17 Dermatological medications and local therapeutics
424
426
427
427
431
432
433
434
441
Paul Peters and Christof Schaefer
2.17.1
2.17.2
2.17.3
2.17.4
2.17.5
2.17.6
2.17.7
2.17.8
2.17.9
2.17.10
2.17.11
2.17.12
2.17.13
Typical skin changes during pregnancy
Anti-infective agents
Antiseptics and disinfectants
Astringents
Polidocanol
Camphor and menthol
Coal tar and slate oil preparations
Local immunomodulators and neurodermatitis therapy
Keratolytics
Retinoids for acne and psoriasis therapy
Photochemotherapy and fumaric acid
Sex hormones and cyproterone acetate
5-Fluorouracil
441
442
444
447
448
448
448
449
449
452
456
456
457
xiv
Contents
2.17.14
2.17.15
2.17.16
2.17.17
2.17.18
2.17.19
2.17.20
2.17.21
2.17.22
Lithium
Scabies and lice medications
Diethyltoluamide and icaridin
Eye, nose, and ear drops
Hemorrhoid medications
Vein therapeutics
Antihidrotica
Minoxidil
Cosmetics
2.18 Vitamins, minerals and trace elements
457
458
458
459
461
462
462
462
463
467
Paul Peters and Christof Schaefer
2.18.1
2.18.2
2.18.3
2.18.4
2.18.5
2.18.6
2.18.7
2.18.8
2.18.9
2.18.10
2.18.11
2.18.12
2.18.13
2.18.14
2.18.15
2.18.16
2.18.17
2.18.18
2.18.19
Vitamin A (retinol)
Vitamin B1 (thiamine)
Vitamin B2 (riboflavin)
Vitamin B3 (nicotinamide)
Vitamin B6 (pyridoxine)
Vitamin B12 (cyanocobalamin)
Folic acid
Vitamin C (ascorbic acid)
Vitamin D group
Vitamin E (tocopherol)
Vitamin K
Multivitamin preparations
Iron
Calcium
Fluoride
Strontium
Biphosphonates and other osteoporosis drugs
Iodide
Trace elements
2.19 Herbs during pregnancy
468
470
470
471
471
471
472
474
475
476
476
477
477
478
479
479
480
481
481
485
Henry M. Hess and Richard K. Miller
2.19.1
2.19.2
2.19.3
2.19.4
2.19.5
2.19.6
2.19.7
2.19.8
The safety of herbs during pregnancy
Counseling a pregnant woman about herbs
General concepts regarding the use of herbs during
pregnancy
Herbs used as foods
Essential oils that are safe during pregnancy
Herbs frequently used during pregnancy
Herbs controversially used during pregnancy
Herbs contraindicated during pregnancy
485
486
488
489
489
490
491
491
Contents
2.20 Diagnostic agents
xv
502
Elisabeth Robert-Gnansia
2.20.1
2.20.2
2.20.3
2.20.4
2.20.5
2.20.6
2.20.7
2.20.8
2.20.9
2.20.10
X-ray examinations
Ultrasound
Magnetic resonance imaging
Barium sulfate
Iodine-containing contrast media
Ultrasonographic and magnetic resonance contrast media
Radioactive isotopes
Stable isotopes
Dyes
Other diagnostic agents
2.21 Recreational drugs
502
505
506
507
507
508
508
509
510
510
514
Paul Peters and Christof Schaefer
2.21.1
2.21.2
2.21.3
2.21.4
2.21.5
2.21.6
2.21.7
2.21.8
Alcohol (ethanol)
Caffeine and other xanthine derivatives
Tobacco and smoking
Drugs of abuse in general (excluding alcohol)
Opiates
Stimulants
Hallucinogens
“Sniffed” substances
2.22 Poisonings and toxins
514
520
521
525
525
527
530
533
543
Christof Schaefer
2.22.1
2.22.2
2.22.3
2.22.4
2.22.5
2.22.6
2.22.7
2.22.8
The general risk of poisoning in pregnancy
Treatment of poisoning in pregnancy
Chemicals
Medicines
Animal toxins
Mushrooms
Other plant toxins
Bacterial endotoxins
2.23 Occupational, industrial, and environmental agents
543
544
545
549
554
555
556
556
561
Richard K. Miller, Paul Peters, and Patricia R. McElhatton
2.23.1
2.23.2
2.23.3
2.23.4
2.23.5
Solvent exposure in general
Formaldehyde and formalin
Chloroprene (chlorbutadiene)
Cyanide
Photographic/printing chemicals
564
573
574
575
575
xvi
Contents
2.23.6
2.23.7
2.23.8
2.23.9
2.23.10
2.23.11
2.23.12
2.23.13
2.23.14
3
Pesticides
Phenoxyacetic acid derivatives and chlorinated
dibenzo-dioxins
Metals
Hazardous waste landfill sites
Radiation associated with the nuclear industry
Video display terminals (VDTs)
Mobile phones
Other sources of electromagnetic radiation
Electric shocks and lightning strikes
576
581
583
590
592
594
596
596
598
General commentary on drug therapy and drug risk
during lactation
Ruth Lawrence and Christof Schaefer
3.1
3.2
3.3
3.4
3.5
3.6
3.7
3.8
4
The advantages of breastfeeding versus the risks of maternal
medication
The passage of medications into the mother’s milk
Infant characteristics
Milk plasma ratio
Amount of medication in the milk and relative dose
Toxicity of medications in the mother’s milk
Medications that affect lactation
Breastfeeding support
609
612
613
614
615
617
619
620
Specific drug therapies during lactation
Christof Schaefer and Ruth Lawrence
4.1 Analgesics, antiphlogistics and anesthetics
623
Christof Schaefer
4.1.1
4.1.2
4.1.3
4.1.4
4.1.5
4.1.6
4.1.7
4.1.8
4.1.9
4.1.10
4.1.11
4.1.12
Paracetamol
Acetylsalicylic acid
Opioid analgesics and other centrally acting analgesics
Classic nonsteroid anti-inflammatory drugs
Selective cyclooxygenase-2 (COX-2) inhibitors
Pyrazolone- and phenylbutazone derivatives
Other antirheumatics
Migraine medications
Local anesthetics
Other medications used in connection with anesthesia
Myotonolytics
Gout therapy
623
624
625
627
629
629
630
631
632
633
634
635
Contents
4.2 Antiallergics, antiasthmatics and antitussives
xvii
639
Christof Schaefer
4.2.1
4.2.2
4.2.3
4.2.4
4.2.5
4.2.6
4.2.7
4.2.8
4.2.9
4.2.10
Antihistamines (H1-blockers)
β2-sympathomimetics for asthma treatment
Other sympathomimetics
Anticholinergics for asthma treatment
Theophylline
Cromoglycic acid and nedocromil
Corticoids
Leukotrien-receptor antagonists
Acetylcysteine and other mucolytics
Antitussives
4.3 Gastrointestinal drugs
639
641
642
642
642
643
643
644
644
644
648
Christof Schaefer
4.3.1
4.3.2
4.3.3
4.3.4
4.3.5
4.3.6
4.3.7
4.3.8
4.3.9
4.3.10
4.3.11
4.3.12
4.3.13
Antacids
H2-receptor blockers and other ulcer therapeutics
Peristaltic stimulators
Cholinergics
Anticholinergic spasmolytics
Laxatives
Agents used for chronic inflammatory bowel diseases
Antidiarrheals for acute diarrhea
Carminatives
Lipid reducers
Chenodeoxycholic acid and ursodeoxycholic acid
Appetite suppressants
Antiemetics
4.4 Anti-infectives
648
649
650
651
652
652
653
654
654
655
655
656
656
659
Christof Schaefer
4.4.1
4.4.2
4.4.3
4.4.4
4.4.5
Antibiotics in general
Penicillins, cephalosporins, and other β-lactam antibiotics
Erythromycin and other macrolides
Tetracyclines
Dapsone, nitrofurantoin, and other drugs for urinary
tract infections
4.4.6 Quinolones
4.4.7 Other antibiotics and urinary tract antiseptics
4.4.8 Nitroimidazole antibiotics
4.4.9 Aminoglycoside antibiotics
4.4.10 Tuberculostatics
4.4.11 Malarial drugs
4.4.12 Local antimycotics
660
660
661
662
662
663
664
665
665
666
667
668
xviii
Contents
4.4.13 Systemic antimycotics
4.4.14 Antihelminthics
4.4.15 Acyclovir, antiretroviral drugs, and other virustatics
4.5 Vaccines and immunoglobulins
668
669
670
674
Ruth Lawrence and Christof Schaefer
4.5.1
4.5.2
4.5.3
4.5.4
4.5.5
4.5.6
4.5.7
4.5.8
4.5.9
4.5.10
4.5.11
Maternal immunization
Efficacy of immunization in breastfed infants
Hepatitis A vaccine
Hepatitis B vaccine
Influenza vaccine
Polio vaccine
Rabies vaccine
Rubella vaccine
Smallpox vaccine
Typhoid vaccine
Immunoglobulins
4.6 Cardiovascular drugs and diuretics
674
675
675
675
676
676
677
677
677
678
678
680
Christof Schaefer
4.6.1
4.6.2
4.6.3
4.6.4
4.6.5
4.6.6
4.6.7
4.6.8
4.6.9
4.6.10
4.6.11
4.6.12
β-receptor blockers
Hydralazine
α-methyldopa
Calcium antagonists
ACE inhibitors
Angiotensin-II receptor-antagonists
Other antihypertensives
Dihydroergotamine and other antihypotensives
Digitalis
Antiarrhythmics
Diuretics
Circulatory drugs and vasodilators
4.7 Anticoagulants and fibrinolytics
680
682
682
683
684
684
685
686
686
687
690
691
695
Christof Schaefer
4.7.1
4.7.2
4.7.3
4.7.4
Heparin
Vitamin K antagonists (coumarin derivatives and
indanediones)
Other anticoagulants
Fibrinolytics
4.8 Antiepileptics
695
696
696
697
699
Christof Schaefer
4.8.1
4.8.2
Carbamazepine
Clobazam and clonazepam
700
700
Contents
4.8.3
4.8.4
4.8.5
4.8.6
4.8.7
4.8.8
4.8.9
4.8.10
4.8.11
4.8.12
4.8.13
4.8.14
4.8.15
4.9
Ethosuximide and mesuximide
Phenobarbitone (phenobarbital), primidone, and
barbexaclone
Phenytoin
Valproic acid
Recommendations: classical anticonvulsants
Gabapentin
Lamotrigine
Levetiracetam
Oxcarbazepine
Topiramat
Vigabatrin
Zonisamide
Recommendations: newer antiepileptics
Psychotropic drugs
xix
701
701
702
702
703
703
704
704
704
705
705
705
705
708
Christof Schaefer
4.9.1
4.9.2
4.9.3
4.9.4
4.9.5
4.9.6
4.9.7
4.9.8
4.9.9
4.9.10
4.9.11
4.9.12
4.9.13
Antidepressants in general
Tri- and tetracyclic antidepressants
Selective serotonin reuptake inhibitors
Other antidepressants
Phenothiazine and thioxanthene neuroleptics
Butyrophenones
Atypical neuroleptics
Antimanic drugs
Benzodiazepines
Other anxiolytics
Other hypnotics
Psychoanaleptics
Parkinson drugs
4.10 Immunomodulating and antineoplastic agents
708
709
714
718
720
724
724
727
727
730
731
732
732
738
Ruth Lawrence and Christof Schaefer
4.10.1
4.10.2
Immunosuppressive and immune antineoplastic agents
Antineoplastics
4.11 Hormones and hormone antagonists
738
740
746
Christof Schaefer
4.11.1
4.11.2
4.11.3
4.11.4
4.11.5
4.11.6
Pituitary and hypothalamic hormones
Methylergometrine (methylergonovine)
Bromocriptine and other prolactin inhibitors
Thyroid hormones and thyroid receptor antibodies
Thyrostatics
Iodine
746
747
748
749
750
751
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