Other Issues of Drug Therapy
Any drug prescription during pregnancy should be considered with caution, including anesthetics and vitamins. All patients with asthma should be careful when taking non-steroidal analgesics (aspirin, analgin, etc.); at Aspirin-sensitive asthma, complete and absolute all this group drugs exclusion is required.
Intolerance to any medicines is not uncommon for asthma. You’ll be safer if you will always have filled by allergologist allergic disease patient passport with you, which contains a list of drugs, that previously caused an allergic reaction or contraindicated for asthma (e. g. beta-blockers), as well as related drugs that can cause polyvalent allergy. Before taking any medication a patient should get familiar with its composition and instructions, and discuss all questions with a doctor.
As it was already mentioned, during pregnancy it is absolutely contraindicated to use any ephedrine drug (including Theofedrin), because it causes uterus vasoconstriction and worsens fetal hypoxia. Adrenaline during asthma recrudescences is not recommended (if needed, injectable terbutaline is applied).
Neither at asthma nor at allergy during pregnancy repository systemic long-acting hormones are applied.
Sometimes it takes special measures to deal with heartburn during pregnancy because it can negatively affect asthma course, especially at night. It is very important to keep to a diet with the complete exception of caffeine, chocolate and other heartburn provocative foods, some cases require medical treatment.
In case of coexistent diseases that require basic therapy (e. g. hypertension), you need to consult a specialist in the appropriate field for correcting therapy taking into account planned a pregnancy.
Among expectorants iodine drugs or iodine-containing substances (e. g. potassium iodide), as they can affect fetal thyroid gland function.
Familiar with allergic patients antihistamines are not applicable for asthma treatment in adults, but they may be applied to treat other allergic diseases such as coexistent allergic rhinitis. They have significant limitations for use during pregnancy, especially during the first trimester. Only limited amount of drugs is applied under strict doctor’s supervision, in small dosage, and according to strict prescriptions (e. g. diphenhydramine). Modern antihistamines during pregnancy are prescribed only in cases of extreme necessity when expected benefit exceeds potential risk to the fetus (experiments of their administration during pregnancy are not enough, experiments on animals haven’t registered teratogenic effects, «B» category). Fexofenadine is currently referred to «C» category (data on its safety during pregnancy are not currently available) and generally is not applied. Mekhitazin is allowed to take with extreme caution. Astemizole and terfenadine are forbidden (arrhythmogenic effect, embryotoxic effects on animals).
US Antihistamines for Pregnancy
FDA refers to «B» category:
- chlorpheniramine (Chlor-Trimeton);
- dexchlorpheniramine (Polaramine);
- brompheniramine (Dimetapp);
- diphenhydramine (Benadryl);
- cyproheptadine (Periactin, Peritol);
- clemastin (Tavist);
- azatadine (Optimine).
- azelastin (Astelin);
- hydroxyzine (Atarax);
- promethazine (Phenergan).
Pregnancy and Allergen-Specific Immunotherapy (ASIT, or SIT)
Although pregnancy is not a contraindication for ASIT, it is not recommended to begin treatment during pregnancy. But if pregnancy appeared during ASIT, treatment may not be interrupted. One research has shown that children born from mothers who received ASIT are less exposed to risk allergies development.