Drugs In Pregnancy And Lactation 11th Edition Pdf |TOP| Free Download

Put essential information at your fingertips - before you prescribe. The updated 11th edition of Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk lists more than 1,200 commonly prescribed drugs taken during pregnancy and lactation, with detailed monographs that provide the information you need on known or possible effects on the mother, embryo, fetus, and nursing infant. For the 11th edition, this bestselling reference has two new authors, both highly knowledgeable on the effects of drugs on the embryo-fetus and nursing infant: Craig V. Towers, a maternal-fetal medicine specialist, and Alicia B. Forinash, a clinical pharmacologist specialist in obstetrics. -- Provided by publisher.

Relevant published information in nursing mothers was not found as of the revision date. Anticholinergics can inhibit lactation in animals, apparently by inhibiting growth hormone and oxytocin secretion.[2-6] Anticholinergic drugs can also reduce serum prolactin in nonnursing women.[7] The prolactin level in a mother with established lactation may not affect her ability to breastfeed.

Drugs In Pregnancy And Lactation 11th Edition Pdf Free Download

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During pregnancy, the amount of zinc needed increases to accommodate fetal growth, and the FNB therefore recommends that pregnant people consume 3 mg/day more zinc than nonpregnant people in the same age group [1,3]. Similarly, the zinc requirement increases by 4 mg/day during lactation.

Employers can violate Title VII by providing health insurance that excludes coverage of prescription contraceptives, whether the contraceptives are prescribed for birth control or for medical purposes.[40] Because prescription contraceptives are available only for women, a health insurance plan facially discriminates against women on the basis of gender if it excludes prescription contraception but otherwise provides comprehensive coverage.[41] To comply with Title VII, an employer's health insurance plan must cover prescription contraceptives on the same basis as prescription drugs, devices, and services that are used to prevent the occurrence of medical conditions other than pregnancy.[42] For example, if an employer's health insurance plan covers preventive care for medical conditions other than pregnancy, such as vaccinations, physical examinations, prescription drugs that prevent high blood pressure or to lower cholesterol levels, and/or preventive dental care, then prescription contraceptives also must be covered.

There are various circumstances in which discrimination against a female employee who is lactating or breastfeeding can implicate Title VII. Lactation, the postpartum production of milk, is a physiological process triggered by hormones.[50] Because lactation is a pregnancy-related medical condition, less favorable treatment of a lactating employee may raise an inference of unlawful discrimination.[51] For example, a manager's statement that an employee was demoted because of her breastfeeding schedule would raise an inference that the demotion was unlawfully based on the pregnancy-related medical condition of lactation.[52]

Jennifer had been successfully managing a neurological disability with medication for several years. Without the medication, Jennifer experienced severe fatigue and had difficulty completing a full work day. However, the combination of medications she had been prescribed allowed her to work with rest during the breaks scheduled for all employees. When she became pregnant, her physician took her off some of these drugs due to risks they posed during pregnancy. Adequate substitutes were not available. She began to experience increased fatigue and found that rest during short breaks in the day and lunch time was insufficient. Jennifer requested that she be allowed more frequent breaks during the day to alleviate her fatigue. Absent undue hardship, the employer would have to grant such an accommodation.

[42] See supra note 37. The Commission disagrees with the conclusion in In re Union Pac. R.R. Employment Practices Litig., 479 F.3d 936 (8th Cir. 2007), that contraception is gender-neutral because it applies to both men and women. Id. at 942. The court distinguished the EEOC's decision on coverage of contraception by noting that the Commission decision involved a health insurance policy that denied coverage of prescription contraception but included coverage of vasectomies and tubal ligations while the employer in Union Pacific excluded all contraception for women and men, both prescription and surgical, when used solely for contraception and not for other medical purposes. However, the EEOC's decision was not based on the fact that the plan at issue covered vasectomies and tubal ligations. Instead, the Commission reasoned that excluding prescription contraception while providing benefits for drugs and devices used to prevent other medical conditions is a sex-based exclusion because prescription contraceptives are available only for women. See also Union Pacific, 479 F.3d at 948-49 (Bye, J., dissenting) (contraception is "gender-specific, female issue because of the adverse health consequences of an unplanned pregnancy"; therefore, proper comparison is between preventive health coverage provided to each gender).

[51] EEOC v. Houston Funding II, Ltd., 717 F.3d 425 (5th Cir. 2013) (lactation is a related medical condition of pregnancy for purposes of the PDA, and an adverse employment action motivated by the fact that a woman is lactating clearly imposes upon women a burden that male employees need not suffer).

[114] See, e.g., Orr v. City of Albuquerque, 531 F.3d 1210, 1216 (10th Cir. 2008) (reversing summary judgment for defendants where plaintiffs presented evidence that they were required to use sick leave for their maternity leave while others seeking non-pregnancy FMLA leave were routinely allowed to use vacation or compensatory time); Maddox v. Grandview Care Ctr., Inc., 780 F.2d 987, 991 (11th Cir. 1986) (affirming finding in favor of plaintiff where employer's policy limited maternity leave to three months while leave of absence for "illness" could be granted for indefinite duration).

[115] See Byrd v. Lakeshore Hosp., 30 F.3d 1380, 1383 (11th Cir. 1994) (rejecting employer's argument that plaintiff, who was discharged partly due to her use of accumulated sick leave for pregnancy-related reasons, additionally was required to show that non-pregnant employees with similar records of medical absences were treated more favorably; the court noted that an employer is presumed to customarily follow its own sick leave policy and, if the employer commonly violates the policy, it would have the burden of proving the unusual scenario).

[116] See Stout v. Baxter Healthcare, 282 F.3d 856, 859-60 (5th Cir. 2002) (discharge of plaintiff due to pregnancy-related absence did not violate PDA where there was no evidence she would have been treated differently if her absence was unrelated to pregnancy); Armindo v. Padlocker, 209 F.3d 1319, 1321 (11th Cir. 2000) (PDA does not require employer to treat pregnant employee who misses work more favorably than non-pregnant employee who misses work due to a different medical condition); Marshall v. Am. Hosp. Ass'n, 157 F.3d 520 (7th Cir. 1998) (upholding summary judgment for employer due to lack of evidence it fired her because of her pregnancy rather than her announced intention to take eight weeks of leave during busiest time of her first year on the job).

In addition, some of these situations, such as pain or constipation, may still exist after the baby is born, raising questions about whether it is safe to take a medication while breastfeeding. Similar to safe medication use in pregnancy, treating conditions when breastfeeding has comparable challenges, such as safety to the baby and mother, effect on lactation supply, and the limited available supporting evidence.5,10 Some medications may pose a safety risk, and careful consideration should be made for those with long half-lives or those that accumulate in breast milk in large amounts, and also for infants who are more prone to side effects (e.g., preterm, neonates, underlying medical conditions).11

With 2% to 3% of birth defects being due to medication use, drug labels or package inserts are required to provide guidance on the use of drugs during pregnancy and lactation.12 Although the number of medications that are known to cause birth defects is small, these medications may also be limited to prescription-drug products. In 2015, the FDA updated the former pregnancy categories on prescription and biological drug labels to a more narrative summary, requiring providers to review the available evidence before making a clinical decision on whether a medication may be safe to take during pregnancy and lactation.13 However, the labeling of OTC medications and the categories that help evaluate safety risk are unchanged. Outside of the FDA labels, a vast number of resources are available to help determine whether a medication is safe (TABLE 1).1,14-20

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin), naproxen (Aleve), or aspirin are not recommended during the last 3 months of pregnancy due to an increase in blood flow and bleeding complications in the mother and baby during pregnancy and at delivery.15-17,21 However, ibuprofen is actually one of the preferred choices for pain/fever in breastfeeding mothers because of its low levels in breast milk and short half-life.1 Aspirin and naproxen are not preferred for breastfeeding due to longer half-lives and reported serious adverse reactions. It is important to note that combination acetaminophen/aspirin/caffeine (Excedrin) for headache may not be considered safe due to effects that aspirin and caffeine have on the growing fetus as well as the infant.

Mild upper-respiratory illnesses and the common cold are caused by viruses that are self-limiting; therefore, OTC medications are heavily relied on for symptoms and quality-of-life improvement.30 Many of the OTC medications contain only a few ingredients; however, these products may not be the safest options in breastfeeding mothers. TABLE 2 provides a summary of the pregnancy and lactation recommendations for these products. 2351a5e196