Medications and Breast-Feeding: A Guide for Pharmacists, Pharmacy Technicians, and other Healthcare Professionals Part III

Abstract

The following discussion of medication categories, including infectious diseases medications and vaccines, psychiatric and neurology agents, and radiopharmaceuticals, will help pharmacists and other healthcare professionals understand which are the optimal drugs within specific categories for breast-feeding mothers to take while minimizing the impact on infants. Drugs for use in ambulatory care, analgesia and anesthesia, and cardiology, as well as general medicines were discussed in Parts I 1 and II 2 of this 3-part series. Data and references supporting the information on each drug are detailed in tables, where applicable. American Academy of Pediatrics' (AAP) recommendations are listed if available. 3 Infectious Diseases ANTIINFECTIVESFortunately, most antibiotics, for various reasons, are generally considered safe for breast-feeding mothers to take. Infants, as well as mothers, should be monitored for FRANK J NICE MS MPA DPA CPHPObjective: To provide a guide for practicing pharmacists, pharmacy technicians, and other healthcare professionals so that they are able to counsel and advise breast-feeding mothers and fellow healthcare professionals on the safety and use of antiinfectives, vaccines, antiepileptics, benzodiazepines, psychotherapeutic drugs, and radiopharmaceuticals during breast-feeding. Data Sources: Primary texts used by the breast-feeding community (Medications and Mothers' Milk, Drugs in Pregnancy and Lactation, Drugs and Human Lactation)were searched, as well as Micromedex, MEDLINE, PubMed, EMBASE, and EMBASE2 (1984-February 2004). Study Selection/Data Extraction:Multiple sources were used wherever available to validate the data, and primary articles were used to verify all tertiary source information. Search terms included breast-feeding, lactation, nursing, and medications, as well as specific drug names.Data Synthesis: Concerns regarding medication use during breast-feeding have caused mothers to either discontinue nursing or not take necessary medications. Complete avoidance of medications or cessation of breast-feeding is often unnecessary. Although there are drugs that can be harmful to nursing infants, breastmilk concentrations of most drugs are insufficient to cause any harm. Conclusions:Having objective and reliable information on medications enables pharmacists, pharmacy technicians, other healthcare providers, and mothers to make educated decisions regarding drug therapy and breast-feeding.

Genotypic glucose-6-phosphate dehydrogenase (G6PD) deficiency protects against Plasmodium falciparum infection in individuals living in Ghana

“…Host-parasite interactions result in a complex balance of pro-oxidant and antioxidant molecules in both host and parasite [ 28 ]. However, the G6PDd erythrocytes may not sufficiently counterbalance oxidative stress generated by the erythrocytes stage malaria parasites observed in drugs such as primaquine, dapsone, sulfonamides, quinolones, chloramphenicol, nitrofurantoin (antibiotics), and phenazopyridine (analgesics) used by affected individuals [ 29 ].…”