Drugs During Pregnancy and Lactation - Treatment Options and Risk Assessment

Front cover

Drugs During Pregnancy and Lactation, Second edition

Copyright page

Contents

List of contributors

Preface

Notice

Chapter 1 General commentary on drug therapy and drug risks in pregnancy

1.1 Introduction

1.2 Development and health

1.3 Reproductive stages

1.4 Reproductive and developmental toxicology

1.5 Basic principles of drug-induced reproductive and developmental toxicology

1.6 Effects and manifestations

1.7 Pharmacokinetics in pregnancy

1.8 Passage of drugs to the unborn and fetal kinetics

1.9 Causes of developmental disorders

1.10 Embryo/fetotoxic risk assessment

1.11 Classification of drugs used in pregnancy

1.12 Paternal use of medicinal products

1.13 Communicating the risk of drug use in pregnancy

1.14 Risk communication prior to pharmacotherapeutic choice

1.15 Risk communication regarding the safety (or otherwise) of drugs already used in pregnancy

1.16 Teratology information centers

Chapter 2 Specific drug therapies during pregnancy

2.1 Analgesics and anti-inflammatory drugs

2.1.1 Paracetamol (acetaminophen)

2.1.2 Aspirin (acetylsalicylic acid)

2.1.3 Pyrazolone derivatives

2.1.4 Combination analgesic preparations

2.1.5 Opioid analgesics in general

2.1.6 Morphine

2.1.7 Codeine

2.1.8 Pethidine (meperidine)

2.1.9 Fentanyl, alfentanil, remifentanil, and sufentanil

2.1.10 Other narco-analgesics and centrally acting analgesics

2.1.11 Naloxone

2.1.12 Nonsteroidal anti-inflammatory drugs (NSAIDs)

2.1.13 Selective cyclooxygenase-2 (COX-2) inhibitors

2.1.14 Migraine medications

2.1.15 Additional analgesics

2.1.16 Additional antiphlogistics and antirheumatics

2.1.17 Myotonolytics

2.1.18 Gout interval therapy

2.1.19 Gout attack therapy

2.2 Antiallergic drugs and desensitization

2.2.1 Antihistamines (H[sub(1)]-blocker)

2.2.2 Glucocorticosteroids

2.2.3 Mast cell stabilizers

2.2.4 Immunotherapy

2.3 Antiasthmatic and cough medication

2.3.1 Asthma and pregnancy

2.3.2 Selective β[sub(2)]-adrenergic agonists

2.3.3 Corticosteroids

2.3.4 Anticholinergic drugs

2.3.5 Theophylline

2.3.6 Cromoglycate, nedocromil, and lodoxamide

2.3.7 Other mast cell inhibitors

2.3.8 Antileukotrienes

2.3.9 Monoclonal antibodies and other asthma medications

2.3.10 Expectorants and mucolytic agents

2.3.11 Antitussives

2.3.12 Non-selective β-adrenergic agonists

2.4 Antiemetics

2.4.1 Nausea and vomiting in pregnancy

2.4.2 Diet manipulations and treatment

2.4.3 Complementary treatment options

2.4.4 Acupuncture and acupressure

2.4.5 Hypnosis

2.4.6 Ginger

2.4.7 Antihistamines (H[sub(1)]-blockers)

2.4.8 Dopamine antagonists

2.4.9 Pyridoxine (vitamin B[sub(6)])

2.4.10 Thiamine (vitamin B[sub(1)])

2.4.11 Serotonin antagonists

2.4.12 Glucocorticoids

2.4.13 Other agents with antiemetic properties

2.5 Gastrointestinal and antilipidemic agents and spasmolytics

2.5.1 Gastritis and peptic ulcer during pregnancy

2.5.2 Antacids and sucralfate

2.5.3 H[sub(2)]-receptor antagonists

2.5.4 Proton-pump inhibitors

2.5.5 Bismuth salts

2.5.6 Additional ulcer therapeutics

2.5.7 Helicobacter pylori therapy

2.5.8 Acids

2.5.9 Atropine and other anticholinergic spasmolytics

2.5.10 Cholinergics

2.5.11 Other prokinetic agents

2.5.12 Constipation during pregnancy

2.5.13 Stool-bulking agents

2.5.14 Hyperosmotic and saline laxatives

2.5.15 Diphenylmethanes

2.5.16 Anthraquinone derivatives

2.5.17 Castor oil

2.5.18 Lubricants and emollient laxatives

2.5.19 Antidiarrheals

2.5.20 Drugs for chronic inflammatory bowel disease

2.5.21 Dimeticon and plant-based carminatives

2.5.22 Chenodeoxycholic acid and ursodeoxycholic acid

2.5.23 Clofibrine acid derivatives and analogs

2.5.24 Cholesterol synthesis-enzyme inhibitors

2.5.25 Cholestyramine and other lipid reducers

2.5.26 Appetite suppressants, obesity and weight loss

2.6 Anti-infective agents

2.6.1 Penicillins

2.6.2 Cephalosporins

2.6.3 Other β-lactam antibiotics and β-lactamase inhibitors

2.6.4 Macrolide antibiotics

2.6.5 Lincomycin and clindamycin

2.6.6 Tetracyclines

2.6.7 Sulfonamides, trimethoprim, atovaquone, and pentamidine

2.6.8 Quinolones

2.6.9 Nitrofurantoin and other drugs for urinary tract infections

2.6.10 Aminoglycosides

2.6.11 Chloramphenicol

2.6.12 Metronidazole and other nitroimidazole antibiotics

2.6.13 Polypeptide antibiotics

2.6.14 Antimycotics in general

2.6.15 Nystatin

2.6.16 Clotrimazole and miconazole for topical use

2.6.17 Other local "conazole" antimycotics

2.6.18 Other local antimycotics

2.6.19 "Conazole" antimycotics for systemic use

2.6.20 Amphotericin B

2.6.21 Flucytosine

2.6.22 Griseofulvin

2.6.23 Terbinafine

2.6.24 Malaria prophylaxis and therapy in pregnancy

2.6.25 Chloroquine

2.6.26 Proguanil

2.6.27 Mefloquine

2.6.28 Pyrimethamine, sulfadoxine and dapsone

2.6.29 Quinine

2.6.30 Halofantrine

2.6.31 Primaquine

2.6.32 Artemisinin derivatives

2.6.33 Other malarial agents

2.6.34 Tuberculosis and pregnancy

2.6.35 Isoniazid (INH)

2.6.36 Rifampicin

2.6.37 Ethambutol

2.6.38 Pyrazinamide (PZA)

2.6.39 Aminoglycosides in tuberculosis

2.6.40 Para-aminosalicylic acid (PAS)

2.6.41 Quinolones in tuberculosis

2.6.42 Other second-line antituberculous drugs

2.6.43 Dapsone

2.6.44 Aciclovir and other herpes antivirals

2.6.45 Antiviral drugs for influenza

2.6.46 Ribavirin

2.6.47 Other antiviral drugs

2.6.48 HIV prophylaxis and therapy

2.6.49 Mebendazole and flubendazole

2.6.50 Pyrviniumembonate

2.6.51 Albendazole and thiabendazole

2.6.52 Niclosamide

2.6.53 Praziquantel

2.6.54 Pyrantel

2.6.55 Ivermectin and diethylcarbamazine

2.6.56 Hyperthermia

2.6.57 Traveling

2.7 Vaccines and immunoglobulins

2.7.1 Vaccination and pregnancy

2.7.2 Cholera vaccine

2.7.3 Hemophilus influenza b (HIB) vaccine

2.7.4 Hepatitis A vaccine

2.7.5 Hepatitis B vaccine

2.7.6 Human Papilloma Virus (HPV) vaccine

2.7.7 Influenza vaccine

2.7.8 Measles and mumps vaccines

2.7.9 Meningococcal meningitis vaccine

2.7.10 Pneumococcal vaccination

2.7.11 Poliomyelitis vaccine

2.7.12 Rabies vaccine

2.7.13 Rubella vaccine

2.7.14 Tetanus and diphtheria vaccines

2.7.15 Typhoid vaccine

2.7.16 Varicella vaccine

2.7.17 Yellow fever vaccine

2.7.18 Immunoglobulins

2.8 Heart and circulatory system drugs and diuretics

2.8.1 Arterial hypertension and pregnancy

2.8.2 α-methyldopa

2.8.3 β-adrenergic receptor blockers

2.8.4 Hydralazine and dihydralazine

2.8.5 Nifedipine and other calcium antagonists

2.8.6 ACE inhibitors

2.8.7 Angiotensin-II receptor antagonists

2.8.8 Clonidine

2.8.9 Diazoxide

2.8.10 Magnesium sulfate

2.8.11 Nitroprusside

2.8.12 Reserpine

2.8.13 Other antihypertensives

2.8.14 Pulmonary hypertension and its medication

2.8.15 Hypotension and antihypotensives

2.8.16 Dihydroergotamine

2.8.17 Adrenergic substances

2.8.18 Cardiac glycosides

2.8.19 Antiarrhythmic therapy of the pregnant woman and of the fetus

2.8.20 Nitrates and other so-called vasodilators

2.8.21 Cardiovascular drugs

2.8.22 Diuretics

2.8.23 Thiazide diuretics

2.8.24 Furosemide and other high-ceiling diuretics

2.8.25 Aldosterone antagonists

2.8.26 Amiloride and triamterene

2.8.27 Mannitol

2.9 Anticoagulant and fibrinolytic drugs

2.9.1 Pregnancy and coagulation

2.9.2 Heparins

2.9.3 Protamines

2.9.4 Low-dose aspirin (LDA)

2.9.5 Other non-coumarin antithrombotic drugs

2.9.6 Vitamin K antagonists

2.9.7 Vitamin K

2.9.8 Fibrinolysis

2.9.9 Streptokinase

2.9.10 Other fibrinolytics

2.9.11 Inhibitors of fibrinolysis

2.9.12 Volume expanders

2.10 Antiepileptics

2.10.1 Epilepsy and antiepileptic drugs in pregnancy

2.10.2 Benzodiazepines

2.10.3 Carbamazepine

2.10.4 Ethosuximide and other succimides

2.10.5 Oxazolidine anticonvulsants

2.10.6 Phenobarbital and primidone

2.10.7 Phenytoin

2.10.8 Sultiam

2.10.9 Valproic acid

2.10.10 Felbamate

2.10.11 Gabapentin

2.10.12 Lamotrigine

2.10.13 Levetiracetam

2.10.14 Oxcarbazepine

2.10.15 Pregabalin

2.10.16 Tiagabine

2.10.17 Topiramate

2.10.18 Vigabatrin

2.10.19 Zonisamid

2.11 Psychotropic drugs

2.11.1 Tricyclic and tetracyclic antidepressants

2.11.2 Selective serotonin reuptake inhibitors (SSRIs)

2.11.3 Monoaminoxidase inhibitors (MAOIs)

2.11.4 Other antidepressants

2.11.5 Antipsychotic drugs and pregnancy – "classical" or atypical antipsychotics?

2.11.6 Phenothiazines and thioxanthenes

2.11.7 Butyrophenones

2.11.8 Atypical antipsychotic drugs

2.11.9 Other neuroleptic drugs

2.11.10 Lithium and other mood-stabilizers/antimanic agents

2.11.11 Barbiturates as sedative-hypnotic agents

2.11.12 Benzodiazepines

2.11.13 Zaleplon, zolpidem, and zopiclone

2.11.14 Other anxiolytic drugs

2.11.15 Chloral hydrate

2.11.16 Other sedative-hypnotic drugs

2.11.17 Psychoanaleptic drugs

2.11.18 Parkinson drugs

2.12 Immunomodulators

2.12.1 Immunomodulators in general

2.12.2 Azathioprine

2.12.3 Cyclosporine A

2.12.4 Selective immunosuppressants

2.12.5 Monoclonal antibodies as part of an immunomodulatory therapy

2.12.6 Interferons

2.12.7 Thalidomide

2.12.8 Other immunomodulators

2.13 Antineoplastic drugs

2.13.1 Cancer and pregnancy

2.13.2 Classification of the drugs used for chemotherapy

2.13.3 Vinca alkaloids and structural analogs

2.13.4 Podophyllotoxin derivatives

2.13.5 Nitrogen mustard agents

2.13.6 Nitrogen mustard analogs

2.13.7 Other alkylating agents

2.13.8 Cytotoxic anthracycline antibiotics

2.13.9 Other cytotoxic antibiotics

2.13.10 Folate antagonistic antimetabolites

2.13.11 Purine-derived antimetabolites (purine antagonists)

2.13.12 Pyrimidine-derived antimetabolites (pyrimidine antagonists)

2.13.13 Taxanes

2.13.14 Platin compounds

2.13.15 Other antineoplastic drugs

2.13.16 Enzymes and antibodies exerting antineoplastic effects

2.13.17 Antineoplastic drugs with endocrine effects

2.13.18 Cytostatic drugs of plant origin

2.13.19 Occupational handling of cytostatic drugs

2.14 Uterine contraction agents, tocolytics, vaginal therapeutics, and local contraceptives

2.14.1 Prostaglandins

2.14.2 Oxytocin

2.14.3 Ergot alkaloids (see also Chapter 2.1)

2.14.4 Tocolytics in general

2.14.5 β[sub(2)]-sympathomimetics

2.14.6 Calcium antagonists

2.14.7 Magnesium sulfate

2.14.8 Oxytocin receptor antagonists

2.14.9 Prostaglandin antagonists

2.14.10 Other tocolytics

2.14.11 Vaginal therapeutics

2.14.12 Spermicide contraceptives

2.14.13 Intrauterine devices

2.15 Hormones

2.15.1 Hypothalamic releasing hormones

2.15.2 Anterior pituitary hormones

2.15.3 Prolactin antagonists

2.15.4 Posterior pituitary hormones

2.15.5 Thyroid function and iodine supply during pregnancy

2.15.6 Hypothyroidism, triiodothyronine (T3), and thyroxine (T4)

2.15.7 Hyperthyroidism and thyrostatics

2.15.8 Glucocorticoids

2.15.9 Diabetes mellitus and pregnancy

2.15.10 Insulin

2.15.11 Oral antidiabetics

2.15.12 Estrogens

2.15.13 Progestins (gestagens)

2.15.14 Diethylstilbestrol

2.15.15 Androgens and anabolics

2.15.16 Antiestrogens, antiandrogens, and danazol

2.15.17 Mifepristone (RU486)

2.15.18 Clomiphene

2.16 General and local anesthetics and muscle relaxants

2.16.1 Halogenated inhalation agents for general anesthesia

2.16.2 Ether (diethyl ether)

2.16.3 Nitrous oxide

2.16.4 Injectable anesthetics

2.16.5 Local anesthetics

2.16.6 Epidural and spinal analgesia/anesthesia in pregnancy

2.16.7 Muscle relaxants

2.16.8 Occupational exposure to inhalation anesthetics

2.17 Dermatological medications and local therapeutics

2.17.1 Typical skin changes during pregnancy

2.17.2 Anti-infective agents

2.17.3 Antiseptics and disinfectants

2.17.4 Astringents

2.17.5 Polidocanol

2.17.6 Camphor and menthol

2.17.7 Coal tar and slate oil preparations

2.17.8 Local immunomodulators and neurodermatitis therapy

2.17.9 Keratolytics

2.17.10 Retinoids for acne and psoriasis therapy

2.17.11 Photochemotherapy and fumaric acid

2.17.12 Sex hormones and cyproterone acetate

2.17.13 5-Fluorouracil

2.17.14 Lithium

2.17.15 Scabies and lice medications

2.17.16 Diethyltoluamide and icaridin

2.17.17 Eye, nose, and ear drops

2.17.18 Hemorrhoid medications

2.17.19 Vein therapeutics

2.17.20 Antihidrotica

2.17.21 Minoxidil

2.17.22 Cosmetics

2.18 Vitamins, minerals, and trace elements

2.18.1 Vitamin A (retinol)

2.18.2 Vitamin B[sub(1)] (thiamine)

2.18.3 Vitamin B[sub(2)] (riboflavin)

2.18.4 Vitamin B[sub(3)] (nicotinamide)

2.18.5 Vitamin B[sub(6)] (pyridoxine)

2.18.6 Vitamin B[sub(12)] (cyanocobalamin)

2.18.7 Folic acid

2.18.8 Vitamin C (ascorbic acid)

2.18.9 Vitamin D group

2.18.10 Vitamin E (tocopherol)

2.18.11 Vitamin K

2.18.12 Multivitamin preparations

2.18.13 Iron

2.18.14 Calcium

2.18.15 Fluoride

2.18.16 Strontium

2.18.17 Biphosphonates and other osteoporosis drugs

2.18.18 Iodide

2.18.19 Trace elements

2.19 Herbs during pregnancy

2.19.1 The safety of herbs during pregnancy

2.19.2 Counseling a pregnant woman about herbs

2.19.3 General concepts regarding the use of herbs during pregnancy

2.19.4 Herbs used as foods

2.19.5 Essential oils that are safe during pregnancy

2.19.6 Herbs frequently used during pregnancy

2.19.7 Herbs controversially used during pregnancy

2.19.8 Herbs contraindicated during pregnancy

2.20 Diagnostic agents

2.20.1 X-ray examinations

2.20.2 Ultrasound

2.20.3 Magnetic resonance imaging

2.20.4 Barium sulfate

2.20.5 Iodine-containing contrast media

2.20.6 Ultrasonographic and magnetic resonance contrast media

2.20.7 Radioactive isotopes

2.20.8 Stable isotopes

2.20.9 Dyes

2.20.10 Other diagnostic agents

2.21 Recreational drugs

2.21.1 Alcohol (ethanol)

2.21.2 Caffeine and other xanthine derivatives

2.21.3 Tobacco and smoking

2.21.4 Drugs of abuse in general (excluding alcohol)

2.21.5 Opiates

2.21.6 Stimulants

2.21.7 Hallucinogens

2.21.8 "Sniffed" substances

2.22 Poisonings and toxins

2.22.1 The general risk of poisoning in pregnancy

2.22.2 Treatment of poisoning in pregnancy

2.22.3 Chemicals

2.22.4 Medicines

2.22.5 Animal toxins

2.22.6 Mushrooms

2.22.7 Other plant toxins

2.22.8 Bacterial endotoxins

2.23 Occupational, industrial, and environmental agents

2.23.1 Solvent exposure in general

2.23.2 Formaldehyde and formalin

2.23.3 Chloroprene (chlorobutadiene)

2.23.4 Cyanide

2.23.5 Photographic/printing chemicals

2.23.6 Pesticides

2.23.7 Phenoxyacetic acid derivatives and chlorinated dibenzo-dioxins

2.23.8 Metals

2.23.9 Hazardous waste landfill sites

2.23.10 Radiation associated with the nuclear industry

2.23.11 Video display terminals (VDTs)

2.23.12 Mobile phones

2.23.13 Other sources of electromagnetic radiation

2.23.14 Electric shocks and lightning strikes

Chapter 3 General commentary on drug therapy and drug risk during lactation

3.1 The advantages of breastfeeding versus the risks of maternal medication

3.2 The passage of medications into the mother's milk

3.3 Infant characteristics

3.4 Milk plasma ratio

3.5 Amount of medication in the milk and relative dose

3.6 Toxicity of medications in the mother's milk

3.7 Medications that affect lactation

3.8 Breastfeeding support

Chapter 4 Specific drug therapies during lactation

4.1 Analgesics, antiphlogistics and anesthetics

4.1.1 Paracetamol

4.1.2 Acetylsalicylic acid

4.1.3 Opioid analgesics and other centrally acting analgesics

4.1.4 Classic nonsteroid anti-inflammatory drugs

4.1.5 Selective cyclooxygenase-2 (COX-2) inhibitors

4.1.6 Pyrazolone- and phenylbutazone derivatives

4.1.7 Other antirheumatics

4.1.8 Migraine medications

4.1.9 Local anesthetics

4.1.10 Other medications used in connection with anesthesia

4.1.11 Myotonolytics

4.1.12 Gout therapy

4.2 Antiallergics, antiasthmatics, and antitussives

4.2.1 Antihistamines (H[sub(1)]-blockers)

4.2.2 β[sub(2)]-sympathomimetics for asthma treatment

4.2.3 Other sympathomimetics

4.2.4 Anticholinergics for asthma treatment

4.2.5 Theophylline

4.2.6 Cromoglycic acid and nedocromil

4.2.7 Corticoids

4.2.8 Leukotrien-receptor antagonists

4.2.9 Acetylcysteine and other mucolytics

4.2.10 Antitussives

4.3 Gastrointestinal drugs

4.3.1 Antacids

4.3.2 H[sub(2)]-receptor blockers and other ulcer therapeutics

4.3.3 Peristaltic stimulators

4.3.4 Cholinergics

4.3.5 Anticholinergic spasmolytics

4.3.6 Laxatives

4.3.7 Agents used for chronic inflammatory bowel diseases

4.3.8 Antidiarrheals for acute diarrhea

4.3.9 Carminatives

4.3.10 Lipid reducers

4.3.11 Chenodeoxycholic acid and ursodeoxycholic acid

4.3.12 Appetite suppressants

4.3.13 Antiemetics

4.4 Anti-infectives

4.4.1 Antibiotics in general

4.4.2 Penicillins, cephalosporins, and other β-lactam antibiotics

4.4.3 Erythromycin and other macrolides

4.4.4 Tetracyclines

4.4.5 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

4.4.13 Systemic antimycotics

4.4.14 Antihelminthics

4.4.15 Acyclovir, antiretroviral drugs, and other virustatics

4.5 Vaccines and immunoglobulins

4.5.1 Maternal immunization

4.5.2 Efficacy of immunization in breastfed infants

4.5.3 Hepatitis A vaccine

4.5.4 Hepatitis B vaccine

4.5.5 Influenza vaccine

4.5.6 Polio vaccine

4.5.7 Rabies vaccine

4.5.8 Rubella vaccine

4.5.9 Smallpox vaccine

4.5.10 Typhoid vaccine

4.5.11 Immunoglobulins

4.6 Cardiovascular drugs and diuretics

β-receptor blockers

4.6.2 Hydralazine

4.6.3 α-methyldopa

4.6.4 Calcium antagonists

4.6.5 ACE inhibitors

4.6.6 Angiotensin-II receptor-antagonists

4.6.7 Other antihypertensives

4.6.8 Dihydroergotamine and other antihypotensives

4.6.9 Digitalis

4.6.10 Antiarrhythmics

4.6.11 Diuretics

4.6.12 Circulatory drugs and vasodilators

4.7 Anticoagulants and fibrinolytics

4.7.1 Heparin

4.7.2 Vitamin K antagonists (coumarin derivatives and indanediones)

4.7.3 Other anticoagulants

4.7.4 Fibrinolytics

4.8 Antiepileptics

4.8.1 Carbamazepine

4.8.2 Clobazam and clonazepam

4.8.3 Ethosuximide and mesuximide

4.8.4 Phenobarbitone (phenobarbital), primidone, and barbexaclone

4.8.5 Phenytoin

4.8.6 Valproic acid

4.8.7 Recommendations: classical anticonvulsants

4.8.8 Gabapentin

4.8.9 Lamotrigine

4.8.10 Levetiracetam

4.8.11 Oxcarbazepine

4.8.12 Topiramate

4.8.13 Vigabatrin

4.8.14 Zonisamide

4.8.15 Recommendations: newer antiepileptics

4.9 Psychotropic drugs

4.9.1 Antidepressants in general

4.9.2 Tri- and tetracyclic antidepressants

4.9.3 Selective serotonin reuptake inhibitors

4.9.4 Other antidepressants

4.9.5 Phenothiazine and thioxanthene neuroleptics

4.9.6 Butyrophenones

4.9.7 Atypical neuroleptics

4.9.8 Antimanic drugs

4.9.9 Benzodiazepines

4.9.10 Other anxiolytics

4.9.11 Other hypnotics

4.9.12 Psychoanaleptics

4.9.13 Parkinson drugs

4.10 Immunomodulating and antineoplastic agents

4.10.1 Immunosuppressive and immune antineoplastic agents

4.10.2 Antineoplastics

4.11 Hormones and hormone antagonists

4.11.1 Pituitary and hypothalamic hormones

4.11.2 Methylergometrine (methylergonovine)

4.11.3 Bromocriptine and other prolactin inhibitors

4.11.4 Thyroid hormones and thyroid receptor antibodies

4.11.5 Thyrostatics

4.11.6 Iodine

4.11.7 Corticosteroids

4.11.8 Adrenaline

4.11.9 Insulin and oral antidiabetics

4.11.10 Estrogens, gestagens, and hormonal contraceptives

4.11.11 Androgens and anabolics

4.11.12 Cyproterone acetate and other sex-hormone inhibitors

4.11.13 Prostaglandins

4.12 Dermatological drugs and local therapeutics

4.12.1 General aspects of external applications: cosmetics, hair products, sunscreens

4.12.2 Medications for lice and scabies

4.12.3 Treatments for acne and psoriasis

4.12.4 Other dermatological medications

4.12.5 Eye, ear, and nose drops

4.12.6 Vaginal therapeutics

4.12.7 Vein therapeutics and other local therapeutics

4.13 Alternative remedies, vitamins, and minerals

4.13.1 Alternative remedies and phytotherapeutics

4.13.2 Herbal galactogogues and anti-galactogogues

4.13.3 Topical treatment for breast problems

4.13.4 Vitamins, minerals, and trace elements

4.13.5 Biphosphonates

4.13.6 Exercise

4.13.7 Glucose 6-phosphate-dehydrogenase deficiency

4.14 Diagnostics

4.14.1 X-ray studies, ultrasound, and magnetic resonance

4.14.2 Iodine-containing contrast media

4.14.3 Radionuclides

4.14.4 Magnetic resonance contrast agents

4.14.5 Fluorescein

4.14.6 Other diagnostics

4.15 Infections

4.15.1 Simple infections

4.15.2 Mastitis

4.15.3 Hepatitis A

4.15.4 Hepatitis B

4.15.5 Hepatitis C

4.15.6 Hepatitis E

4.15.7 Herpes simplex

4.15.8 Herpes zoster (shingles), chickenpox

4.15.9 HIV infection

4.15.10 Human cytomegalovirus

4.15.11 Tuberculosis

4.15.12 Other infectious diseases

4.16 Recreational drugs

4.16.1 Alcohol

4.16.2 Caffeine

4.16.3 Cannabis

4.16.4 Cocaine

4.16.5 Nicotine

4.16.6 Opiates, including methadone

4.16.7 Other drugs

4.17 Plant toxins

4.18 Industrial chemicals and environmental contaminants

4.18.1 Persistent organochlorine compounds (pesticides, polychlorinated biphenyls and dioxins)

4.18.2 Mercury

4.18.3 Lead

4.18.4 Cadmium

4.18.5 Other contaminants

4.18.6 Breastfeeding despite environmental contaminants?

4.18.7 Breastfeeding and the workplace

Appendix A: Teratology information services and centers

Appendix B: Addresses for breastfeeding support

Subject Index

A

B

C

D

E

F

G

H

I

J

K

L

M

N

O

P

Q

R

S

T

U

V

W

X

Y

Z