NEW:Drugs & Chemicals excreted in milk

Drugs & Chemicals excreted in milk:
(contraindicated for lactating woman)

Anticoagulants
Bishydroxycoumarin , Phenendione=====> hemorrhage for baby which is increased by Vit K deficiency
Warfarin=====>appears safe but some authorities consider breast feeding contraindicated during therapy


NSAIDS
Aspirin=====>occasional dose: safe
continious use:rash , hypoprothrombinemia (in case of
(low Vit K stores
Indomethacin=====> convulsions for baby
Paracetamol , Ibuprofen=====>Safe


Antimicrobials
Penicillins=====>decrease intestinal flora so diarrhea & thrush
Cephalosporins=====>excreted in small amounts
Sulfonamides &Co-trimoxazole=====>increase biliribin in fetus
(blood..reach brain..so damage (Kernicterus
Tetracyclines=====>dental staining ,dental & bone marrow malformation


CNS depressants
Alcohol=====> in large amounts : toxicity
Barbiturates=====>drowsiness
Benzodiazepines=====>repeated dose: lethargy &weight loss
Chloral hydrate=====>drowsiness
Li=====>CVS &CNS disturbances


CNS stimulants
Theobromine(ex. chocolate)=====>irritability &poor sleep patterns
Caffeine(ex. cola ,tea, coffee) =====>accumulation irritability , wakefulness &Jitteriness
(تحريك الأيدى لأعلى وأسفل بعصبية زى التشنجات)
Theophylline(antiasthmatic)=====>irritability &sleep disturbances
Ephedrine &Pseudoephedrine=====>irritability &sleep disturbances


Endocrine acting drugs
Antithyroids(Methimazole ,Carbimazole)=====>hypothyrodism goiter &
Corticosteroids=====>cont. therapy with doses >10 mg Prednisolone :adrenocortical disturbance
Androgens=====>musculinization of female fetus
Female --- hormones (Oral contraceptives)===>gynecomastia (in males) & supressed lactation (in females)


Others
Narcotics
(ex. Morphine ,Heroin ,Methadone &opiates)
withdrawal symptoms & risk of addiction<=====

(H2-blockers & Poton pump Inhibitors (ex. Omeprazole
<=====
excreted in milk with amount 3-12 times that present in mother blood ,so should Not be used during lactation
Clochicine=====>Cytotoxicity
Vit D(high dose)=====>hypercalcemia
Atropine=====> suppression of lactation , as it decreases secretions
Ergotamine=====>Ergotism & suppresion of lactation

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