Betamethasone/Gentamicin Pregnancy

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Consists of betamethasone, Gentamicin

Pregnancy of Betamethasone in details

Pregnancy is always a special situation where every action or side effect of the drug varies when compared to a situation of a non-pregnant patient. It is not only because the pregnant woman's metabolism differs due to the hormonal and other changes happened to her, but also because every medicine or its metabolite passes to the baby and shows its action there. The only thing is, be cautious, attentive and well supervised when you take any single drug in pregnancy. The interactions can vary in pregnancy, and the dosage may differ as well. Strict supervision of the Physician is mandatory.
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Betamethasone crosses the placenta (Brownfoot 2013) and is partially metabolized by placental enzymes to an inactive metabolite (Murphy 2007). Some studies have shown an association between first trimester systemic corticosteroid use and oral clefts or decreased birth weight; however, information is conflicting and may be influenced by maternal dose/indication for use (Lunghi 2010; Park-Wyllie 2000; Pradat 2003). Hypoadrenalism may occur in newborns following maternal use of corticosteroids during pregnancy; monitor.

Because antenatal corticosteroid administration may reduce the incidence of intraventricular hemorrhage, necrotizing enterocolitis, neonatal mortality, and respiratory distress syndrome, the injection is often used for antenatal fetal lung maturation in patients with preterm premature rupture of membranes or preterm labor who are at risk of preterm delivery. A single course of betamethasone is recommended for women between 24 and 34 weeks gestation who are at risk of delivering within 7 days, including those with ruptured membranes or multiple gestations. A single course of betamethasone may be considered for women beginning at 23 weeks gestation, who are at risk of delivering within 7 days, in consultation with the family. In addition, a single course of betamethasone may be given to women between 34 0/7 weeks and 36 6/7 weeks who are at risk of preterm delivery within 7 days and who have not previously received corticosteroids; use of concomitant tocolytics is not currently recommended and administration of late preterm corticosteroids has not been evaluated in women with intrauterine infection, multiple gestations, pregestational diabetes, or women who delivered previously by cesarean section at term. Multiple repeat courses are not recommended. However, in women with pregnancies less than 34 weeks gestation at risk for delivery within 7 days and who had a course of antenatal corticosteroids >14 days prior, a single repeat course may be considered; use of a repeat course in women with preterm prelabor rupture of membranes is controversial (ACOG 171 2016; ACOG 713 2017, ACOG 188 2018).

When systemic corticosteroids are needed in pregnancy for rheumatic disorders, it is generally recommended to use the lowest effective dose for the shortest duration of time, avoiding high doses during the first trimester. Intra-articular dosing may also be used during pregnancy (Götestam Skorpen 2016; Makol 2011; Østensen 2009).

Betamethasone breastfeeding

When a drug is taken when the patient is breast feeding, a part of the drug is secreted in her breast milk and is passed to the baby. The dosage of the medicine to mother and baby are different, and many drugs actions are side effects when you take them without a disease, and what if you the baby takes them without a disease? What if the drug is contraindicated in newborns, infants or children? So, breastfeeding is a very alarming situation when the mother is on medications. Ask your Physician or Pediatrician about the effect of the drug on the baby and how much is excreted in breast milk and if it harms the baby!
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There are no data on the excretion betamethasone into human milk. The manufacturer recommends that due to the potential for serious adverse reactions in nursing infants, a decision should be made to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.

See references

References for pregnancy information

  1. Sybulski S "Effect of antepartum betamethasone treatment on cortisol levels in cord plasma, amniotic fluid, and the neonate." Am J Obstet Gynecol 127 (1977): 871-4
  2. Derks JB, Mulder EJH, Visser GHA "The effects of maternal betamethasone administration on the fetus." Br J Obstet Gynaecol 102 (1995): 40-6
  3. Ballard RA, Ballard PL "Use of prenatal glucocorticoid therapy to prevent respiratory distress syndrome. A supporting view." Am J Dis Child 130 (1976): 982-7
  4. Anderson AB, Gennser G, Jeremy JY, Ohrlander S, Sayers L, Turnbull AC "Placental transfer and metabolism of betamethasone in human pregnancy." Obstet Gynecol 49 (1977): 471-4
  5. Maltau JM, Stokke KT, Moe N "Effects of betamethasone on plasma levels of estriol, cortisol and HCS in late pregnancy." Acta Obstet Gynecol Scand 58 (1979): 235-8
  6. Petersen MC, Nation RL, Ashley JJ, McBride WG "The placental transfer of betamethasone." Eur J Clin Pharmacol 18 (1980): 245-7
  7. Ohrlander S, Gennser G, Batra S, Lebech P "Effect of betamethasone administration on estrone, estradiol-17 beta, and progesterone in maternal plasma and amniotic fluid." Obstet Gynecol 49 (1977): 148-53
  8. "Product Information. Celestone (betamethasone)." Schering Corporation, Kenilworth, NJ.
  9. Kuhn RJ, Speirs AL, Pepperell RJ, Eggers TR, Doyle LW, Hutchison A "Betamethasone, albuterol, and threatened premature delivery: benefits and risks. Study of 469 pregnancies." Obstet Gynecol 60 (1982): 403-8

References for breastfeeding information

  1. "Product Information. Celestone (betamethasone)." Schering Corporation, Kenilworth, NJ.

Pregnancy of Gentamicin in details

Pregnancy is always a special situation where every action or side effect of the drug varies when compared to a situation of a non-pregnant patient. It is not only because the pregnant woman's metabolism differs due to the hormonal and other changes happened to her, but also because every medicine or its metabolite passes to the baby and shows its action there. The only thing is, be cautious, attentive and well supervised when you take any single drug in pregnancy. The interactions can vary in pregnancy, and the dosage may differ as well. Strict supervision of the Physician is mandatory.
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Gentamicin crosses the placenta.

[US Boxed Warning]: Aminoglycosides may cause fetal harm if administered to a pregnant woman. There are several reports of total irreversible bilateral congenital deafness in children whose mothers received another aminoglycoside (streptomycin) during pregnancy. Although serious side effects to the fetus/infant have not been reported following maternal use of all aminoglycosides, a potential for harm exists.

Due to pregnancy-induced physiologic changes, some pharmacokinetic parameters of gentamicin may be altered (Popović 2007). Gentamicin use has been evaluated for various infections in pregnant women including the treatment of acute pyelonephritis (Jolley 2010) and as an alternative antibiotic for prophylactic use prior to cesarean delivery (Bratzler 2013).

Gentamicin breastfeeding

When a drug is taken when the patient is breast feeding, a part of the drug is secreted in her breast milk and is passed to the baby. The dosage of the medicine to mother and baby are different, and many drugs actions are side effects when you take them without a disease, and what if you the baby takes them without a disease? What if the drug is contraindicated in newborns, infants or children? So, breastfeeding is a very alarming situation when the mother is on medications. Ask your Physician or Pediatrician about the effect of the drug on the baby and how much is excreted in breast milk and if it harms the baby!

Gentamicin is excreted into breast milk in small amounts. At 1 and 7 hours following a dose of gentamicin, serum concentrations averaged 3.9 and 1.1 mcg/mL, respectively, while milk concentrations averaged 0.4 and 0.4 mcg/mL. The milk:plasma ratio averaged 0.11 and 0.44, respectively. Infants were fed one hour after administration of gentamicin. Gentamicin was detected in the serum of 5 of 10 infants with an average serum concentration of 0.4 mcg/mL. The five other infants had undetectable levels (below 0.27 mcg/mL). Gentamicin is considered compatible with breast-feeding by the American Academy of Pediatrics.

See references

References for pregnancy information

  1. "Product Information. Garamycin (gentamicin)." Schering-Plough Corporation, Kenilworth, NJ.
  2. Weinstein AJ, Gibbs RS, Gallagher M "Placental transfer of clindamycin and gentamicin in term pregnancy." Am J Obstet Gynecol 124 (1976): 688-91
  3. Briggs GG, Freeman RK, Yaffe SJ.. "Drugs in Pregnancy and Lactation. 5th ed." Baltimore, MD: Williams & Wilkins (1998):

References for breastfeeding information

  1. "American Academy of Pediatrics. Committee on Drugs. The transfer of drugs and other chemicals into human milk." Pediatrics 108 (2001): 776-89
  2. Celiloglu M, Celiker S, Guven H, Tuncok Y, Demir N, Erten O "Gentamicin excretion and uptake from breast milk by nursing infants." Obstet Gynecol 84 (1994): 263-5
  3. "Product Information. Garamycin (gentamicin)." Schering-Plough Corporation, Kenilworth, NJ.



References

  1. DailyMed. "GENTAMICIN SULFATE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  2. DailyMed. "BETAMETHASONE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  3. PubMed Health. "Ocu-Mycin: This section provide the link out information of drugs collectetd in PubMed Health. ". http://www.ncbi.nlm.nih.gov/pubmedhe... (accessed September 17, 2018).

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