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Re: Scared about Rx Changes

From: Harvey S. Marchbein, M.D. (anonymous@obgyn.net)
Wed, 29 Dec 1999 10:41:28 -0600 (CST)

At Wed, 29 Dec 1999, AnnMarie wrote: >
>I had an appointment with the allergy doc this afternoon, too. I don't
>know what he is thinking! I have told him that I seriously can't live
>without my sinus meds. So what does he do? He takes my most important
>one away and changes another because I am pregnant! The other doctor
>said all of my meds were okay. I'll play his game for now. I have to
>call back on a culture this Friday so I figure by then I should be
>feeling even worse when I talk to him. I am late for my prized Rx's now
>and I can feel it. The man has a reputation of being too conservative.
>This is just another example. After I left his office I was kind of
>freaked. I was NOT happy! I'm a little better now, but still cautious
>and unsure of what to do. A RPh at work thought that my meds should be
>okay b/c even though one of the ingredients is different from one of the
>"safe" OTC products (okay, Sudafed), they both act the same. Does
>anyone else have an opinion?

FWIW, a study done on pregnant sheep showed acceleration of fetal heartbeat with Sudafed. The paper didn't say don't use it, just be aware of possible problems.

>What would others do? I would hate to
>override his decision and call another MD w/o even trying his way. For
>now, I am just going to see what happens, but I've tried this on my own
>too many times already that I'm not confident.
>
>My current (sinus only) meds are as follows:
>Claritin (1/day)

No studies on Claritin that I'm aware of. As a general rule, most obstetricians will recommend minimizing meds during organogenesis (1st three months) and try and stay with "safest" meds thereafter.

>Dura-Vent (1/2xday)
>Rhinocort (2/en 2xd)
>
>He is now saying to STOP the Dura-Vent and switch the Rhinocort to
>Vancenase Pockethaler. Sudafed doesn't work well for me, and I tried
>Vancenase a year or two ago but it didn't work well either. I have been
>happy with my current meds even if I still have frequent antibiotcs, but
>this is the *BEST* that I have been! I am actually kind of scared of not
>taking any Dura-Vent, espcially, and Rhinocort.
>
>AM

The most important thing to remember is "does the benefit to the mother outweigh the potential or unknown disadvantage to the fetus". That's how decisions are made. 

--
Harvey S. Marchbein, M.D. FACOG, FACS
Great Neck, New York


**Note:  Opinions expressed here are for educational purposes only
and, as such, do not constitute a physician-patient relationship.
This information is not intended to supplant the need for you to
consult with your physician prior to choosing therapeutic options
and/or interventions.


**Private emails cannot be entertained due to time constraints,
consequently no private emails will receive a response.


**Thank you for your understanding ;-)



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