Adalat Oros 30 gekregen
From: Ikke0 (anonymous@obgyn.net)
Thu Nov 20 07:32:05 2003
Op "aandringen" ( is erg geen alternatiefvoor Lerdip?) van mij heeft de
internist dit middel nu voorgeschreven. Ik heb veel onderzoek gedaan op
internet ( medisch engelstalig) en dit blijkt het meest voorgeschreven
middel tijdens zwangerschap als betablokkers/de-uretica niet werken (
wat bij mij dus is) . Op de nederlandstalige bijsluiter staat dat het
niet mag, maar het is in andere landen een veel gebruikt middel. Dat is
ook wat de internist zei: "er is meer ervaring mee"...het blijft kiezen
uit 2 kwaden...ben dus heel benieuwd, ga morgen beginnen....
Zie voor meer info:(via google)
Prodigy Guidance(NHS) - Hypertension in pregnancy.htm:
Antihypertensive drugs used during pregnancy
Antihypertensive medication should only be initiated after specialist
advice.
There is insufficient evidence to make firm recommendations on the
choice of antihypertensive medication in pregnancy [Ramsay et al, 1999;
Magee, 2001b].
Methyldopa is usually the drug of first choice because of its long and
extensive use without reports of serious adverse effects on the fetus
[National Teratology Information Service, 1998; Ramsay et al, 1999;
Magee, 2001b; Rosenthal and Oparil, 2002]. Methyldopa does not alter
maternal cardiac output or blood flow to the uterus or kidneys.
Labetalol (a combined alpha- and beta-blocker) is also often used.
Atenolol should be avoided, as there is some evidence that its use may
be linked to fetal growth retardation when given in early pregnancy
[Onwude et al, 1995]. Other beta-blockers are seldom used, as there is
little data on their safety during pregnancy.
Nifedipine is the most extensively used calcium-channel blocker in
pregnancy. There is no evidence of harm to the fetus, but in view of
limited safety data it is recommended as an alternative to more
established treatments only if these are ineffective. The
modified-release preparation is recommended in preference to the
standard-release product, which may cause a precipitous fall in BP
[National Teratology Information Service, 2002]. There is less
experience with other calcium-channel blockers.
Hydralazine seems to be safe for use during pregnancy, although a few
cases of fetal thrombocytopenia have been reported [Khedun et al, 2000].
Use in pregnancy is normally restricted to intravenous treatment for
hypertensive emergencies. Less commonly, it is used orally for mild to
moderate hypertension. Taken orally as monotherapy, it is poorly
tolerated because of adverse effects such as palpitations, headache, and
dizziness. It is therefore usually combined with methyldopa or
labetalol [Awad et al, 2000; Drugs & Therapy Perspectives, 2001].
Diuretics are little used, owing to theoretical concerns that they may
further reduce the already decreased circulatory blood volume in women
with pre-eclampsia. However, low-dose thiazide diuretics in women with
pre-existing hypertension are not thought to be harmful, and may be
continued throughout pregnancy [Ramsay et al, 1999].
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Last Updated Tue Feb 2 05:55:24 2010
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