Re: Adalat Oros 30 gekregen
From: Rona (anonymous@obgyn.net)
Thu Nov 20 09:07:48 2003
Bij ons op de afdeling wordt Adalat heel veel gebruikt. Niet alleen als
anti hypertensiva maar ook als weeën remmer.
At Thu, 20 Nov 2003, Ikke0 wrote:
>
>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].
--
Rona
http://europe.obgyn.net/nederland/default.asp?page=/nederland/Forum/wieiswie#Rona
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