Pregnancy & Drugs

 Forget about the stork delivering the baby to the happy couple Once a month during ovulation, the female body releases a fertile egg. For pregnancy to occur, unprotected sexual intercourse must be performed no more than 48 hours before or up to 15 hours after ovulation. The sperm is attracted to the ovum through “attracting chemicals” and makes contact with the cells surrounding the ovum. Pregnancy starts when the male sperm and a female egg-cell (also called an ovum) unite. The newly formed cell contains 46 chromosomes (genetic information) and the process of fertilization has been completed. The fertilized ovum undergoes a number of cell divisions and is transferred to the uterus. At the same time the lining of the uterus (endometrium) has been prepared by the female hormones (oestrogen and progesterone) to receive the fertilized ovum. On about the   seventh day after ovulation, the fertilized cell (embryo) will be implanted into the prepared uterus.  During the next nine months the foetus (floating in the fluid-filled cavity and attached by the umbilical cord to the placenta) will grow and develop into a viable infant. Pregnancy is divided into three three-month stages called trimesters. Each trimester has unique characteristics, changes and symptoms associated with it.

What to avoid during pregnancy: Drugs and foods taken by the mother can cross the placenta and enter the baby’s bloodstream. Some drugs or substances are known to have adverse (other than expected) effects during pregnancy. The first trimester is the most critical period. As soon as your client knows that she  is pregnant, for the sake of her own health and for that of the life now developing within her the following steps should be taken:

• Dietary changes: Curries, chutneys and offensive foods (garlic, onions and acidic fruits) should be avoided as it can increase the chances of digestive discomfort. Fatty and fried foods are slow to digest and stay in the stomach for a longer period. This will contribute to an uncomfortable feeling and can increase the chances of vomiting.
• Caffeine: Caffeine and stimulating substances should be avoided as they relax the lower oesophageal sphincter and may cause acid reflux. They also contribute to dehydration.
• Diets: Pregnancy is definitely not the time to experiment with fad diets! One should eat and drink slowly. Ingest smaller portions and eat more frequent meals.
• Smoking: If a woman continues to smoke or regularly breathes in  second-hand smoke during pregnancy, the risk to the unborn baby’s health and development will increase These women are more likely to have a miscarriage during the second trimester. The best advice to clients would be to stop smoking immediately (during the first trimester)
• Alcohol: Alcohol is never recommended during pregnancy. It contributes to dehydration and should be avoided.
• Drugs:Prescription and over-the-counter (OTC) medication can cross the placenta and the bloodstream to the unborn baby. The following factors determine the effect of the medicine on the foetus.
  • o Stage of gestation: Some drugs affect during the first trimester while other drugs have negative effects during the later stages of pregnancy.
  • o Dosage of the medicine: The dose and the time of exposure.
  • o Maternal conditions: Age and nutritional status

It is very important to enquire about the pregnancy status of all clients   before recommending any over-the-counter medication.

What to take during pregnancy: The following helpful tips and advice can equip the pharmacist assistant to  render a better service to their pregnant clients as well as being more profitable:

• Dietary requirements: The mother has to be on the guard for excessive weight gain during pregnancy. The maximum recommended weight gain should not exceed 12,5kg in total. The weight gain can be broken down as follows:

In order to achieve this, the mother should increase her normal daily dietary intake to between 2200 and 2700 kilojoules. She should consume a healthy, well-balanced diet rich in fruits, vegetables, grains, proteins and dairy. Fruit juices and water should also be taken. Protein is important as the amino acids it contains builds the baby’s body. Sources of protein are meat, milk, yoghurt and cheese.

• Additional supplements: Our modern lifestyle has made it more and more difficult to maintain a natural, healthy approach to the way we live! This lifestyle can affect the developing baby! What supplements do we need during pregnancy?

• Folic acid: Folic acid is a water-soluble vitamin that reduces the risk of neural tube defects such as spina bifida.  It also assists the body to build strong red blood cells.  Studies have also proven that it can lower the incidence of miscarriage and reduce the likelihood of premature births. Folic acid can be found in whole wheat bread, beans, leafy vegetables, fruit and yeast. Supplements like Preg Omega Plus and Pregvit MR^® contain (amongst other vitamins & minerals) folic acid.

• Vitamin B complex: This family of vitamins forms the backbone of supplementation. They are found in many foodstuffs, including yeasts, meat, dairy products, eggs and grains. Nutrients in a food state form are bonded to proteins which act as the chaperones to guide the nutrients to the appropriate sites in the body. Supplements like Pregnavit^®, Chelapreg^®, Preg Omega Plus^® contain a full range of the B-complex vitamins and should be taken daily.

• Other vitamins and minerals: Vitamin C helps build bones and teeth and is present in citrus fruits and broccoli. Vitamin D helps build strong bones, teeth and tissue and is found in milk, eggs, sardines and salmon. Zinc boosts the baby’s growth and guards against premature delivery. Red meat and seafood are sources rich in zinc. Ultimag® contains a zinc and magnesium combination. Omega-3 fatty acids help develop and boost the baby’s brain power. It can be found in oily fish, almonds, walnuts, and sesame seeds.

• Calcium: Calcium builds strong bones and teeth, and is found in green vegetables, sardines and dairy products. The developing baby needs a great deal of calcium throughout the pregnancy and the daily intake through the diet will seldom meet the requirements. Without that additional calcium, the baby will take it from the mother’s body, which may ultimately weaken the mother’s bones! Supplements like Caltrate Plus^® and Sandoz Calcium^® can be recommended to supply that additional requirement.

• Iron: Iron helps to make haemoglobin which enables the blood to carry more oxygen to the baby. Iron containing foods include dried fruit, leafy vegetables red meat and whole grain bread. 

• Formance^® is quality nutritional supplement specially formulated to meet the demanding needs of pregnancy and lactation. It contains folic acid and iron to prevent anaemia. Fibre will prevent constipation. This formulation will support the quality and quantity of breast milk.

• Moisturize: Moisturizing plays a major role in any body care routine. Taking care of your breasts should not be any different! Comfrey or calendula containing ointments (in a lanolin base) rubbed into the breasts and nipples will create healthy, flexible tissues that are resistant to chapping and cracking! Bio-Oil^® is formulated to help reduce the possibility of stretch marks forming during periods of rapid change in body size such as pregnancy. Massage Bio-Oil into the abdomen, hips, breasts, lower back and upper thighs twice daily from the first trimester until after birth.

Conclusion: Pregnancy marks a beautiful period in any mother’s life, but it is also a time of an extra burden and responsibility. The safety and well-being of the unborn baby must always be taken into consideration.

References: Available on request