Zdravljenje bolečine v nosečnosti = Treatment of pain in pregnancy
Zaletel, Marjan, 1963-
Pregnant women may present with medical and surgical conditions that result inboth acute or chronic pain. The publication Drugs in Pregnancy and Lactationis one of the few resources available to ...health care providers when questions arise about safety of drugs during pregnancy and lactation. The recognition of teratogenicity of aminopterin and thalidomide changed the perception and resulted in recommendation of extremely conservative drug use during pregnancy. Our knowledge about risk of birth defects from drug exposureis limited. The lack of information on the treatment of pain syndromesis compounded by complex physiological and pharmacological factors inpregnancy. The maternal-placental-fetal unit can be viewed as a three-compartment pharmacokinetic model with distinct properties of absorption, distribution, metabolism and elimination of drugs. The teratogenicpotential of a drug varies with gestational age. The review of literature did not offer much information about use of nonopioid analgetic drugs in the treatment of pain in pregnancy. Further studies of new antiepileptics such as gabapentin and topiramate are required, as well as of cyclooxygenase-2 inhibitors. There are some well-documented cases supporting safety of use of opioid drugs in therapy ofacute and chronic pain. In migraine, nonpharmacologic treatment should be tried first. Analgesics such asparacetamol and opiods should be used with caution. Prophylactic treatment should be the last resort.
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