Sunday, 16 July 2017

INDIAN HEMP DRIVES FEAR



When soaked in hard-drugs, fear and anxiety become history,  but then,  this anxiolysis has no limit  when lost,  that one can donate his head for another's beating.

Dangerous risk taking
• Let me die for her!
• Trailer does not kill,  let me try!
• That food is poisoned,  lie,  let me eat it first!
• HIV is real,  says who,  let me try!
• If you fight,  you will be jailed,  story,  let me try!
• Flee from hard-drugs they can kill even as they give you pseudo-ecstacy and euphoria!

Refrain: Codeine,  Cocaine,  alcohol,  rohypnol, hashish, Indian hemp, tobacco, tramadol, animal wastes, heroin, gums,  and others.

• Bring down your alcohol consumption to moderation.
• Reject cigarette smoking!
Take only calculated risks and not drug-directed risks,  they are not the same.
Live safe
Allow safety!

Chuka Amukamara
Faculty of pharmacy
University of Benin

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Wednesday, 12 July 2017

OPIOID

Friends and Enemies of OPIOIDS

Considering the rate of abuse and misuse of opioids, I wish to ask if the discovery of opioids was a blessing to the world or a curse?

OPIOIDS are chemical agents derived from opium puppy;  They act on the opioid receptors and produce  morphine-like effects. They are classified as either semi-synthetic or synthetic in nature. They include morphine, tramadol, codeine, methadone, pentazocine, loperamide and the less popular such as hydrocodone, oxycodone, fentanyl,  pethidine etc.
Opioids are mostly available as oral and parenteral preparations.

Opioids are very effective for a host of medical conditions for which the most important is their use for PAIN

Treatment :  they are used for the treatment of acute pain such as post surgical pain or for the treatment of chronic non cancer and cancer pain.
They provide immediate relief for mild to severe pain, and are usually reserved as second line therapy.
Opioids are diverse in nature as certain types of Opioids are used in the treatment of Cough (e.g hydrocodone and codeine as well as opioid analogue such as dextromethorphan) as well as  treatment of diarrhoea (loperamide, diphenoxylate) and shortness of breath.

Even as they present benefits, we are pushed to tag their occurrence as CURSE and not blessing?
ADDICTION; DEPENDENCE; TOLERANCE; WITHDRAWAL SYMPTOMS; RELAPSE

Opioids are amongst psychoactive agents with high addictive tendencies; with heroin an opioid having the highest addiction rating of 3.0 (although other Opioids are less addictive compared to heroin).
The continuous use of these drugs leads to cases of physical and psychological dependence:  where the individual finds it difficult to cope without the drug.

Due to tolerance resulting from their persistent use,  the individual tends to increase the dose consumed in order to experience the prior euphoric feeling ,thus having to do everything possible to get such quantities (armed robbery, pilfering).

Chronic use of these agents gives way to system-drug synchronization such that an attempt to stop-use would present the following withdrawal symptoms: severe dysphoria, craving, irritability, sweating, nausea, rhinorrhea, tremor, vomiting and myalgia. Such untoward effects which are mostly unbearable discourage quitting and hence,  relapse ensues.

A number of arthritic patients become addicted to oral tramadol as well as codeine or other opioid preparations,
girls addicted to opioids after use for painful menstruation,
sickle cell patients become addicted to parenteral opioids after they were used to treat some of their painful episodes,
young boys addicted to cough preparations containing Opioids such as codeine or dihydrocodeine.

Editor's note: 
The use of opioids as well as  "drugs" can only be a blessing to humanity if they are used as prescribed and advised by our health professionals and not as self-prescribed.
Drugs are primarily defined as poisons,  but become medicines only when they are presented by the right persons.
To avert misfortunes that follow the use of opioids, always consult your doctor or pharmacist for the best advice on the use of drugs.

Author: Justice Enoma
Editor:   Chuka Amukamara
Faculty of Pharmacy
University of Benin

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Wednesday, 24 May 2017

WATER THERAPY

WATER THERAPY

Drinking of water and the benefits that ensue, has induced a number of writers to put up different notes,  directing us on the do's and don'ts of drinking water, the when to and when not to,.
The benefits of drinking water varies in the organs/tissues affected in the body as the intervals of it's consumption varies.
The earth is filled to about 70% with water,  same is the whole body weight;  made up of about 70% by water.
The total water input must be equal to total water output to ensure homeostasis in the body's fluidity!
Water therapy therefore implies the medical benefits derived from drinking water;  benefits ranging from prophylactic, palliative to curative basis.
You may have read lots of notes in the past about when and how to drink water and all it promises, nevertheless;
please find below some of the benefits of water and when to take water in order to enjoy such nature's gift to man.
  


1.  Early morning

Taking about 4 glasses of water first thing in the early morning :
At the beginning, you may not be able to take such a volume,  but start with the quantity you can tolerate and increase subsequently.
A number of benefits have been credited to this practice.
Let us state and explain some of them:

a. Prevents colon cancer: this quantity of water aids in washing properly the walls of the empty intestine as it pushes all the debris down to the rectum to initiate defecation reflex, thus preventing clogging up of debris and other harmful particles on the pores of the intestine .

b.  Prevention of arthritis and it's crisis (gouty arthritis) : gout is a medical condition that is mostly caused by poor excretion of urates and a build up of uric acid in the blood,  which accumulates in the joints to cause inflammation. When such volume of water is taken, it dilutes these crystals and exerts sufficient pressure on the kidney to expel all of the urates preventing their accumulation.

c.  Prevention of Kidney stone and kidney diseases: similarly as in (b) above, water dilutes the chemical build ups on the kidney and prevent the formation of crystals, casts, and their resultant renal disturbances.


2. Before going to bed

Drinking a glass of water while going to bed:
Helps keep heart problems far from you. [The water ensures that your plasma volume is maintained while sleeping and not requiring the heart to do extra work in ensuring appropriate blood pressure]
Although you may be woken up by micturation reflex to urinate,  but still,  the benefit outweighs the disturbance.

3. Drinking while eating:

Several writers have written against this act without being able to draw lines and explain the reasons behind it.
Taking small quantity of temperate water while eating starchy and hard foods like garri helps one prevent:
Constipation or Strenuous defecation
Hemorrhoids or pile

But drinking plenty water while eating foods rich in protein is wrong as such quantity of water may dilute to some extent your gastric acid content leading to the indigestion of some food particles, this in turn may cause
Flatulence
Belching
Tinnitus

Again, Drinking cold water while eating is wrong! Cold water reduces the optimal temperature of the stomach required for the instant enzymatic activities on the ingested food leading to some portions of the food not being properly digested. The undigested food undergoes fermentation causing :
Flatulence
Belching
Steartorrhea
GIT disturbances
Colon cancer
Tinnitus (sounds of wave in the ear)

4. Interval Drinking of water:

The act of drinking water during the day is another good one.
Mostly,  you see some persons carry bottled water along, yes,  they do so because they understand the benefits of drinking water.
Since water intake must be equal to water loss:
We loss water through urination, sweating, perspiration, breathing, talking etc, this requires that we replenish the lost water from drinking and from food.
Drinking enough water keeps you far from kidney diseases and to some extent cardiovascular diseases, fights internal stress and restores vitality.

5. Taking medicine with water:

Check leaflets of every pharmaceutical you are taking,  it always says "take with a glass full of water" this water aids in the dissolution and proper absorption of the medicament inturn enhancing bioavalability. Water here is indispensable hence should not be replaced with any soft drinks or the likes (remember the issue of coca-cola and Vitamin C ).

Thanks.

Chuka Amukamara
Faculty of Pharmacy
University of Benin


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Thursday, 6 April 2017

MARKING WORLD HEALTH DAY; WITH DEPRESSION AS THE TOPIC


JOIN THE FIGHT AGAINST DEPRESSION. 

Depression! Depression!! Depression!!!

: a state of feeling sad

: a serious medical condition in which a person feels very sad, hopeless, and unimportant and often is unable to live in a normal way

: a period of time in which there is little economic activity and many people do not have jobs.

By virtue of bad government, a very significant risk factor of depression,  an average Nigerian is predisposed to depression.

Yesterday,  a man stopped his vehicle,  came down and jumped into the sea,

The other day,  someone was cooking and something stoke her mind, she immediately killed herself with the knife she was cutting onions with,

A young boy suddenly stopped talking, couldn't reason out answers to questions,

One man just resigned not considering the outcome of his resignation.

His wife just put to birth ,and he rememered his condition prior to wife's parturition, became suddenly thoughtless and was tagged a psychiatric patient afterwards.

A student who always hoped for the best result couldn't read to see the result manifest.

Husband sees wife as a problem and burden,

Depression the deadly scourge  that drains people's optimism must be dealt with.

When finally the person is taken to hospital,  cos hardly can they differentiate between depression,  schizophrenia manifesting negative symptoms and manic-depressive-psychosis,  hence the person is subjected to all kinds of therapy which mostly are pharmacotherapy with dreadful side effects.

Dear fellow Nigerians,

As our government has refused to lift this risk factor placed permanently on our side,  can we adopt the following  recommendations to help ourselves and one another:

1.  Always give someone around you hope,

2. Do not add to someone's stress. ,help them

3. Always check on your neighbor. ,ask him/her "how are you?

4. Join social groups where we have a lot reasons to laugh freely

5. Discover those musics that help your moment,  as good musics have been identified as prophylactic antidepressants.

6. Always pray,  and leave your problems with God.

7. Reduce your rate of expectations from human,

8. Always assume  that there is no government

9. Discover positive people and make them friends

10. Read your Bible always.


Chuka Amukamara
Faculty of Pharmacy
University of Benin


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Tuesday, 4 April 2017

MENINGITIS THE MONSTER

                    Join the fight against Meningitis 






Meningitis is an acute inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges.

The inflammation may be caused by infection with:

viruses : enterovirus, herpes simplex virus, Varicella zoster virus, mumps virus, HIV and LCMV

bacteria: Nisseria meningitidis, Streptococcus pneumoniae, Listeria monocytogenes etc

other microorganisms: fungi, protozoa etc

drugs: NSAIDS, some Antibiotics, IV immunoglobulin


Meningitis can be life-threatening because of the inflammation's proximity to the brain and spinal cord; therefore, the condition is classified as a medical emergency.

Symptoms

• headache

• neck stiffness associated with fever

• confusion or altered consciousness, vomiting,

• Inability to tolerate light (photophobia) or loud noises (phonophobia).

• Children often exhibit only nonspecific symptoms, such as irritability and drowsiness.

• Rashes

Preventive/control measures
As we await government and the vaccines for meningitis, let us employ the following measures to at least control it's spread.

• Avoid contact with respiratory droplets

• Be conscious of whom you kiss

• Coughing or sneezing on someone should be avoided

• Contaminations from feces or fecal matters should be avoided

• Avoid self-diagnosis

• Avoid self-medication

• Visit or take to the nearest hospital for proper attention, anyone who exhibits any of the above symptoms; especially where these triad is found

1. Severe Headache
2. stiffness of neck with high fever
3. Sudden alteration of mental status




Chuka Amukamara
Department of Pharmacy
University of Benin

Nigeria. 





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Saturday, 26 November 2016

Harmattan and Health

Harmattan and Our Health.

Harmattan is characterized with dry air and dust-laden wind.  This season promote the onset and progression of various disease conditions including;
  • Cough/catarrh 
  • Conjunctivitis(apolo) 
  • Respiratory tract infections
  • Skin diseases
  • Constipation
  • Hemorrhoids/pile
  • Predisposes one to kidney diseases
  • Cardiovascular disturbances


During this season, the body system losses some of its water to perspiration and evaporation, leading to mass dehydration (we notice that our urine turns dark amber) which when not checked reduces the kidney functions as the plasma volume reduces, lowering the GFR. This in turn may precipitate increased heart rate and other cardiovascular conditions.
Constipation is also common during harmattan, during which defecation (stooling)  becomes very  strenuous and may result to tear/expansion beyond elastic limit of the anal sphincter which may result to pile.

The dust-laden air we inhale during this season contains allergens,  microbial particles and other substances that are capable of triggering inflammatory responses that manifest as either cough or catarrh. These particles (especially the microbial) when in contact with the eyes, will mostly cause  conjunctivitis (apolo).

When the inflammatory/mechanical response of the body is unable to prevent the dust from getting to the lower respiratory tract, it gets  trapped and causes respiratory disturbances.

During harmattan, our skin looses to some  extent,  it's moistening capability, appearing   tough and vulnerable to tear and easily bleed.    
During  this season, people yield to the use of medicines like cough syrups, piriton,  eye drops,  suppositories, lozenges and   antibiotics; most of which have their respective side effects.  

Guides to preventing harmattan-induced health conditions.

  •  DRINK PLENTY OF WATER REGULARLY: Water will keep the body hydrated thereby preventing dehydration and protects the individual from all the above listed conditions,  "Your neighbor carries bottle water to wherever he goes not because he enjoys carrying load,  but because he understands the need to keep the system hydrated this season"

  • WASH YOUR HANDS REGULARLY:  This habit  will protect you from contracting conjunctivitis (conjunctivitis is easily transmitted through handshake)

  • INCLUDE FIBER IN DIET:  Eat more fibre containing fruits like oranges and apple to prevent constipation and the resultant hemorrhoid 

  • AVOID DUST:  Lessen your exposure to dust,  

  • USE OF CLEAN HANDKERCHIEFS: Endeavour to make use of clean handkerchief while cleaning your eyes of dusts, DO NOT USE YOUR BARE FINGERS


Pharm. Chuka Amukamara
 
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Sunday, 9 October 2016

Chuka Amukamara: PREVENT HEART DISEASE TODAY

                                   KEEP THE HEART ALIVE

                   common heart diseases





  • Angina
  • Atherosclerosis 
  • Heart failure
  • Heart attack 
  • Hypertension 
  • Hypotension
  • Stroke, etc


Heart disease is a general name for a wide variety of diseases, disorders and conditions that affect the heart and sometimes the blood vessels as well.
Heart disease is the number one killer of women and men in the United States, and more than a million Americans have myocardial infarction,  according to the National Heart, Lung and Blood Institute.

The term "heart disease" is often used interchangeably with "cardiovascular disease". Cardiovascular disease generally refers to conditions that involve narrowed or blocked blood vessels that may lead to a heart attack, chest pain(angina) or stroke. Other heart conditions such as those that affect the heart muscles, valves or rhythm, also are considered forms of heart diseases.

Symptoms

Symptoms of heart disease vary depending on the specific type of disease. While most of the heart diseases present chest pain, atherosclerosis may be asymptomatic unless life-threatening complications develop. Other mild symptoms of heart diseases

include:

Weakness
cough
fatigue
dizziness
backache
palpitation
shortness of breath
chills
anxiety
cyanosis
fainting
oedema etc.

 Although some other diseases or drug interactions/side effects may present some of these symptoms,
 hence one is advised to see a doctor.

 Risk factors for developing heart diseases

 Heart diseases are common in the United States due to their life style, eating habit and types of food. Sadly, heart disease is becoming Africa's next problem as we replace most of our traditional African dishes with adopted pattern of meal. Risk factors include:

High cholesterol
Hyperlipidaemia
Obesity
Hypertension
African-American ancestry
Drinking excessive alcohol
Long-term stress
Smoking
Diabetes
Family history
Certain congenital heart defects may be as a result of exposure to specific toxins during pregnancy
                             
Prevention of heart diseases

Considering the risk factors, it becomes obvious that we can prevent heart diseases since most of the causes can actually be avoided by a mere

adjustment in diet,

Healthy life style

Regular exercise

Avoid smoking

Reduce or avoid alcohol consumption

Achieving and maintaining a healthy body weight

Eating a heart-healthy,  balanced diet

Regular prenatal care, to help prevent congenital heart defects




Where heart disease is suspected, the individual is advised to see a doctor for proper diagnosis and treatment.


Dietician Says

Cooking habits
cooking oils and their rates of consumption play the most significant role in about 60% of the heart diseases recorded.

Taking Nigeria as a case study, there are areas through which we invite heart defects. Although their impact is not felt immediately, a build up of effects leads to defects. Areas like:

Bleaching of oil while cooking

Cooking with oils that contain mostly saturated fats

Little or no intake of essential fatty acids

Consumption of animal fats, an unhealthy source of cholesterol

Bleaching of oil

Different oil have different smoke point "temperature which they can be heated before they smoke, discolored  and  broken down. Palm oil "red oil" has the lowest smoke point. Immediately the smoke point of most oils is exceeded, the natural cis-fatty acids they contain are converted to trans-fatty acids which are very dangerous to the heart as they decrease the level of HDL (high density lipoprotein) and increase level of LDL(low density lipoprotein ) bad cholesterol. The best oil for frying are those with very high smoke point, they include: sunflower oil, soy oil, canola oil peanut oil etc. Frying with palm oil is strictly not healthy.

Oil consistency

The consistency of oil (whether liquid or semisolid ) at room temperature is a clue to it's fatty acid make up.
Vegetable oils that are liquid at room temperature "ordinary temperature without extra heating" contain high amount of unsaturated fatty acids and little amount of saturated fatty acids.  They are most healthy for consumption.
Oils and their most suitable uses

Frying:  soy oil, sunflower oil, canola oil

Cooking: olive oil, peanut oil, sesame oil, almond oil, avocado oil, palm oil etc.

Essential fatty acids

These are fatty acids required by human for good health and healthy heart. They cannot be synthesized by human body hence must be taken as diet or supplement. They are required in the synthesis of body defence substances and other important chemicals in the body. Examples include: linolenic acid, linoleic acid etc.
Sources:  fishes, soy oil, canola oil, leafy vegetables, walnuts etc.
Being selective about the type of lipid you consume is very important for the health of your heart, as well as avoiding animal fats.

Alcoholism

Whenever the issue of alcohol is raised, a scientist and alcoholic would want to defend other alcoholics by quoting that alcohol inhibits ADH and reduces LDL level in the body, this is true only for low-moderate consumption.  High levels of alcohol consumption are associated with an increased risk of:

  • Alcoholism
  • Malnutrition 
  • Damage to central nervous system and peripheral nervous system 
  • Hypertension 
  • Coronary heart disease
  • Ischemic stroke
  • Cancer
  • Liver diseases
  • Risk of developing diabetes known as the sick-quitter effect etc.
  • Wernicke-Korsakoff syndrome: severe memory loss, mental confusion, and partial paralysis. The syndrome is more common among alcoholics than in the general population.
  • Alcohol affects Blood Glucose Levels: Consumption of alcohol (ethanol), especially after periods of strenuous activity or after not eating for several hours, results in a deficiency of glucose in the blood, a condition termed hypoglycemia 

Chukwuka Francis Amukamara 

Department of Pharmacy
University of Benin
Nigeria.



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Monday, 3 October 2016

Justice Enoma: CONTRACEPTION

CONTRACEPTION; THE UNTOLD STORY

A friend once asked me a question. He asked me, “please which do think is the safest form of contraception?” this question was double edged in nature and I told him to re-examine it because it connotes two things. The first is, which of the various methods of contraception is most safe health-wise and the other connotation to the question is which of the various methods of contraception available is the safest in terms of actually preventing the pregnancy. As much as this would seem like a question with a straight answer, I quickly dug up on some facts in other to have an accurate answer to his double edged question.
 Contraception is a popular term amongst sexually active adults be it the married or the unmarried ones. It is a useful tool in family planning as well as to prevent unwanted pregnancy after coitus. By definition, contraception is the deliberate attempt to prevent the fertilization of the ovum by the superm that is a consequence of sexual intercourse. Many methods are available for contraception and these different methods have their own advantages and disadvantages. By gross classification contraceptive methods include

PERIODIC ABSTINENCE:

        Periodic abstinence by the name means the couple only indulge in sexual intercourse at controlled times. By this technique only the periods in which the woman is least fertile in her menstrual cycle do sexual inter course occur. A woman with a regular menstrual cycle has about 9 or more days each month when she us able to get pregnant. These fertile days area about 5 days before and 3 days after ovulation as well as the day of ovulation so a red alert is placed on these period concerning sex. The success of this method however now depends on how well the woman understands her menstrual cycle and it involves checking cervical mucus (discharge from vagina) and recording body temperature . A woman is most fertile when the mucus is clear and slippery like raw egg whites.
The pros of this method is the fact that it is non invasive in nature, it is the cheapest method of contraception, but the method has huge disadvantages. Firstly it is the least safe method both health wise and pregnancy wise. A record 30 pregnancy could occur out of 100 sexual inter course  using this method of contraception. Secondly, this method provides absolutely no protection against sexually transmitted diseases and other infections.

b)   BARRIER METHOD:

          Here a block or a barrier is put to prevent the entry of the sperm into the uterus to reach the egg. Barrier contraception includes the use of
 Conntraceptive sponges : this method is made up of disc shaped device made out of polyurethane foam and contains a spermicide (nonoxynol-9). It is made wet and placed inside the vagina before sex to cover the cervix.
Diaphragm,cervical caps and cervical shields : they are soft domeshaped silicone materials placed in the vagina before sex to cover the cervix and stop sperm getting into the uterus.
Female and male condoms.; male condoms are made of latex and are rolled onto the erect penis before sex. The female condoms are made of similar materials which are placed into the vagina before sex.
         For the Pros, the barrier method such as the condom protect the body against sexually transmitted disease. The condoms are easily available and they are cheap in nature. However, condoms may have physical deformity during the sexual intercourse (tearing) that could result due to improper storage or improper use such as the lack of a lubricant. Thus the condoms only provide 79-98% protection from pregnancy.The diaphragm and cervical sponges provide no protection against STIs, they are invasive in nature and may require professional help to apply them before use such as by a nurse. Another disadvantage of the sponge method is that some women are hypersensitive to the spermicidal compound which limits the use of that method in some of these women.

C)   HORMONAL METHODS :

 this method involves the use of synthetically produced
hormones to alter ovulation,fertilization and implantation of the fertilized egg. They are also known as oral or parenteral contraceptives and they range from combination pills (meaning they contain both oestrogen and progesterone, two important female hormones), progestine only pills, patches,injection and vaginal rings. These pills are taken by different regimens to prevent pregnancy. The combination pills are usually taken for 21 days after which a 7 day free period is left for the menstrual bleeding to occur. Emergency pills or "morning after" pills are progestines(e.g levonogestrel) which are to be taken within 72 hours of unprotected sexual intercourse.
The pros include the fact that hormonal methods are highly safe. A maximum of less than 1 pregnancy can occur out of 100 sexual inter course in which this method of contraception is used. The drugs are cheap and easily available.
The Cons of this method include the fact that it offers no protection against sexually transmitted diseases. Do to tge fact that hormonal levels are externally controlled, side effects such Weight Gain, changes in period, changes in mood, dizziness, stomach upset, heart attack, stroke, etc could occur

D).   IMPLANT METHOD:

                  Implant devices are long term methods of contraception, they consist of small devices that are put in to the body and left for a few years. They include
    Implantable rods : which contains progestin and releases it slowly for over 3 years, this stops the sperm from reaching the egg by uttering the uterine lining and ess often it prevents the ovaries from releasing the egg
Intrauterine Devices (IUDs) : the are "T" shaped devices that are place in the uterus. It could be the "COPPER-TYPE" which releases small amount of copper to prevent fertilization and the "HORMONAL-TYPE" that contains progestin which prevents the ovaries from releasing egg and causes cervical mucus to thicker to prevent sperm from reaching the egg.
The advantages of this method is the comfort it provides after administration the patient usually does not worry about pregnancy for a long period of 3 years and would not have to take drugs, it is highly safe in terms of preventing pregnancy as it has a success rate of 99%. The implants do not interfere with everyday life as the are administered under the skin or the uterus.
The method however does not protect against sexually transmitted diseases. The drugs have the same side effects as the pills and some women may become uncomfortable with the lack of menstrual flow that could occur if hormonal types prevent the release of egg.

E) SURGICAL STERILISATION :

       This method is irreversible in nature, an operation is carried out to sterilise both men and women. It is highly safe and is 99.5% effective.
In Women, the fallopian tube is tied or blocked which prevents the sperm from reaching the egg, while for men, a vasectomy is carried out. After the Vasectomy the semen usually contains sperm for 3 months after which a semen analysis is carried out to denote the complete absence of sperm .
    Sterilisation does not protect from STIs and it is the most expensive method of contraception because it requires surgery. Another shortfall is its irreversibility, it becomes a problem for adults that decide to have babies in the future.
In conclusion, there is no "safest" method for contraception as each has Its own advantages and shortfalls. The choice of contraception should thus depend on every individual bearing in mind

  • Cost
  • Effectiveness
  • Protection from infections
  • Side effect profile 
  • Likelihood of having children in the future
  • Comfort of the various methods 

                               
Thank You

Enoma Justice

Department of Pharmacy
University of Benin.


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Tuesday, 27 September 2016

Pharm Justice Enoma writes: DRUGS AND PREGNANCY

DRUGS AND PREGNANCY

A woman walks into a near by drug store and makes a complaint to the owner of the shop “madam I feel feverish, I have headache and body pain and I vomited in the morning. The woman did not hesitate to go to her shelf and bring out an Artemesinin combination therapy drug for the lady. She was healed after 3 days and sang praises to the owner of the drug store, but little did she know that 8 months later she will give birth to a deformed baby.

Patient M, was 3 months pregnant but she had diarrhea she was stooling and she needed an intervention. Getting  to a drug store she made a complaint to the owner of the drug store who gave her a combination of drugs containing tetracycline and ciprofloxacin to effectively take care of the micro organism that was responsible for the case. Mrs modupe gave birth to a baby girl Kemi who was very beautiful but had a single flaw which was her teeth. Kemi  in all her beauty as a child had discolored teeth.

pregnancy or the gestation period is a very fragile and complicated time for the female anatomy. The mother and the unborn foetus are connected in ways beyond what the lay man imagines. They share a common circulation. The mother is connected to the child by virtue of the placenta and it is an organ that connects the developing fetus to the uterine wall to allow nutrient uptake, waste elimination, thermo-regulation and gas exchange via the mothers blood supply. The placenta attaches to the wall of the uterus, and the baby’s umbilica cord develops from the placenta.

Although once thought to be a barrier to drug transfer the placenta is a medium of transfer of a number of substances between the mother and foetus especially drugs and the placenta functions fully for such transport by the fifth week of conception. Drugs which albeit were of no harm to the mother posse significant treats to the developing foetus. Most of these so called drugs could cause physical or functional deformites to the foetus these drugs are called teratogens. The degree to which exposure to a drug influence s the embryo/fetus also maybe a function of the timing of the exposure. Drug exposure using the embryonic period (period between fertilisation and 10th weeks of gestation) has the greatest potential influence on organ development. Indeed, the most obvious teratogenic effects occur during this period. Teratogenic effects may include,

  • Loss of pregnancy
  • Structural abnormalities 
  • Growth impairment 
  • Functional loss

However more subtle change in function and behaviour  may be associated with drug exposure at other times during pregnancy

Thus care is paramount when pregnant patients are prescribed or dispensed to. Some of the common drugs which posse a potential hazard to the developing foetus includes

NSAIDS (Non-steroidal anti-inflammatory drugs) : Children whose mothers use the pain reliever during pregnancy may be at risk for asthma, behavior problems and attention deficit disorder according to preliminary reports. For women who use Paracetamol the risk to the foetus is quite small

Simvastatin and other statins : Cholesterolis needed for the growth of the foetus and its reduction by statins could harm the foetus

Oral Contraceptives : they can cause birth defects

Dutasteride : affects the sex organ development of the male fetus

Tetracycline : it gets deposited in fetal bones and retard their growth, also affect teeth causing them to be discolored and deformed

Chloramphenicol : Grey Baby Syndrome

ACE Inhibitors : Growth retardation, Birth defects and Fetal Death
During the last 3 months of pregnancy, drugs crossing the placental barrier may interfere with the vital functions of the fetus e.g. sulphonamides which may increase bilirubin levels leading to kernicterus (fetal jaundice), or morphine which when given to the mother during labor can cause fetal asphyxia, etc
In conclusion to the above certain tips that must be considered before taking a drug during pregnancy include :

Try non drug measures

Consult your healthcare provider

Avoid combination products

Read labels
                                   Thank you





Enoma Justice
600 Level pharmacy student
University Of Benin

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