Archive for April, 2022

According to the Centers for Disease Control and Prevention (CDC), approximately 90% of women in the United States take at least one medication during pregnancy¹. Medication use during the first trimester of pregnancy has increased by over 60% in the last 30 years. Unfortunately, substantial information about the effects of over-the-counter (OTC) and prescription medications on the fetus may not be readily available, as pregnant women are often excluded from drug trials.

Many women rely on daily medications to treat chronic health conditions like diabetes and short-term therapies to treat acute problems such as infection, constipation, or pain. Certain medications can increase the chance of pregnancy loss, birth defects, premature birth, or developmental disabilities in babies.

Those who are pregnant or planning pregnancy will benefit from speaking to their local pharmacist or doctor about their current medication regimens. Doctors will most likely start patients on prenatal vitamins, as well. Prenatal vitamins are highly recommended to supplement nutrients that are important for the growth and health of the fetus.

It is imperative that mothers do not simply stop or avoid chronic medications, as doing so could cause more harm to both mother and baby. For example, many anti-seizure medications, like valproic acid (Depakote®), are capable of causing physical malformations in the fetus². Yet stopping anti-seizure medications altogether can result in poor seizure control, which carries detrimental consequences for the mother and fetus. There are safer options, such as lamotrigine (Lamictal®) or levetiracetam (Keppra®), that may be preferred during pregnancy.

Healthcare professionals can help pregnant patients with chronic conditions determine if they should continue all their medications or if they should pursue safer alternatives or substitutes. Using their knowledge of drug properties, a pharmacist may be able to determine if a given medication has a high risk of crossing the placenta into the baby’s bloodstream and affecting developmental growth.

Pregnancy also impacts the mother’s bodily absorption, metabolism, and clearance and therefore the levels of drugs in her system. For medications impacted by these changes, a pharmacist may be able to work with the patient’s doctor and recommend dosing adjustments.

Some published studies have already linked certain medications to birth defects. A good example is thalidomide, an over-the-counter morning sickness remedy from the 1950s-1960s, which resulted in numerous miscarriages and babies born with physical deformities³.

Within the following lists below, you will find prescription and OTC medications to avoid, safe OTC medications that can be used, and beneficial prenatal vitamin doses.

Prescription and OTC Medications to Avoid

Safe OTC Medications to Take During Pregnancy⁴

These lists of harmful and safe medications may NOT be comprehensive, since there is still limited data for many medications. Additionally, some medications can have more severe effects on the fetus depending on the trimester.

If you ever have any questions or concerns about what you are taking during or prior to pregnancy, please never hesitate to check in with your healthcare team, including your pharmacist. They can help you determine whether or not the health benefits outweigh risks.

References

1. Pregnant or thinking of getting pregnant? Centers for Disease Control and Prevention. https://www.cdc.gov/pregnancy/meds/treatingfortwo/facts.html. Published July 31, 2020. Accessed April 10, 2022.
2. Fetal valproate syndrome. NORD (National Organization for Rare Disorders). https://rarediseases.org/rare-diseases/fetal-valproate-syndrome/. Published May 21, 2020. Accessed April 10, 2022.
3. Medicine Guidelines for Pregnancy. https://my.clevelandclinic.org/health/drugs/4396-medicine-guidelines-during-pregnancy. Published January 1, 2018. Accessed April 10, 2022.
4. Kim JH, Scialli AR. Thalidomide: the tragedy of birth defects and the effective treatment of disease [published correction appears in Toxicol Sci. 2012 Feb;125(2):613]. Toxicol Sci. 2011;122(1):1-6. doi:10.1093/toxsci/kfr088

This month, we are joined at Happy Druggist on Karl Road by Madison Price, a fourth-year pharmacy student from The Ohio State University’s College of Pharmacy.

Madison will graduate in May 2022 with her PharmD degree and will then take the test to become a registered pharmacist. Madison will be with Kristie and the staff on Karl Road throughout April, so please stop by and meet her while she is in the pharmacy.

Here is what Madison tells us about herself:

My name is Madison Price and I am a current fourth year student at The Ohio State University College’s of Pharmacy. I am the student pharmacist at Happy Druggist for the month of April. I’m excited to learn about patient care and expand my knowledge of community pharmacy.

A native North Carolinian, I attended the University of North Carolina at Chapel Hill for undergrad and received my Bachelor of Arts in Exercise and Sports Science. Go Tarheels!

I knew I wanted to pursue a career in healthcare since middle school. It wasn’t until my sophomore year in high school that I ultimately chose pharmacy. My father was diagnosed with a brain tumor that required specific therapy. I was worried how the treatment would impact his overall health. His cancer diagnosis sparked my interests in pharmacology and drug interactions and I’ve been interested in pharmacy ever since.

The summer after my pharmacy school P1 year, I began an internship at The James Comprehensive Cancer Hospital through The Ohio State Wexner Medical Center.  I perform sterile compounding, preparing inpatient and outpatient chemotherapy preparations for patients. I have enjoyed working in the IV room, sharpening my aseptic technique. I cannot wait to expand my direct patient care skills at Happy Druggist.

I am pursuing a post graduate pharmacy practice residency in the acute care setting following graduation in May. My clinical interests include emergency medicine, oncology, and solid organ transplant. I hope to specialize in an area of interest, practice at a teaching hospital, precept the next generation of student pharmacists, and collaborate with other healthcare professionals to benefit patients.

Outside of pharmacy school, I love going to the movies to see the latest action or comedy films. The last movie I saw in theaters was The Batman; I loved it!

In addition to movies, I enjoy cooking and baking new recipes. I’m a big fan of the Air Fryer and Instant Pot. They have become my go-to kitchen appliances.

Lastly, I have a collection of over 20 houseplants and find it extremely rewarding watching them grow from small cuttings to vining plants.

I look forward to meeting everyone at Happy Druggist and cannot wait to learn from your amazing patients and staff.

This month, we are joined at Plain City Druggist by Elaine Sim, a fourth-year pharmacy student from The Ohio State University’s College of Pharmacy.

Elaine will graduate in May 2022 with her PharmD degree and will then take the test to become a registered pharmacist. Elaine will be with Tayler and the gang here in Plain City throughout April, so please stop by and meet her while she is here.

Here is what Elaine tells us about herself:

Hi all! My name is Elaine Sim. I am in my final year of pharmacy school at The Ohio State University and am looking forward to spending April at Plain City Druggist learning what it takes to run an independent pharmacy.

I presently work as an inpatient intern at Nationwide Children’s Hospital and previously worked at the Medication Management Program at OSU. I was born and raised in Southern California where my parents own an orange orchard (they mail me oranges every other month!). I have also lived in Missoula, Montana and Atlanta, Georgia for a few years each before moving to Ohio. I was drawn to Ohio for the top-notch pharmacy education I knew I could receive and for the people. I feel fortunate to have been able to call Ohio my home for the past four years, as I’ve met some of the most warm and welcoming people here.

My interest in pharmacy began when I formed a friendship with my own pharmacist back in California. I remember feeling intimidated stepping foot in my local pharmacy to pick up my parents’ medications, but the pharmacist eased my family’s minds when it came to taking medications and always followed up with us to see how we were doing. It was reassuring for us to know that we had a relationship with a healthcare professional who was invested in our health and livelihood and who we could trust to clearly explain our medication regimens.

Ever since I was young, I have really looked up to all the different pharmacists in my community and wanted to pursue this fulfilling journey of following in their footsteps. I hope, as a pharmacist, I can help people become better informed so that they can better take care of themselves and the ones they love.

This summer, I will be heading back to San Diego, California to complete a one-year pharmacy residency at Rady Children’s Hospital. I’ve always been passionate about working with children and families both inside and outside the hospital and plan to find a job as a Pediatric pharmacist in the future. I am happy I will be reunited with my family soon, but I will definitely miss my time in Ohio.

This is my very last month of pharmacy school, and I am thrilled to end on a high note as I have heard so many wonderful things about the pharmacy and staff at Plain City Druggist.

I am even more excited to meet all the patients and provide them with the quality care they deserve.