Contributor: Megan Hurley, MD
Educational Pearls:
Fevers
Tylenol
Up until 20 weeks NSAIDs are ok but after 20 weeks they are contraindicated
Can limit the amount of amniotic fluid produced
Can lead to growth restriction
Can cause premature closure of the ductus arteriosus
Cough
Cough drops
Humidifier
Guafenesine and dextromethorphan (Mucinex) is not well studied but is probably ok with caution in certain circumstances such as post-tussive emesis causing poor PO intake and weight loss
Congestion
Flonase (Fluticasone nasal spray)
Nasal rinses
Humidifier
1st generation anti-histamines (Diphenhydramine, Doxylamine, etc.)
However, these tend to have more side effects such as fatigue, drowsiness, and dizziness
Concider switching to a 2nd generation (Cetirizine, Loratidine, etc.) during the day
Disease specific treatments
Flu (A and B) gets tamiflu (Oseltamivir)
Covid gets paxlovid (Nirmatrelvir/ritonavir)
Antibiotics for suspected pneumonia
Additional recommendations
Elevating the head of bed
Nasal strips
Stay well hydrated
Tea
Ice chips
Echinacea
Zinc
Rest
Avoid
NSAIDs
Pseudophedrine
Afrin (Oxymetazoline)
Combined meds in general
References
Antonucci, R., Zaffanello, M., Puxeddu, E., Porcella, A., Cuzzolin, L., Pilloni, M. D., & Fanos, V. (2012). Use of non-steroidal anti-inflammatory drugs in pregnancy: impact on the fetus and newborn. Current drug metabolism, 13(4), 474–490. https://doi.org/10.2174/138920012800166607
Black, E., Khor, K. E., Kennedy, D., Chutatape, A., Sharma, S., Vancaillie, T., & Demirkol, A. (2019). Medication Use and Pain Management in Pregnancy: A Critical Review. Pain practice : the official journal of World Institute of Pain, 19(8), 875–899. https://doi.org/10.1111/papr.12814
D'Ambrosio, V., Vena, F., Scopelliti, A., D'Aniello, D., Savastano, G., Brunelli, R., & Giancotti, A. (2023). Use of non-steroidal anti-inflammatory drugs in pregnancy and oligohydramnios: a review. The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 36(2), 2253956. https://doi.org/10.1080/14767058.2023.2253956
Summarized by Jeffrey Olson MS3 | Edited by Meg Joyce, MS1 & Jorge Chalit, OMS3