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Oct 2024
5m 45s

Episode 924: Pregnancy Cold Remedies

EMERGENCY MEDICAL MINUTE
About this episode

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

  1. 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

  2. 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

  3. 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

 

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