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Drug Overdoses during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Ibuprofen overdose during pregnancy has not been described in case studies and no specific antidote exists. Therefore, nonspecific antidote and supportive therapy should be given. Symptoms of ibuprofen toxicity include nausea, epigastric pain, diarrhea, vomiting, dizziness, blurred vision, and edema. The half-life of ibuprofen is 0.9–2.5 hours in the post-absorptive period (Baselt, 2017). Among 67 cases of ibuprofen overdose, 36 percent occurred among children. Fifty reports of ibuprofen overdose during pregnancy were published, with mothers and infants suffering no untoward effects (i.e., hepatorenal failure, etc.) among those followed prospectively (Barry et al., 1984). Forty-three cases of ibuprofen overdose during pregnancy were followed prospectively in post-marketing surveillance, and 23 live birth normal infants were born after maternal supportive therapy because no antidote exists. Nine elective terminations and one spontaneous abortion occurred, and one stillbirth. Nine were still pregnant at the time of publication (Barry et al., 1984). More than 150 infants born following ibuprofen overdose in pregnancy were reported to have no increased frequency of birth defects, although the course of pregnancy was not reported in detail (Schaefer, 2007). These cases are from the UK TIS, and were followed prospectively, but no details were published.
Headache
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Stephen Silberstein, Shuhan Zhu
For acute treatment of primary headache, acetaminophen alone (preferably) or with codeine (for refractory headache) should be the first choice during all trimesters. Naproxen and ibuprofen are safe and well tolerated in pregnancy, but should be avoided after 28 weeks. Severe unrelenting migraine responds well to parenteral antiemetics, such as metoclopramide and prochlorperazine. Beta-blockers (such as propranolol or metoprolol) or low- dose tricyclics (amitriptyline) can be considered as a prophylactic medication for the pregnant patient whose headache frequency requires daily preventive medication, and for whom non-pharmacologic approaches to headache prophylaxis have failed.
Functional Rehabilitation
Published in James Crossley, Functional Exercise and Rehabilitation, 2021
Medication should be a short-term intervention to manage sysmptoms and support a return to normal function. Whilst effective, medications tend to have side effects that impact health. Taken over extended periods, Ibuprofen irritates the stomach lining, causing digestive symptoms, for example.
Online information discrepancies regarding safety of medicine use during pregnancy and lactation: an IMI ConcePTION study
Published in Expert Opinion on Drug Safety, 2021
Ulrika Nörby, Benedikte Noël-Cuppers, Sashka Hristoskova, Monali Desai, Linda Härmark, Michael Steel, Chantal El-Haddad, Ludivine Douarin
To avoid non-adherence to therapy [1] and other negative effects due to conflicting information, pregnant/lactating women and HCPs should be encouraged to use well-grounded and updated sources produced by experts in the field, such as TIS centers or independent knowledge databases. If women are in doubt whether to use a medicine, it is obviously important that they have the possibility to discuss any online advice that they discover with a medical professional. This is especially true for chronic diseases where treatment may be essential. Preferably, patients and HCPs should use the same information source so that they will receive uniform messages. Our results indicate that the recommendation categories can vary considerably between patient and HCP data sources. A specific example was a news article in a Swedish tabloid stating that ibuprofen should not be used during early pregnancy due to risks of fetal cardiac malformations and miscarriage whilst the HCP data sources recommended that a benefit risk assessment should be undertaken regarding the use of ibuprofen during early pregnancy.
Ibuprofen and COVID-19 disease: separating the myths from facts
Published in Expert Review of Respiratory Medicine, 2021
Frideriki Poutoglidou, Athanasios Saitis, Dimitrios Kouvelas
Ibuprofen is a Non-Steroidal Anti-Inflammatory Drug (NSAID), commonly used to relieve fever caused by viral or bacterial infections, that is available over the counter (OTC). Concern about the role of NSAIDs in the management of COVID-19 has led to significant speculation. The concerns were initially raised by the publication of a letter published in the Lancet, on March 2020 [1], which hypothesized that ibuprofen may affect disease outcomes by indirectly raising Angiotensin-Converting Enzyme 2 (ACE-2). In March 2020, the French authorities warned against the use of ibuprofen in possible or confirmed COVID-19 cases, suggesting that it might aggravate disease course. A few days later, the World Health Organization (WHO) released a statement advising patients with COVID-19 to avoid taking ibuprofen. However, the next day, WHO retracted their initial statement. Food and Drug Administration (FDA) and the European Medicines Agency (EMA) also issued statements emphasizing that there is no scientific evidence establishing a link between ibuprofen and worsening of COVID-19.
Ibuprofen-based advanced therapeutics: breaking the inflammatory link in cancer, neurodegeneration, and diseases
Published in Drug Metabolism Reviews, 2021
Arun Upadhyay, Ayeman Amanullah, Vibhuti Joshi, Rohan Dhiman, Vijay Kumar Prajapati, Krishna Mohan Poluri, Amit Mishra
As explained earlier, nonsteroidal anti-inflammatory drugs are a class of molecules, which have been investigated thoroughly in the past few decades for an array of therapeutic functions under various conditions of physiological disturbances. We have discussed several of those potential benefits that these small molecules may present under different physiological conditions, considering the example of Ibuprofen. However, these drugs may also generate a large number of physiological changes in the body, leading to abnormalities in the intestine, heart, and kidney functioning (Perneger et al. 1994; Ray et al. 2002; Graham et al. 2005). Many of these side effects or toxicities generated due to the high dosage of Ibuprofen reported so far in various studies or case reports in the past are summarized in Table 2. The primary reason behind the toxic effects presented by ibuprofen or other similar drugs is their nonselective inhibition of cyclooxygenases. This leads to the suppression of the synthesis of prostaglandins, which are involved in many crucial physiological processes associated with vital organs like the intestine, kidney, and heart (Hawkey and Langman 2003; Ong et al. 2007).