Nama : Muhammad Faaizin

Nim: 1948201016
Unit: A Semester 5
1. Jelaskan beberapa obat yang harus dihindari pada saat kehamilan,
menyusui?
2. Pengaruh kehamilan pada berbagai organ/keadaan?
1.

 Lactation Risk Categories   Pregnancy Risk Categories 

L1 (Paling Aman)
L2 (Aman)
L3 (Cukup Aman)
L4 (Kemungkinan
Barbahaya)
L5 (Kontra Indikasi)
A (studi terkontrol menunjukkan tanpa
resiko)
B (tidak ada bukti risiko pada manusia)
C (risiko tidak dapat dikesampingkan)
D (bukti positif resiko)
X (dikontraindikasikan untuk Ibu Hamil)

Pregnancy Lactation
Risk Risk
Generic name Trade Name AAP approved?* Category** Category**
Analgesics (Pain-killers) [more]
Acetaminophen Tylenol Approved/diseujui B L1
Colchicine Colchicine Approved D L4
Nefopam Acupan Approved - NR
        Non-steroidal anti-inflammatory analgesics (NSAIDs)  [more]
Azapropazone (apazone) Rheumox Approved - L2
Dipyrone (banned in the US &
- Approved - NR
UK)
Flufenamic acid - Approved - NR
B (1st, 2nd
Advil, Nuprin,
Ibuprofen Approved trim.) L1
Motrin, Pediaprofin
D (3rd trim.)
B (1st, 2nd
Indomethacin Indocin Approved trim.) L3
D (3rd trim.)
B (1st, 2nd
Ketorolac Toradol, Acular Approved trim.) L2
D (3rd trim.)
Mefenamic acid Ponstan, Ponstel Approved - NR
L3
Anaprox, Naprosyn,
Naproxen Approved B L4 (for chronic
Naproxen, Aleve
use)
Phenylbutazone Butazolidine Approved - NR
Piroxicam Feldene Approved B L2
Suprofen Profenal Approved - NR
Tolmetin Tolectin Approved C L3
        Narcotic analgesics [more]
Butorphanol Stadol Approved B (1st, 2nd L3
trim.)
 D (3rd trim.)
Codeine Tylenol #3, #4 Approved C L3
Fentanyl Sublimaze Approved B L2
L2
L3 (if used
Meperidine Demerol Approved B
early
postpartum)
Methadone Dolophine Approved B L3
Morphine Morphine Approved B L3
Darvocet N,
Propoxyphene Approved C L2
Propacet, Darvon
Anesthesia, Anesthetics [more] [contents]
Halothane Fluothane Approved C L2
Lidocaine Xylocaine Approved C L2
Methohexital Brevital Approved B L3
Thiopental Pentothal Approved C L3
Antacids, GI meds [contents]
Cimetidine (Antacid) Tagamet Approved B L2
Cisapride (GI tract stimulant) Propulsid Approved C L2
Domperidone (used for nausea &
vomiting, stimulates lactation) Motilum Approved - L1
[more]
Antibiotics [contents]
Amoxicillin Larotid, Amoxil Approved B L1
Aztreonam Azactam Approved B L2
Cefadroxil Ultracef, Duricef Approved B L1
Cefazolin Ancef, Kefzol Approved B L1
Cefotaxime Claforan Approved B L2
Cefoxitin Mefoxin Approved B L1
Cefprozil Cefzil Approved C L1
Ceftazidime, Fortaz,
Ceftazidime Approved B L1
Taxidime
Ceftriaxone Rocephin Approved B L2
Ciprofloxacin [more] Cipro Approved C L3
Clindamycin Cleocin Approved B L3
L1
E-Mycin, Ery-tab,
Erythromycin Approved B L3 early
ERYC, Ilosone
postnatal
Fleroxacin - Approved - NR
Gentamicin Garamycin Approved C L2
Kanamycin Kebecil, Kantrex Approved D L2
Moxalactam Moxam Approved - NR
Nitrofurantoin Macrobid Approved B L2
Ofloxacin Floxin Approved C L2
Penicillin - Approved B L1
Streptomycin Streptomycin Approved D L3
Sulbactam - Approved - NR
Gantrisin, Azo-
Sulfisoxazole Approved C L2
Gantrisin
Achromycin,
Tetracycline Sumycin, Approved D L2
Terramycin
Ticarcillin, Ticar,
Ticarcillin Approved B L1
Timentin
Trimethoprim/sulfamethoxazole Proloprim, Trimpex Approved C L3
Anticoagulants [contents]
Bishydroxycoumarin (dicumarol) - Approved - NR
Coumadin,
Warfarin Approved D L2
Panwarfin
Anticonvulsants [contents]
Carbamazepine Tegretol, Epitol Approved C L2
Ethosuximide Zarontin Approved C L4
Magnesium sulfate Epsom salt Approved B L1
Phenytoin Dilantin Approved D L2
Depakene,
Valproic acid Approved D L2
Depakote
Antifungals [contents]
Fluconazole [more] Diflucan Approved C L2
Nizoral Shampoo,
Ketoconazole Approved C L2
Nizoral
Antihistamines [more] [contents]
Dexbrompheniramine maleate
- Approved - NR
with d-isoephedrine
Fexofenadine Allegra Approved C L2
Loratadine Claritin Approved B L1
Terfenadine Seldane Approved - NR
Triprolidine Actidil, Actifed Approved C L1
Antivirals [contents]
Acyclovir [more] Zovirax Approved C L2
Alferon N,
Interferon-alpha [more] Approved C L2
Interferon Alpha
Arthritis meds (see also: pain meds) [contents]
 Ridaura,
Gold salts Myochrysine, Approved C L5
Solganal
Asthma meds (see also: steroids) [contents]
Dilor, Lufyllin,
Dyphylline Approved C L3
Dyphylline
Terbutaline Bricanyl, Brethine Approved B L2
Aminophylline,
Theophylline Approved C L3
Quibron, Theo-Dur
Contraceptives, Hormones [more] [contents]
L3 (may
Estratab, Permarin, interfere with
Estradiol Approved X
Menest milk
production)
Clogestone - Approved - NR
Preven, Seasonale,
Norinyl, Norlestin, L3 (may
Contraceptive pill with Ortho-Novum, interfere with
Approved X
estrogen/progesterone Ovral, Lunelle milk
injection, Ortho- production)
Evra patch, etc.
Norplant, Mirena,
Levonorgestrel Approved X L2
Plan B
L1
Provera, Depo- L4 (if used first
Medroxyprogesterone Approved D
Provera, Cycrin 3 days
postpartum)
Norethynodrel Enovid Approved X L2
Crinone,
Progesterone Approved - L3
Prometrium
Cough meds [more] [contents]
Codeine Tylenol #3, #4 Approved C L3
Noscapine - Approved - NR
Decongestants [more] [contents]
L3 (for acute
Sudafed, Halofed, use)
Pseudoephedrine Approved C
Novafed, Actifed L4 (for chronic
use)
Diabetes meds [contents]
Note: Insulin has not been reviewed by the AAP. Pregnancy risk category = B; Lactation risk category =
L1.
Tolbutamide Oramide, Orinase Approved D L3
Diarrhea meds [contents]
Imodium, Pepto
Diarrhea Control,
Maalox Antidiarrheal
Loperamide Caplets, Kaopectate Approved B L2
II Caplets,
Immodium
Advanced
** Note: Pepto-Bismol & Kaopectate (bismuth subsalicylate is the active ingredient in both) are not
recommended for routine use by nursing moms, due to the association of salicylates with Reyes
syndrome in children. [more]
Diuretics [contents]
Acetazolamide Dazamide, Diamox Approved C L2
L4 (may inhibit
Bendroflumethiazide Naturetin Approved D
lactation)
Chlorothiazide Hydrodiuril Approved D L3
Chlorthalidone Hygroton Approved D L3
Hydrodiuril, Esidrix,
Hydrochlorothiazide Approved D L2
Oretic
Spironolactone Aldactone Approved D L2
Galactagogues (milk supply) [more] [contents]
Domperidone Motilum Approved - L1
Heart, Blood Pressure meds 
[contents]
(Antiarrhythmics, Antihypertensives, Cardiac stimulants)
        Antiarrhythmics
Disopyramide Norpace, Napamide Approved C L2
Flecainide Tambocor Approved C L3
Mexiletine Mexitil Approved B L2
Procainamide Pronestyl, Procan Approved C L3
Quinaglute,
Quinidine Approved C L2
Quinidex
        Antihypertensives
L3 (if used
Captopril Capoten Approved D
after 30 days)
Cardizem Sr,
Dilacor-XR,
Diltiazem/Diltiazem HCL Approved C L3
Diltiazem, Cardizem
CD
C (1st trim.)
Enalapril/Enalapril Maleate Vasotec Approved D (2nd, 3rd L2
trim.)
Hydralazine Apresoline Approved C L2
 Trandate,
Labetalol Approved C L2
Normodyne
Methyldopa Aldomet Approved C L2
Metoprolol Toprol XL, Lopressor Approved B L3
Loniten, Minodyl, L2 (topically)
Minoxidil Approved C
Rogaine L3 (orally)
Nadolol Corgard, Nadolol Approved C L4
Nifedipine Adalat, Procardia Approved C L2
Apsolox, Slow-
Oxprenolol Approved - NR
Trasicor, Trasicor
Propranolol Inderol Approved C L2
Sotalol Betapace Approved B L3
Timolol Blocadren Approved C L2
Calan, Isoptin,
Verapamil Approved C L2
Covera-HS
        Cardiac stimulants
Digoxin Lanoxin, Lanoxicaps Approved C L2
Laxatives [more] [contents]
Cascara/Cascara Sagrada - Approved C L3
Danthron - Approved - NR
Magnesium sulfate Epsom salt Approved B L1
Senna - Approved - L3
Malaria meds [contents]
Aralen, Novo-
Chloroquine Approved C L3
chloroquine
Hydroxychloroquine Plaquenil Approved C L2
Pyrimethamine Daraprim Approved C L4
Quinine Quinamm Approved D L2
Medical Testing [more] [contents]
Diatrizoate - Approved - NR
Fluorescein - Approved C L3
Gadopentetic (Gadolinium) - Approved C L2
Iohexol Omnipaque Approved B L2
Iopanoic acid Telepaque Approved D L2
Metrizamide Amipaque Approved B L2
Metrizoate Isopaque Approved B L2
Migraine meds (see also: pain meds) [more] [contents]
Sumatriptan Imitrex Approved C L3
Sedatives [more] [contents]
Chloral hydrate Aquachloral, Noctec Approved C L3
Methyprylon (withdrawn from use - Approved - NR
in US & Canada)
Bromide - Approved D L5
Secobarbital Seconal Approved D L3
Sleep Aids [contents]
Zolpidem/Zolpidem Tartrate Ambien Approved B L3
Steroids [contents]
Methylprednisolone
Solu-Medrol, Depo-
[  high dosage Approved C L2
Medrol, Medrol
methylprednisolone]
Prednisolone - Approved C L2
Deltasone,
Prednisone Approved C L2
Meticorten, Orasone
Thyroid meds [more] [contents]
Carbimazole - Approved D L3
Methimazole (active metabolite of
Tapazole Approved D L3
carbimazole)
Propylthiouracil PTU Approved D L2
Thiouracil - Approved - NR
Synthroid,
Levothyroxine Levothroid, Thyroid, Approved A L1
Levo-T, Levoxyl
Tuberculosis meds [contents]
Cycloserine Seromycin Approved C L3
Ethambutol,
Ethambutol Approved B L2
Myambutol
Isoniazid INH, Laniazid Approved C L3
Rifampin Rifadin, Rimactane Approved C L2
Vitamins [more] [contents]
B-1 (thiamin) - Approved - NR
B-12 (Cyanocobalamin) - Approved A L1
L2; L4 in high
doses (may
B-6 (pyridoxine) - Approved A
inhibit
lactation)
L3 (do not
D, vitamin Calciferol, Delta-d Approved A
overdose)
A (1st, 2nd
Folic acid - Approved trim.) L1
C (3rd trim.)
K-1, vitamin (Phytonadione) - Approved C L1
Riboflavin/B2  - Disetujui A L1
Miscellaneous [contents]
Acitretin (Anti-psoriasis) Soriatane Disetujui - NR
Alcohol/Ethanol [more] - Disetujui D L3
Allopurinol Zyloprim, Lopurin Disetujui C L2
Antimony - Disetujui - NR
Atropine (Anticholinergic, drying Belladonna,
Disetujui C L3
agent) Atropine
Azapropazone/apazone
Rheumox Disetujui - L2
(Antirheumatic)
Baclofen (muscle relaxant) Lioresal, Atrofen Disetujui C L2
Barbiturate - Disetujui - NR
Vivarin, NoDoz,
Caffeine [more] Disetujui B L2
Coffee
Carbetocin (Antihemorrhagic) Duratocin Disetujui - NR
Chloroform - Disetujui - NR
Cisplatin (Anti-cancer) Platinol Disetujui D L4
Dapsone (Antileprosy) Avlosulfon, DDS Disetujui C L4
Hydroxychloroquine
Plaquenil Disetujui C L2
(Antirheumatic, lupus)
Iodides - Disetujui - NR
Iodine - Disetujui - NR
Iodine (povidone-iodine, eg, in a
- Disetujui - NR
vaginal douche)
Ivermectin (Antiparasitic) Mectizan Disetujui C L3
Nalidixic acid (Urinary Anti-
NegGram Disetujui B L4
infective)
Norsteroids - Disetujui - NR
Pyridostigmine (Muscle stimulant) Mestinon, Regonol Disetujui C L2
Scopolamine (Motion sickness) Transderm Scope Disetujui C L3
Sulfapyridine Dagenan Disetujui - NR
Timolol (glaucoma med) Blocadren Disetujui D L3

*  Per the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human Milk,
revised September 2001.
Approved: (Table 6) Maternal Medication Usually Compatible With Breastfeeding
Caution: (Table 5) Drugs That Have Been Associated With Significant Effects on Some
Nursing Infants and Should Be Given to Nursing Mothers With Caution
NR: Not Reviewed. This drug has not yet been reviewed by the AAP.
** Per Medications' and Mothers' Milk by Thomas Hale, PhD (2004 edition).
 Lactation Risk Categories   Pregnancy Risk Categories 
 L1 (Paling Aman) A (studi terkontrol menunjukkan tanpa
L2 (Aman) resiko)
L3 (Cukup Aman) B (tidak ada bukti risiko pada manusia)
L4 (Kemungkinan C (risiko tidak dapat dikesampingkan)
Barbahaya) D (bukti positif resiko)
L5 (Kontra Indikasi) X (dikontraindikasikan untuk Ibu Hamil)
NR: Not Reviewed. This drug has

3. 1. Kandung kemih, yang terletak di bawah rahim seperti mendapat tekanan dari atas.
Hormon kehamilan progesteron akan membuat kandung kemih melemaskan otot-otot
rahim dan otot saluran kemih. Ini yang menyebabkan ibu hamil  sering berkemih sejak
awal kehamilan. Jangan membatasi minum, mengurangi asupan cairan bisa menyebabkan
infeksi kandung kemih akibat kandung kemih tidak tercuci dengan baik. Kurang cairan
pun mengganggu peredaran darah, apalagi saat hamil volume darah meningkat hingga
50%. Agar tidur malam tidak terganggu karena sering ke toilet, 2 jam sebelum tidur
hentikan minum dan pipis utnuk mengosongkan kandung kemih.

2. Lambung, yang terletak di area tertinggi rahim akan terdesak oleh pembesaran rahim,
sehingga memasuki minggu ke-30 akan cepat penuh saat diisi makanan. Akibatnya Anda
cepat merasa kenyang saat makan. Desakan rahim juga menyebabkan otot penutup
lambung terbuka sehingga asam lambung mudah naik ke kerongkongan. Ini yang
menyebabkan heartburn, rasa panas di kerongkongan dan perih di perut. Atasi
dengan makan dalam porsi kecil namun sering untuk menghindari rasa sesak di perut.
Setelah makan, jangan langsung berbaring dan di malam hari tidurlah dengan posisi
kepala lebih tinggi agar asam tidak mengalir ke kerongkongan. Mengonsumsi oat
dicampur susu dipercaya dapat ”mengikat” asam lambung sehingga tidak mudah
mengalir ke bagian atas tubuh.

3. Lever atau hati, yang berada di bagian pinggir rahim terdesak sehingga seolah-olah
ukurannya mengecil. Akibatnya, kerja hati jadi tidak optimal dalam menyaring dan
mengalirkan darah, zat-zat beracun di dalam darah pun tinggal lebih lama di tubuh, kulit
pun kurang cantik dan terasa gatal. Solusinya, mudahkan kerja lever dengan mengurangi
konsumsi makanan berlemak, sumber karbohidrat sederhana –misalnya tepung putih-
dan  bahan makanan yang rasanya pahit, karena semuanya mengandung bahan-bahan
yang sulit disaring di hati.

4. Jantung, akan tergeser 2 cm ke atas, tapi tak perlu khawatir karena terlindung tulang
dada. Meski demikian, di masa kehamilan jantung juga punya tugas berat; akibat
meningkatnya volume darah hingga 50%, otot jantung lebih banyak bekerja memompa
darah. Detak jantung jadi  lebih cepat karena keterbatasan oksigen dan dialirkannya darah
ke tubuh janin. Atasi dengan banyak bergerak di udara bebas untuk meningkatkan
asupan oksigen dalam darah.

5.Paru-paru. Pembesaran janin mengakibatkan paru-paru tidak dapat mengembang

maksimal saat bernafas. Efeknya, volume udara yang masuk ke paru-paru berkurang ¼ 
bagian. Karena itu, paru-paru harus lebih keras bekerja. Akan terasa saat Anda naik
tangga, jadi mudah lelah. Atasi dengan banyak latihan pernapasan perut untuk
memperbanyak oksigen yang masuk ke dalam tubuh.

6. Usus. Pembesaran janin mengakibatkan kerja usus menjadi tidak teratur karena

tingginya hormon progestoren. Hormon progesteron membuat  gerakan perilstatik usus
(menggiling dan mendorong) gagal bekerja secara ritmik dan teratur. Akibatnya, banyak
bahan makanan terhambat di usus, menyebabkan ibu mengalami gangguan
sembelit. Atasi sembelit dengan banyak minum air untuk membantu melicinkan usus dan
mencairkan makanan.