DRUGS FOR

PREGNANCY
怀孕药物
Prepared by : Precious Junorm P. Fulgarinas, RPh
“No drugs is safe beyond
all doubt in early
pregnancy”
“ 在怀孕早期，没有任何
药物是安全的
O1 PHARMCOKINETICS IN PREGNANCY
妊娠期药代动力学

O2 FETAL-PLACENTAL TRANSFER
胎盘移植

O3 HOW CAN DRUGS AFFECT FETUS?

药物如何影响胎儿？

O4 BASIC PRINCIPLE OF MEDICATION IN

PREGNANCY 妊娠期用药的基本原则

O5 RECOGNITION OF TERATOGENIC DRUGS 致畸药物

的识别
 INTRODUCTION
Taking drugs or medications during pregnancy can be harmful.
Possible effects include prenatal death (miscarriage), developmental
delay, intellectual disability and birth defects. Some medications may
be necessary but should only be taken under medical supervision.
Alcohol, tobacco, caffeine and illicit drugs including cannabis and
cocaine are all classified as drugs. Limit caffeine drinks and don't
smoke or drink alcohol during pregnancy.
怀孕期间服用药物或药物可能是有害的。可能的影响包括产前死亡
（流产）、发育迟缓、智力障碍和出生缺陷。有些药物可能是必需
的，但只能在医疗监督下服用。酒精、烟草、咖啡因和非法药物（包
括大麻和可卡因）都被归类为毒品。限制咖啡因饮料，怀孕期间不要
吸烟或饮酒。
Most women take some kind of drug, substance or
medication during pregnancy, often without realizing
the potential for harm. Drugs or medication taken by
the mother may cross the placenta and reach the
developing fetus. The possible effects may include
prenatal death (stillbirth), developmental delay,
intellectual disability and birth defects.
大多数女性在怀孕期间服用某种药物、物质或药物，往
往没有意识到潜在的伤害。母亲服用的药物或药物可能
会穿过胎盘到达发育中的胎儿。可能的影响可能包括产
前死亡（死产）、发育迟缓、智力障碍和出生缺陷。
 PHARMCOKINETICS IN
01 PREGNANCY
妊娠期药代动力学
ABSORPTION 吸收
DISTRIBUTION 分配
METABOLISM 新陈代谢
EXCRETION 排泄
ABSORPTION 吸收
-THE PROCESS OF GETTING DRUG INTO THE BODY
- 药物进入体内的过程
DISTRIBUTION 分配
-THE PROCESS OF DISTRIBUTION INTO AND OUT OF THE TISSUES
- 分布进出组织的过程
METABOLISM 新陈代谢
-THE PROCESS THAT CHANGE THE DRUG INTO ANOTHER MOLECULE
- 将药物变成另一种分子的过程
EXCRETION 排泄
-THE PROCESS THAT REMOVE THE DRUG FROM THE BODY
- 从体内清除药物的过程
 ABSORPTION 吸收
A Pregnancy can affect the absorption of
drugs due to changes in gastric emptying
D time, intestinal motility, and gastric pH.
Some medications may be absorbed more
M slowly or incompletely during pregnancy.
妊娠可因胃排空时间、肠蠕动和胃 pH 值的
E 变化而影响药物的吸收。一些药物在怀孕期
间的吸收可能更慢或不完全。
 DISTRIBUTION 分配
Pregnancy can alter the distribution of
A drugs in the body. Increased blood volume,
D changes in body composition, and protein
binding alterations can affect the
M distribution of drugs, leading to changes in
their concentration and availability at the
E target site.
怀孕可以改变药物在体内的分布。血容量增
加、身体成分变化和蛋白质结合改变会影响
药物的分布，导致其浓度和靶位点可用性发
生变化。
 METABOLISM 新陈代谢
The metabolism of drugs can be
A influenced by pregnancy. Enzyme activity,
D particularly in the liver, may change
during pregnancy, affecting the rate at
M which drugs are broken down and cleared
from the body. Some drugs may be
E metabolized more rapidly or slowly during
pregnancy.
药物的代谢会受到怀孕的影响。酶活性，
特别是在肝脏中，可能会在怀孕期间发生
变化，从而影响药物分解和清除体外的速
度。一些药物在怀孕期间可能代谢得更快
或更慢。
 EXCRETION 排泄
A Excretion of drugs via the kidney increases
because renal plasma flow almost doubles
D and the glomerular filtration rate increases
during pregnancy. This has been
M documented for digoxin, lithium, ampicillin,
cefalexin and gentamicin.
E 由于肾血浆流量几乎翻倍，肾小球滤过率增
加，药物经肾脏排泄增加 怀孕期间减少三分之
二。这已被记录在地高辛、锂、氨苄西林、头
孢氨苄和庆大霉素中。
 FETAL-PLACENTAL TRANSFER
02 胎盘移植
REMEMBER!!! 记得！
LIPOPHILIC HYDROPHILIC
UNIONIZED IONIZED
NONPOLAR POLAR
ABSORBED EXCRETED
 FETAL-PLACENTAL TRANSFER
02 胎盘移植
 Fetal-placental transfer refers to the process of
transporting substances across the placenta from the
mother to the developing fetus during pregnancy. 胎盘
转移是指在怀孕期间将物质通过胎盘从母亲输送到发育
中的胎儿的过程。
 The placenta acts as a barrier and exchange system
between the maternal and fetal circulations. 胎盘是母
体和胎儿循环之间的屏障和交换系统。
 MATERNAL-FETAL TRANSFER
Some of the fetus’s blood vessels are contained in
tiny hairlike projections(villi) of the placenta that
extend into the wall of the uterus. The mother’s blood
passes through the space surrounding the villi
(intervillous space). Only a thin membrane(placental
membrane) separates the mother’s blood in the
intervillous space from the fetus’s blood in the villi.
Drugs in the mother’s blood can cross this membrane
into blood vessels in the villi and pass through the
umbilical cord the fetus. 胎儿的一些血管包含在胎盘
的微小毛发状突起（绒毛）中，这些突起延伸到子宫
壁。母亲的血液通过绒毛周围的空间（绒毛间隙）。
只有一层薄膜（胎盘膜）将绒毛间隙中的母体血液与
绒毛中的胎儿血液分开。母亲血液中的药物可以穿过
该膜进入绒毛中的血管，并通过脐带进入胎儿。
 FETAL-PLACENTAL TRANSFER
02 胎盘移植
 Transfer occurs through mechanisms such as passive
diffusion, facilitated diffusion, and active transport. 转
移通过被动扩散、促进扩散和主动运输等机制
发生。
 Passive diffusion relies on concentration gradients and
is most effective for small, lipophilic, and non-ionized
substances. Molecular weight generally less than 500
Daltons. 被动扩散依赖于浓度梯度，对小的、亲脂性的
和非电离的物质最有效。分子量一般小于 500 道尔顿。
 FETAL-PLACENTAL TRANSFER
02 胎盘移植
 Facilitated diffusion involves the use of carrier proteins to
transport molecules across the placental membrane.
Molecular weight varies depending on the specific carrier
proteins involved. 促进扩散涉及使用载体蛋白将分子转运
到胎盘膜上。分子量取决于所涉及的特定载体蛋白。
 Active transport requires energy expenditure to move
substances against their concentration gradient. Molecular
weight varies depending on the specific transport
mechanisms involved. 主动运输需要能量消耗来使物质逆
其浓度梯度移动。分子量取决于所涉及的特定转运机制。
 FACTORS AFFECTING FETAL-PLACENTAL
02 TRANSFER 影响胎盘转移的因素

 MOLECULAR SIZE: Small molecules can pass through the

placenta more easily than larger ones. 分子大小：小分子比
大分子更容易通过胎盘。
 MOLECULAR WEIGHT: Generally, substances with a
molecular weight less than 500 Daltons can cross the placenta
more readily. 分子量：通常，分子量小于 500 道尔顿的物质更
容易穿过胎盘。
 LIPID SOLUBILITY: Lipophilic (fat-soluble) substances can
diffuse across the placenta more easily than hydrophilic (water-
soluble) substances. 脂溶性：亲脂性（脂溶性）物质比亲水性
（水溶性）物质更容易扩散到胎盘。
 FACTORS AFFECTING FETAL-PLACENTAL
02 TRANSFER 影响胎盘转移的因素

 MATERNAL FACTORS: Maternal health conditions, such as

hypertension or diabetes, can impact placental function and
transfer. 孕产妇因素：孕产妇健康状况，如高血压或糖尿病，会影
响胎盘功能和转移。
 FETAL FACTORS: Genetic variations or fetal health conditions
can affect placental transfer. 胎儿因素：遗传变异或胎儿健康状况
会影响胎盘移植。
 pH and pKa: Drugs with a pKa near 7.4 will exist in a partially non-
ionized state, and are associated with high placental transfer.
Drugs with a pKa > 7.4 are associated with less placental transfer.
pH 值和 pKa ： pKa 接近 7.4 的药物将以部分非电离状态存在，并且与
高胎盘转移有关。 pKa > 7.4 的药物与较少的胎盘转移有关。
 EFFECTS OF DRUGS IN PREGNANCY
03 药物对怀孕的影响
In the first 4 weeks, prior to implantation, drug exposure is relatively safe as the
fetus is not exposed to the mother's blood supply. An adverse effect currently is
likely to result in spontaneous abortion (all or nothing effect).
Post-partum, drugs with a long half-life may continue to affect the baby. Drugs with
a short half-life may result in neonatal withdrawal symptoms. After implantation,
fetal drug concentrations are similar to those in the mother. Adverse effects
depend on both drug toxicity and the developmental stage of the fetus.
在植入前的前 4 周，药物暴露相对安全，因为胎儿不会暴露于母亲的血液供应。
此时的不良反应可能导致自然流产（全部或无影响）。
产后，半衰期长的药物可能会继续影响婴儿。半衰期短的药物可能导致新生儿戒断
症状。植入后，胎儿的药物浓度与母亲的浓度相似。不良反应取决于药物毒性和胎
儿的发育阶段。
SAFE PREIMPLANTATION
安全胚胎植入前
 1ST TRIMESTER 孕早期
Teratogenicity 致畸性
Spontaneous abortion 自然流产
 2ND TRIMESTER 孕中期
General development
especially neurological.
一般发育，尤其是神经发育。
 3RD TRIMESTER 孕中期
Acceleration or delay of delivery
Hemorrhage (mother & baby) 交
货的加速或延迟 出血（母亲和婴
儿）

POSTPARTUM 产后的
Drug withdrawal
Prolonged drug activity in baby
Patent ductus arteriosus
药物戒断 婴儿药物活性延长 动脉导
管未闭
The stage of gestation influences the effects of drugs on the fetus.
妊娠阶段影响药物对胎儿的影响。

It is convenient to divide pregnancy into four stages, namely

fertilization and implantation (17 days), the
organogenesis/embryonic stage (17–57 days), the fetogenic stage
and delivery. 将 妊 娠 分 为 四 个 阶 段 是 方 便 的 ， 即 受 精 和 着 床 （ 17
天）、器官发生 / 胚胎阶段（ 17-57 天）、胎儿形成阶段和分娩。
HOW CAN DRUGS AFFECT FETUS?
1. FERTILIZATION AND IMPLANTATION (17 DAYS)
Animal studies suggest that interference with the fetus before 17 days
gestation causes abortion, i.e. if pregnancy continues the fetus is
unharmed.

2. ORGANOGENESIS/EMBRYONIC STAGE
At this stage, the fetus is differentiating to form major organs, and this is
the critical period for teratogenesis. Teratogens cause deviations or
abnormalities in the development of the embryo that are compatible with
prenatal life and are observable postnatally. Drugs that interfere with this
process can cause gross structural defects (e.g. thalidomide phocomelia).
HOW CAN DRUGS AFFECT FETUS?

3. FETOGENIC STAGE

In this stage, the fetus undergoes further development and

maturation. Even after organogenesis is almost complete, drugs can
still have significant adverse effects on
fetal growth and development. 在这个阶段，胎儿经历了进一步的发
育和成熟。即使在器官发生几乎完成之后，药物仍可能对 胎儿生长发
育。
HOW CAN DRUGS AFFECT FETUS?
4. DELIVERY
Some drugs given late in pregnancy or during delivery may cause
problems. Pethidine, administered as an analgesic can cause fetal apnea
(which is reversed with naloxone. Anesthetic agents given during
Caesarean section may transiently depress neurological, respiratory and
muscular functions. Warfarin given in late pregnancy causes a
haemostasias defect in the baby, and predisposes to cerebral hemorrhage
during delivery. 一些在妊娠晚期或分娩期间服用的药物可能会引起问
题。哌替啶作为镇痛药给药可引起胎儿呼吸暂停（纳洛酮可逆
转）。剖宫产时给予麻醉剂可能会暂时抑制神经、呼吸和肌肉功
能。妊娠晚期给予华法林会导致婴儿止血缺陷，并在分娩过程中易
发生脑出血。
QUESTION
Can drugs taken by a man affect the
fetus?

YES NO
DRUGS TAKEN BY MEN 男性服用的药物

Although it is generally considered that sperm cells damaged by

drugs will not result in fertilization, the manufacturers of
griseofulvin, an antifungal agent, advise men not to father children
during or for six months after treatment. Finasteride, an
antiandrogen used in the treatment of benign prostatic hyperplasia
and male pattern baldness , is secreted in semen, and may be
teratogenic to male fetuses. 虽然人们普遍认为药物损伤的精子细胞
不会导致受精，但抗真菌剂灰黄霉素的制造商建议男性在治疗期间或
治疗后六个月内不要生育孩子。非那雄胺是一种用于治疗良性前列腺
增生的抗雄激素药物，在精液中分泌，可能对男性胎儿致畸。
 PRECAUTIONS
GRISEOFULVIN 灰黄霉素
Griseofulvin should not be taken in pregnancy as there is a slight risk
of malformation of the fetus. Males should not father children within 6
months of treatment with griseofulvin as it may damage sperm cells. 灰黄
霉素不应在怀孕期间服用，因为胎儿有轻微畸形的风险。男性不应在灰黄
霉素治疗后 6 个月内生育孩子，因为它可能会损害精子细胞。
INTERACTION: GRISEOFULVIN AND ORAL CONTRACEPTIVES
相互： 灰黄霉素 和 口服避孕药
If you are relying on oral contraception, the “pill”, griseofulvin may prevent it
working. All sexually active patients should use additional barrier contraception,
such as condoms, throughout griseofulvin therapy, and for four weeks (female) and
6 months (male) after stopping the therapy . 如果您依赖口服避孕药，灰黄霉素可
能会阻止其起作用。所有性活跃的患者都应在整个灰黄霉素治疗期间以及停止治疗
后 4 周（女性）和 6 个月（男性）使用额外的屏障避孕措施，例如避孕套。
 PRECAUTIONS
FINASTERIDE 非那雄胺
Women who are pregnant or may become pregnant should not handle
crushed or broken tablets. Finasteride can be absorbed through the skin and
cause birth defects in male babies. If a woman does come in contact with
this medicine, the affected area should be washed right away with soap and
water. (Drug information provided by: Merative, Micromedex®) 怀孕或可能
怀孕的妇女不应处理压碎或破损的药片。非那雄胺可通过皮肤吸收，导致男
婴出生缺陷。如果女性确实接触了这种药物，应立即用肥皂和水清洗患处。
It is crucial to stop using Finasteride when trying to conceive a child. The
medication can impact male fertility by decreasing sperm count and motility,
and it can also potentially harm the development of a fetus in pregnant
women. 在尝试怀孕时停止使用非那雄胺至关重要。这种药物可以通过减少
精子数量和活力来影响男性的生育能力，并且还可能损害孕妇胎儿的发育。
BASIC PRINCIPLE OF
MEDICATION IN
PREGNANCY
妊娠期用药的基本原则

03
 THE FOLLOWING PRINCIPLES SHOULD BE FOLLOWED:
I. Pregnancy medication must have clear indications, try to avoid early
pregnancy( 1-12 weeks) medication. 孕期用药一定要有明确的适应症，尽量避免
孕早期（ 1-12 周）用药。
II. medication under the guidance of a doctor, as far as possible a single, small
dose of medication, to avoid joint and large doses of medication; try to use old
drugs and try to avoid new ones. refer to the FDA's drug classification, promote
the use of A,B drugs , avoid the use of C,D drugs. 用药时，在医生的指导下，尽
量单次用药，小剂量用药，避免联合用药和大剂量用药 ; 尝试使用旧药并尽量避
免使用新药。参考 FDA 的药品分类，提倡使用 A 、 B 类药物，避免使用 C 、 D
类药物。
III. The application of drugs that may be harmful to the fetus, to weigh the pros and
cons before deciding whether to use drugs, if the condition is urgent need of the
application of certain drugs that are harmful to the fetus, should first terminate
the pregnancy and then use drugs. 应用可能对胎儿有害的药物，在决定是否使
用药物之前要权衡利弊，如果情况急需应用某些对胎儿有害的药物，应先终止妊
FDA PREGNANCY RISK CATEGORIES
在孕妇中进行的充分、对照良好的研究
并未显示胎儿畸形的风险增加

动物研究显示没有证据表明对胎儿有害：然而，没
有充分和良好对照的孕妇研究。手术室动物研究显
示有不良反应，但对孕妇进行充分且对照良好的研
究未能证明对胎儿有风险
动物研究显示有不良反应，并且没有对孕妇进
行充分且对照良好的研究。或者没有进行动物
研究，也没有对孕妇进行充分和良好对照的研
究。
对孕妇进行充分的、对照良好的研究或
观察性研究已经证明对胎儿有风险。然
而，该疗法的益处可能大于潜在风险。
对动物或孕妇进行的充分的良好控制或观
察性研究已经证明了胎儿异常的积极证
据。该产品禁用于怀孕或可能怀孕的妇女
QUESTION 问题 PREGNANT
怀孕
ANIMALS
动物

Under the FDA Pregnancy Risk Category Safe 安全

system, where would the statement "The
benefits of therapy outweigh the risks" be Safe 安全 Unsafe 不安全
的
classified?
No studies safe 安全
在之前的 FDA 妊娠风险分类系统下，“治疗的益处大
于风险”的说法应该归类在哪里？ No studies unsafe 不安全
的

A. CATEGORY A A类 Unsafe 不安全

的
B. CATEGORY B B类 (benefits>risk)
C. CATEGORY C C类 （收益 > 风
险）
D. CATEGORY D D类
Unsafe
E. CATEGORY X X类 (benefit<risk)
不安全的
（收益 < 风
ANSWER 答 PREGNANT
怀孕
ANIMALS
动物

Under the FDA Pregnancy Risk Category Safe 安全

system, where would the statement "The
benefits of therapy outweigh the risks" be Safe 安全 Unsafe 不安全
的
classified?
No studies safe 安全
在之前的 FDA 妊娠风险分类系统下，“治疗的益处大
于风险”的说法应该归类在哪里？ No studies unsafe 不安全
的
A. CATEGORY A A类
B. CATEGORY B B类 Unsafe 不安全
的
C. CATEGORY C C类 (benefits>risk)
D. CATEGORY D D类 （收益 > 风
险）
E. CATEGORY X X类
Unsafe
(benefit<risk)
不安全的
（收益 < 风
 PREGNANT ANIMALS
QUESTION 问题 怀孕 动物

Under the FDA Pregnancy Risk Category system, Safe 安全

where would the statement “The risks of therapy

Safe 安全 Unsafe 不安全
outweigh the benefits (UNSAFE)" be classified?
的
在 FDA 妊娠风险类别系统下，“治疗风险大于益 No studies safe 安全
处（不安全）”的说法将归类在哪里？
No studies unsafe 不安全
的
A. CATEGORY A A类
B. CATEGORY B B类
Unsafe 不安全
C. CATEGORY C C类 的
D. CATEGORY D D类 (benefits>risk)
（收益 > 风
E. CATEGORY X X类 险）
Unsafe
(benefit<risk)
不安全的
（收益 < 风
 PREGNANT ANIMALS
ANSWER 答 怀孕 动物

Under the FDA Pregnancy Risk Category system, Safe 安全

where would the statement “The risks of therapy

Safe 安全 Unsafe 不安全
outweigh the benefits (UNSAFE)" be classified?
的
在 FDA 妊娠风险类别系统下，“治疗风险大于益 No studies safe 安全
处（不安全）”的说法将归类在哪里？
No studies unsafe 不安全
的
A. CATEGORY A A类
B. CATEGORY B B类
Unsafe 不安全
C. CATEGORY C C类 的
D. CATEGORY D D类 (benefits>risk)
（收益 > 风
E. CATEGORY X X类 险）
Unsafe
(benefit<risk)
不安全的
（收益 < 风
 PREGNANT ANIMALS
QUESTION 问题 怀孕 动物

Under the FDA Pregnancy Risk Category system, Safe 安全

where would the statement “ human studies

Safe 安全 Unsafe 不安全
show no risk in any trimesters (SAFE)" be
的
classified? 在 FDA 妊娠风险类别系统下，“人体 No studies safe 安全
研究显示任何三个月都没有风险 （ SAFE ）”的说
法将归类在哪里？ No studies unsafe 不安全
的

A. CATEGORY A A类
Unsafe 不安全
B. CATEGORY B B类 的
C. CATEGORY C C类 (benefits>risk)
（收益 > 风
D. CATEGORY D D类 险）
E. CATEGORY X X类 Unsafe
(benefit<risk)
不安全的
（收益 < 风
 PREGNANT ANIMALS
ANSWER 答 怀孕 动物

Under the FDA Pregnancy Risk Category system, Safe 安全

where would the statement “ human studies

Safe 安全 Unsafe 不安全
show no risk in any trimesters (SAFE)" be
的
classified? 在 FDA 妊娠风险类别系统下，“人体 No studies safe 安全
研究显示任何三个月都没有风险 （ SAFE ）”的说
法将归类在哪里？ No studies unsafe 不安全
的

A. CATEGORY A A类
Unsafe 不安全
B. CATEGORY B B类 的
C. CATEGORY C C类 (benefits>risk)
（收益 > 风
D. CATEGORY D D类 险）
E. CATEGORY X X类 Unsafe
(benefit<risk)
不安全的
（收益 < 风
QUESTION 问题 PREGNANT
怀孕
ANIMALS
动物
Under the FDA pregnancy risk category system, where Safe 安全
would the statement “Animal studies have failed to
demonstrate a risk and there are no adequate and
Safe 安全 Unsafe 不安全
well-controlled studies in pregnant women.
的
Medications in this class are generally considered No studies safe 安全
safe.” be classified? 在 FDA 的妊娠风险类别系统下，
“动物研究未能证明风险，并且没有对孕妇进行充分且对 No studies unsafe 不安全
照良好的研究”的声明在哪里。这类药物通常被认为是安 的
全的。
Unsafe 不安全
A. CATEGORY A A类 的
B. CATEGORY B B类 (benefits>risk)
（收益 > 风
C. CATEGORY C C类 险）
D. CATEGORY D D类 Unsafe
E. CATEGORY X X类 (benefit<risk)
不安全的
（收益 < 风
ANSWER 答 PREGNANT
怀孕
ANIMALS
动物
Under the FDA pregnancy risk category system, where Safe 安全
would the statement “Animal studies have failed to
demonstrate a risk and there are no adequate and
Safe 安全 Unsafe 不安全
well-controlled studies in pregnant women.
的
Medications in this class are generally considered No studies safe 安全
safe.” be classified? 在 FDA 的妊娠风险类别系统下，
“动物研究未能证明风险，并且没有对孕妇进行充分且对 No studies unsafe 不安全
照良好的研究”的声明在哪里。这类药物通常被认为是安 的
全的。
Unsafe 不安全
的
A. CATEGORY A A类 (benefits>risk)
B. CATEGORY B B类 （收益 > 风
C. CATEGORY C C类 险）
D. CATEGORY D D类 Unsafe
(benefit<risk)
E. CATEGORY X X类 不安全的
（收益 < 风
QUESTION 问题 PREGNANT
怀孕
ANIMALS
动物
Under the FDA pregnancy risk category system, where Safe 安全
would the statement “Animal studies have shown
adverse effect and there are no adequate and well-
Safe 安全 Unsafe 不安全
controlled studies in pregnant.” be classified? 在 FDA 的
妊娠风险类别系统下，“动物研究显示不良反应，并且没有 No studies safe 安全
充分和良好对照的妊娠研究”的陈述将在哪里分类？
No studies unsafe 不安全
的
A. CATEGORY A A类
B. CATEGORY B B类
Unsafe 不安全
C. CATEGORY C C类 的
D. CATEGORY D D类 (benefits>risk)
（收益 > 风
E. CATEGORY X X类 险）
Unsafe
(benefit<risk)
不安全的
（收益 < 风
 PREGNANT ANIMALS
ANSWER 答 怀孕 动物

Under the FDA pregnancy risk category system, where Safe 安全

would the statement “Animal studies have shown
adverse effect and there are no adequate and well- Safe 安全 Unsafe 不安全
controlled studies in pregnant.” be classified? 在 的
FDA 妊娠风险类别系统下， “ 动物研究显示不良反应，并 No studies safe 安全
且没有充分且对照良好的妊娠研究”的说法将归类在哪里？
No studies unsafe 不安全
的
A. CATEGORY A A类 Note: Category C is the confusing
category. A drug gets this
B. CATEGORY B B类 classification if there are insufficient Unsafe 不安全
C. CATEGORY C C类 data on its use during pregnancy, as 的
D. CATEGORY D D类 it may be safe or it may be harmful. (benefits>risk)
E. CATEGORY X X类 注意： C 类是令人困惑的类别。如果 （收益 > 风
怀孕期间使用的数据不足，则药物会 险）
进行此分类，因为它可能是安全的， Unsafe
也可能是有害的。 (benefit<risk)
不安全的
（收益 < 风
RECOGNITION OF
TERATOGENS
致畸剂的识别
03
 TERATOGEN
Teratogens are substances that
cause congenital disorders in a
developing embryo or fetus. A teratogen is
anything a person is exposed to or
ingests during pregnancy that’s known to
cause fetal abnormalities. Drugs,
medicine, chemicals, certain infections
and toxic substances are examples of
teratogens. Teratogens can also increase
the risk for miscarriage, preterm
labor or stillbirth.
HARMFUL DRUGS AND SUBSTANCES: 有害药物和物质：
Some drugs, substances or medications that may be harmful during pregnancy,
depending on amount and frequency of use, include: 根据使用量和频率，一些在怀
孕期间可能有害的药物、物质或药物包括：
• Medicines – including some prescription drugs, over-the-counter medicines and
complementary medicines such as herbal remedies or nutrition supplements
• 药物 – 包括一些处方药、非处方药和补充药物，如草药或营养补充剂
• Tobacco 烟草
• Alcohol 酒精
• Caffeine – for example tea, coffee and cola drinks 咖啡因 – 例如茶、咖啡和
可乐饮料
• Illegal drugs – such as cannabis, heroin, cocaine or amphetamines 非法药物，
如大麻、海洛因、可卡因或安非他明
• Substances used as drugs – such as inhalants (aerosols). 用作药物的物质，
例如吸入剂（气溶胶）。
TERATOGENIC AGENTS 致畸药物
MNEMONIC: “WARFARIN” 助记词：”华法林”
WARFARIN 华法林
ACE INHIBITOR ACE 抑制剂
RETINOID (VITAMIN A) 类视黄醇（维生素 A ）
FLUOROQUINOLONES 氟喹诺酮类药物
ALCOHOL 酒精
RADIATION 辐射
ISOTRITINOIN 异曲维甲酸
NSAIDS 非甾体抗炎药
MNEMONIC: “WARFARIN” 助记词：”华法林”
WARFARIN -This is an anticoagulant drug used to prevent blood clots.
However, it can cause severe birth defects, including fetal hemorrhage and
central nervous system abnormalities 华法林 - 这是一种用于预防血栓的抗凝
药物。然而，它可能导致严重的出生缺陷，包括胎儿出血和中枢神经系统异常
ACE INHIBITORS- These drugs are used to lower blood pressure in patients
with hypertension. However, they can cause sever fatal abnormalities,
including renal dysfunction, skull malformation and lung hypoplasia. 血管紧张
素转换酶抑制剂 - 这些药物用于降低高血压患者的血压。然而，它们可能导致
严重的致命异常，包括肾功能不全、颅骨畸形和肺发育不全。
RETENOIDS- These are drugs used to treat acne, psoriasis and other skin
conditions. However, they can cause severe birth defects including craniofacial
abnormalities, neural tube defects, and cardiac anomalies. RETENOIDS- 这些
是用于治疗痤疮、牛皮癣和其他皮肤病的药物。然而，它们会导致严重的出生
缺陷，包括颅面畸形、神经管缺陷和心脏异常。
MNEMONIC: “WARFARIN” 助记词：”华法林”
FLUOROQUINOLONES- These are antibiotics used to treat bacterial
infections. However, they can cause cartilage damage in the fetus, leading to
skeletal malformations. 氟喹诺酮类 - 这些是用于治疗细菌感染的抗生素。然
而，它们会导致胎儿软骨损伤，导致骨骼畸形。
ALCOHOL- This is not a drug, but it’s important to remember that alcohol
consumptions during pregnancy can cause fetal alcohol syndrome, which
includes facial malformations, developmental delays, and intellectual disability.
酒精 - 这不是一种药物，但重要的是要记住，怀孕期间饮酒会导致胎儿酒精综
合征，包括面部畸形、发育迟缓和智力障碍。
RADIATIONS- This is not a drug either, but it’s essential to remember that
exposure to radiation during pregnancy can cause fetal abnormalities,
including growth retardation, mental retardation and developmental delays. 辐
射 - 这也不是药物，但必须记住，怀孕期间暴露于辐射会导致胎儿异常，包括
生长迟缓、智力迟钝和发育迟缓。
MNEMONIC: “WARFARIN” 助记词：”华法林”

ISOTRETINOIN- This is a retinoid used to treat severe acne . . However, it can

cause severe birth defects including craniofacial abnormalities, neural tube
defects, and cardiac anomalies
异维 A 酸 - 这是一种用于治疗严重痤疮的类视黄醇。 . 然而，它可能导致严重
的出生缺陷，包括颅面畸形、神经管缺陷和心脏异常

NSAIDS- These are nonsteroidal anti-inflammatory drugs used to relieve pain

and inflammation. However, they can cause fetal renal dysfunction, constriction
of the fetal ductus arteriosus , and delayed labor.
非甾体抗炎药 - 这些是用于缓解疼痛和炎症的非甾体抗炎药。然而，它们会导
致胎儿肾功能不全、胎儿动脉导管收缩和延迟分娩。
TERATOGENIC DRUGS 致畸药物

MNEMONIC: “TERATOWA” 助记词：“ TERATOWA”

THALIDOMIDE
EPILIPTIC DRUGS ( VALPROIC AND PHENYTOIN)
RETINOID (VITAMIN A)
ACE INHIBITOR
THIRD ELEMENT ( LITHIUM)
ORAL CONTRACEPTIVES, HORMONES
WARFARIN
ALCOHOL
THALIDOMIDE EPILIPTIC DRUGS (PHENYTOIN)

POCOMELIA
Table: Some Medications Considered Safe for Use during Pregnancy 表：一些被认
为在怀孕期间安全使用的药物

Condition Medication
Asthma 哮喘 • Budesonide inhaled or nasal spray
布地奈德吸入或鼻喷雾剂

Bladder infection (UTI) • Nitrofurantoin - Avoid in patients with possible

膀胱感染 （ UTI ） G6PD deficiency
• 呋喃妥因 - 避免用于可能存在 G6PD 缺乏症
的患者
Cough 咳嗽 • Dextromethorphan 右美沙芬

Constipation 便秘 • Citrucel® 瓜氨酸 ® ，

• Docusate 多苏塞特
• Milk of magnesia. 氧化镁乳。
• Polyethylene glycol 聚乙二醇
Table: Some Medications Considered Safe for Use during Pregnancy 表：一些
被认为在怀孕期间安全使用的药物

Condition Medication
THANK
YOU