Thursday, January 19, 2006
Pregnant women need to be aware of effects of drugs

By Dr. Anthony Policastro
Nanticoke Memorial Hospital,
Medical director

People frequently ask me about the safety of drugs during pregnancy. I usually need to look up the answer. There are too many drugs available to have them all committed to memory. In addition, I would not want to guess at something like that without being sure. When I look up a drug in these situations, they are broken into categories. Therefore, I cannot usually say that one drug will do one thing and another will do something else. All I can do is pass on the level of safety as recommended by the FDA. The safest level is a Category A. The official definition of Category A is: "Controlled human studies show no increased risk in first trimester. No evidence of second or third trimester risk. Fetal harm is remote." These drugs are safe. Unfortunately, there are very few drugs that fall into this category. One good example is folic acid. This is the vitamin that we encourage all women of child-bearing age to take. We know it prevents birth defects like spina bifida. Other vitamins fall into this category as well. Most of the drugs that we do prescribe during pregnancy are Category B. The official definition of Category B is: "Animal studies show no risk or adverse fetal effects but controlled human first trimester studies not available. No evidence of second or third trimester risk; fetal harm possible but unlikely." What this means is that we have not formally looked at these drugs in an experimental way. We use them frequently. We do not think that they are harmful. Many women have taken them without any obvious ill effects. Many antibiotics fall into this category. However, if a mother wants a guarantee that the drugs will not harm the baby, there is no scientific proof of that. The next group of drugs is Category C. The official definition of Category C is: "Animal studies show adverse fetal effects but no controlled human studies or no animal or human studies exist. Weigh possible fetal risk vs. maternal benefit." Two things could land a drug in this category. One would be if we have seen adverse effects in animals but did not check that in humans. The other would be if we did not study the drug at all in either animals or humans. For drugs such as these, the recommendation is to look at the mother's real need for the drug. Then we look at the possible harm to the fetus. We then need to decide which is more important in that situation. There are many drugs that fall into this category. They often are drugs that people take for long periods of time for things like asthma or high blood pressure. The next group falls into Category D. The official definition of this is as follows: "Positive evidence of human fetal risk. Maternal benefit may outweigh fetal risk in serious or life threatening situations." This group represents drugs that are known to cause potential harm in a small percent of infants. However, in mothers who have a serious illness, they might be necessary. Many seizure medications fall into this group. It might make sense to take the risk with the infant to prevent the mother from having seizures. The last group is Category X. The official definition of this category is: "Contraindicated. Positive evidence exists of serious fetal abnormalities in animals, humans or both. Fetal risks clearly outweigh maternal benefits." These drugs clearly can cause harm to the developing infant. Therefore, other drugs should be used instead. Examples of these drugs include Zocor and Coumadin. Some drugs fall into one category early in pregnancy and a different category later in pregnancy. As you can see there is no yes or no answer about taking many of these medications. Most are in categories in which there is some potential risk to the fetus. Most are needed because of risk to the mother of her disease. A decision frequently must be made as to which is the best way to go. If the drug in question is a Category A or B, you can feel relatively safe. If it is Category C, it depends on the degree of illness that the mother has. Even then, the risk is probably low. If it is Category D, the risk is higher. However, for many of those drugs, the risk to the mother is even more significant if she is not treated. Like most things in medicine, there are risks, benefits and alternatives involved. Each pregnant mother needs to have a discussion of those with her physician when taking medications.

CHEER to host program on Medicare drug help
A representative from the Delaware Prescription Assistance Program will be at the CHEER Community Center on Sand Hill Road, Georgetown, to offer education and outreach support to those needing assistance in understanding the new prescription drug program, on Tuesday, Jan. 24, from 11:30 a.m. to 1:30 p.m. For more information call 854-9500.

Nanticoke to hold annual cholesterol screening
Nanticoke Memorial Hospital will offer cholesterol screenings on Feb. 14, 18 and 22, 7:30 to10 a.m. at the Nanticoke Stein Highway building, located in the former PK complex, next to County Bank. Participants will have the opportunity to select from two types of blood tests. One option is a total cholesterol test, which is a non-fasting blood test that will read the total cholesterol level. The cost is $5. The second option is a Lipid Profile test, which requires a 12-hour fasting and reads the HDL and LDL blood levels. Cost for the Lipid Profile is $15. No pre-registration is required. In addition to the cholesterol screening, free blood pressure checks will be offered. Results from the cholesterol screening will be mailed approximately two weeks after the test is performed. For additional information, call 629-6611 extension. 2404.

CHEER Center also to offer cholesterol tests
The CHEER Community Center of Georgetown will be holding a free cholesterol screening on Wednesday, Jan. 24, from 8:30 a.m. to 11 a.m. The screenings will be provided by Beebe Medical Center's community health department. This screening will be open to the public for those who want to know their cholesterol numbers. The test takes about 10 minutes and does not require fasting. Test results provide total cholesterol, HDL (good cholesterol) levels within five minutes. Pre-registration is required. Call 302-854-9500 to schedule a 10-minute appointment.

Program will teach caregivers how to relax
On Tuesday, Jan. 31, 10 a.m. to 2 p.m., at the CHEER Community Center, 20520 Sand Hill Road, Georgetown, will offer demonstrations on mediation, deep breathing, deep muscle relaxation, color imagery, yoga, and visualization for caregivers. There also will be demonstrations on golfing, reading, gardening, walking, swimming, dancing and aerobics. Caregivers will learn about the help available from CHEER Home Services, CHEER Homebound Meals, Gull House Adult Day Care, Brandywine Assisted Living, DART Transportation nand Long-term Care. For more information contact Cindy Mitchell at 854-9500.

Prescription assistance rep to be at CHEER center
A representative from the Delaware Prescription Assistance Program will be at the CHEER Community Center on Sand Hill Road, Georgetown, to offer education and outreach support to those needing assistance in understanding the new prescription drug program. The representative will be at the center on the following dates: Tuesday, Feb. 14 and 28, from 11:30 a.m. to 1:30 p.m. Tuesday, March 14 and 28, from 11:30 a.m. to 1:30 p.m. Tuesday, April 11 and 25, from 11:30 a.m. to 1:30 p.m. For more information, call 302-854-9500.

March health fair to focus on holistic foods, natural healing
The Delmarva CommunityWellnet Foundation is hosting the 14th annual Holistic Health Fair on Saturday, March 11, from 9:30 a.m. to 4:30 p.m., at the Cape Henlopen High School at 1250 Kings Highway in Lewes. The yearly non-profit event is open to the public. Admission is free with a donated non-perishable food item. This year's event is focused on natural health products and services plus alternative and integrative health practices. It will include exhibits, demonstrations, workshops and healthy foods. The keynote speaker will be David Winston, a nationally respected herbalist and author. Holistic health practitioners, natural products retailers, growers or producers of natural/organic products and other types of holistic service providers are invited to register to participate. The final deadline for registration is Feb. 20. Registration forms are available at most local health food stores and at the Resort Beaches Women in Business Resource Center in Dewey Beach. Delmarva Community Wellnet is a growing organization that is dedicated to improving the health of the region. The main focus is upon three core functions, community service pilot programs (Take Charge of your Health community lecture series), the Whole Foods School Lunch Program as well as information resources and networking. The organization is seeking volunteers for the health fair and/or any of the foundation's core function areas. Interested individuals can contact the foundation through the Web site