Vomiting pregnancy

Phenobarbitone is used to treat epilepsy, migraine headache, dental infections, pregnancy vomiting, tetanus, enuresis, chorea, pre and post operative sedation, hypertension, anxiety states, neurosis, and in the treatment of drug and alcohol addiction. This drug is also called phenobarbital. 

Pregnancy vomiting is prone to occur in the first trimester thus pharmacotherapy would coincide with the period of maximal fetal vulnerability to chemical injury. Accordingly, antiemetics (antihistamines, or neuroleptics if required) should be used only when continuous vomiting threatens to disturb electrolyte and water balance to a degree that places the fetus at risk. 

This compound has antihistaminic activity and is usehil in the therapy of motion sickness. It may also be effective in the control of post-operative nausea and vomiting. It is classified as FDA Category B for Pregnancy, ie, no demonstrated risks shown in animal studies however, no controlled trials in pregnant women. Large doses may cause drowsiness and dry mouth owing to decreased secretion of saUva. 

Ovarian enlargement, nausea, vomiting, breast tenderness, ectopic pregnancy, abdominal discomfort... 

Dantrolene is the mainstay of MH treatment. It has long been available for the treatment of muscle spasm in cerebral palsy and similar diseases. It is a hydantoin derivative that was first synthesized in 1967, and reported to be effective in the treatment of porcine MH in 1975. Also in 1975, dantrolene was shown to be more effective than procainamide in the treatment of human MH, which until that time was the drug of choice. However, the intravenous preparation was not made available until November 1979. It significantly lowered mortality. The half-life of dantrolene is estimated to be 6-8 hr. Dantrolene s primary mode of action is the reduction in calcium release by the sarcoplasmic reticulum. Dantrolene also exerts a primary antiarrhythmic effect by increasing atrial and ventricular refractory periods. Side effects of dentrolene include hepatotoxicity, muscle weakness, ataxia, blurred vision, slurred speech, nausea, and vomiting. Dantrolene is not contraindicated in pregnancy, but it does cross into breast milk and its effect on the neonate is unknown. 

Recommend a treatment regimen for a patient with nausea and vomiting associated with cancer chemotherapy, surgery, pregnancy, or motion sickness. 

Nausea and vomiting of pregnancy affects the majority of pregnant women the teratogenic potential of the therapy is the primary therapeutic consideration. 

What general considerations about treating nausea and vomiting of pregnancy will you discuss with this patient ... 

American College of Obstetricians and Gynecologists. ACOG practice bulletin nausea and vomiting of pregnancy. Obstet Gynecol 2004 103 803-814. 

Recommend nonpharmacologic therapy for the following disorders when they occur during pregnancy or lactation nausea and vomiting, constipation, heartburn, pain, and cough and cold. 

First trimester Menstrual spotting, missed menses, fatigue, breast tenderness, increased urination, mood swings, nau-sea/vomiting, headache, heartburn, constipation Second trimester Frequent urination, heartburn, constipation, dry skin, edema, linea nigra, melasma Third trimester Backache, edema, shortness of breath Routine Pregnancy Visits... 

Effectiveness of acupuncture and acupressure for nausea and vomiting of pregnancy has not been clearly proven in clinical studies, but both methods are safe to recommend.10,16 Benefits may include a reduction in nausea and dry heaving but not in vomiting.10... 

Hyperemesis gravidarum A rare disorder of severe and persistent nausea and vomiting during pregnancy that can result in dehydration, malnutrition, weight loss, and hospitalization. 

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