I N T E R N A L M E D I C I N E N E W S • S e p t e m b e r 1 5 , 2 0 0 5
D R U G S , P R E G N A N C Y ,
L A C T A T I O N
B Y S H A R O N W O R C E S T E R
The autoimmune disorder traindicated in pregnancy. Exposure of
S T. P E T E B E A C H , F L A . — A total of
228 adverse events associated with the use
fluoxetine, 9 with sertraline, and 7 with
ate is contraindicated during pregnancy.
nancy, the incidence is about 1 in 1,000.
Administration’s Adverse Event Reporting
System since the drug’s approval in 1998,
J. Edward Fisher, Jr., Ph.D., reported at the
large study, the association between parox-
factor–α (TNF-α) and interleukin-1 in
annual meeting of the Teratology Society.
riod for structural defects is 8-10 weeks
after the first day of the last menstrual
developmental events, including 38 during
the peri- or postnatal period. Of the 38 cas-
Fisher and the other reports involving var-
es, 31 occurred during the first week of life,
gest a class effect. But the data cannot ver-
rigidity, tremor, and confusion associated
ify significant differences among individual
with citalopram exposure in either the 3rd
drugs in this class, he told this newspaper.
As a rule, "the use of this agent has to
be balanced with respect to the benefit to
mg/day, said Dr. Fisher, a pharmacologist
the mother if she is depressed. There is a
are preferable to tricyclics in terms of safe-
ty and efficacy," said Jeffrey Jonas, M.D., se-
B Y G E R A L D G .
nior vice president of Forest Research In-
B R I G G S , B . P H A R M .
ciated with maternal use of selective sero-
tonin reuptake inhibitors (SSRIs) and se-
lective norepinephrine reuptake inhibitors
risks and benefits of SSRI and SNRI use in
(SNRIs) prompted the FDA last year to re-
quire labeling changes warning of the risk
risk of maternal morbidity associated with
chelating agent associated with a risk of
associated with their use during pregnancy.
fetal connective tissue defects (cutis laxa),
with their long elimination half-lives, in-
conception, fetal renal toxicity, and pre-
esis of unplanned pregnancies is likely.
B Y N A N C Y A . M E LV I L L E
C o n t r i b u t i n g Wr i t e r
ble transient side effects after use of anti-
T U C S O N , A R I Z . — Recent research
depressants late in pregnancy, but the few
carries a low risk for oral clefts and pro-
linking use of selective serotonin reuptake
long-term studies that have looked at the
topic did not find any lasting consequences
be carries its own serious risks, Marlene
ative effects on maternal weight gain and
the child’s birth weight as well as an in-
drawal syndrome” in the first days of life
the U.S. Food and Drug Administration.
that is linked to SSRI use, especially to
With its own letter rating system consid-
own officials, according to Dr. Freeman—
to be highly unreliable, the agency is talk-
Organization database of adverse drug re-
professionals can call the toll-free num-
actions. Researchers reported 93 suspect-
about enrolling patients in this study.
and it “raises more questions than it an-
specialist, Women’s Pavilion at Miller
Children’s Hospital, Long Beach, Calif.;
“Discuss the risks and benefits of anti-
clinical professor of pharmacy, University
anxiety disorders played a role. Also, there
depressant treatment and seek advice from
of California, San Francisco, and adjunct
was no clear denominator, so it’s not clear
other clinicians,” Dr. Freeman advised at
professor of pharmacy, University of
Southern California, Los Angeles. He also
medications and did not have the problems,
“It’s definitely important to use the low-
is coauthor of the reference book, “Drugs
said Dr. Freeman, director of the women’s
est effective doses, but we also don’t want
mental health program at the university.
Produits de coupe de la cocaïne La cocaïne est souvent un mélange de cocaïne et d'une ou plusieurs substances utilisées afin d’en augmenter la volume. Une partie des produits de coupe n’est pas psychoactive (par exemple le lactose) et au-delà des effets de la consommation de cocaïne, ces substances n’ont pas ultérieures conséquences physiques et psychiques. To
NOTIFICATION S.R.O.574(I)/2012. - In exercise of the powers conferred by section 19 of the Customs Act, 1969 (IV of 1969), the Federal Government is pleased to direct that the following further amendments shall be made in its Notification No. S.R.O. 567(I)/2006, the brackets and letters “PACCS” shall be omitted; and in clause (a), for the expression “Ministry of Health”, the expres