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Authors
Abstract(s)
Introdução e objetivos: Na prĂĄtica clĂnica, Ă© comum observar-se alguma
insegurança por parte dos profissionais de saĂșde relativamente Ă abordagem
farmacoterapĂȘutica a adotar em lactantes. Dados os inĂșmeros benefĂcios associados ao
aleitamento materno, importa esclarecer qual deve ser o procedimento a seguir, tendo em
conta a evidĂȘncia cientĂfica atual. Assim, os objetivos do trabalho consistiram em: analisar
os fatores que determinam a transferĂȘncia dos fĂĄrmacos para o leite materno; investigar que
fĂłrmulas existem para calcular a quantidade de substĂąncia a que o lactente estĂĄ exposto
através do leite materno; e inferir acerca da segurança de determinados medicamentos para
os lactentes, verificando a sua compatibilidade com a amamentação.
MĂ©todos: A metodologia de trabalho desta revisĂŁo bibliogrĂĄfica assentou na pesquisa
em bases de dados online, nomeadamente PubMed, Science Direct e Google Scholar,
utilizando como termos de pesquisa as palavras-chave: breastfeeding, breast milk,
lactation e drugs. A pesquisa, realizada entre julho e outubro de 2020, restringiu-se a
artigos publicados nas lĂnguas portuguesa e inglesa entre 2000 e 2020. Adicionalmente,
foram consultados livros e websites relevantes na ĂĄrea.
ConclusĂ”es: A maior parte dos medicamentos demonstrou ser compatĂvel com a
amamentação. As taxas de excreção da maioria dos fårmacos comummente prescritos são
reduzidas e nĂŁo existem registos de efeitos adversos significativos em lactentes. Os fĂĄrmacos
que constituem a exceção, estando contraindicados durante a amamentação, são, por
exemplo, o lĂtio, a amiodarona, a isotretinoĂna oral e diversos citostĂĄticos.
Muita da evidĂȘncia existente sobre esta temĂĄtica baseia-se em estudos de casos
individuais, o que é uma limitação à extrapolação dos resultados para a população geral.
Assim, conclui-se ser necessårio investir em métodos informatizados que permitam prever
individualmente qual o nĂvel de transferĂȘncia de cada fĂĄrmaco para o leite materno.
Enquanto tal nĂŁo se encontra implementado, os dados disponĂveis transmitem a segurança
necessåria para a prescrição da maioria dos medicamentos em lactantes.
Introduction and objectives: In clinical practice, it is common to observe some insecurity of health professionals regarding the pharmacotherapeutic approach to be adopted in lactating women. Given the countless benefits associated with breastfeeding, it is important to clarify which procedure should be followed, considering the current scientific evidence. Thus, the objectives of the work were: to analyse the factors that determine the transfer of drugs to breast milk; to investigate what formulas exist to calculate the amount of substance to which the infant is exposed through breast milk; and to infer about the safety of certain medications for infants, checking their compatibility with breastfeeding. Methods: The work methodology of this narrative review was based on research in online databases, namely PubMed, Science Direct and Google Scholar, using the keywords: breastfeeding, breast milk, lactation and drugs as search terms. The survey, carried out between July and October 2020, was restricted to articles published in Portuguese and in English between 2000 and 2020. In addition, relevant books and websites were consulted in the area. Conclusions: Most medications have been shown to be compatible with breastfeeding. The excretion rates of most commonly prescribed drugs are low and there are no reports of significant adverse effects in infants. The drugs that constitute the exception, being contraindicated during breastfeeding, are, for example, lithium, amiodarone, oral isotretinoin and several cytostatics. Much of the existing evidence on this topic is based on individual case studies, which is a limitation to extrapolating the results to the general population. Thus, itâs necessary to invest in computerized methods that allow to predict individually the level of transfer of each drug to breast milk. While this is not yet implemented, the available data provide the necessary security for the prescription of most medications in lactating women.
Introduction and objectives: In clinical practice, it is common to observe some insecurity of health professionals regarding the pharmacotherapeutic approach to be adopted in lactating women. Given the countless benefits associated with breastfeeding, it is important to clarify which procedure should be followed, considering the current scientific evidence. Thus, the objectives of the work were: to analyse the factors that determine the transfer of drugs to breast milk; to investigate what formulas exist to calculate the amount of substance to which the infant is exposed through breast milk; and to infer about the safety of certain medications for infants, checking their compatibility with breastfeeding. Methods: The work methodology of this narrative review was based on research in online databases, namely PubMed, Science Direct and Google Scholar, using the keywords: breastfeeding, breast milk, lactation and drugs as search terms. The survey, carried out between July and October 2020, was restricted to articles published in Portuguese and in English between 2000 and 2020. In addition, relevant books and websites were consulted in the area. Conclusions: Most medications have been shown to be compatible with breastfeeding. The excretion rates of most commonly prescribed drugs are low and there are no reports of significant adverse effects in infants. The drugs that constitute the exception, being contraindicated during breastfeeding, are, for example, lithium, amiodarone, oral isotretinoin and several cytostatics. Much of the existing evidence on this topic is based on individual case studies, which is a limitation to extrapolating the results to the general population. Thus, itâs necessary to invest in computerized methods that allow to predict individually the level of transfer of each drug to breast milk. While this is not yet implemented, the available data provide the necessary security for the prescription of most medications in lactating women.
Description
Keywords
Amamentação Fårmacos Lactação Leite Materno