דחוף

אני נוסעת לאפריקה ואני לא רוצה לקחת את הכדורים של המלריה משום שהם אינם מיועדים לנשים שמנסות להכנס להריון ואני מנסה להיקלט כבר זמן מה. האם אפשר לתת לי מידע בדבר סטטיסטיקות של נזק במידה ולוקחים את התרופה או מה ההשפעה האפשרית על עובר אם לוקחים את התרופה (מלרון) תודה ליאת

לא בכל מקום באפריקה צריך לקחת טיפול מונע במלריה. א. כדאי לבדוק אם היעד של הנסיעה מחייב טיפול מונע. ב. אם היעד הינו איזור אנדמי למלריה, ומומלץ לקבל טיפול, כדאי להתייעץ עם רופא מומחה במרפאת מטיילים, לגבי כל האפשרויות הקיימות במצבך. ג. מלריה מחלה מסוכנת, ואין לזלזל בה.

שלום ליאת, ככלל, מסכים עם כל מילה שנכתבה ע"י "רוקחת ואמא". לגבי הנושא של מלרון והריון (MALARONE = Atovaquone and Proguanil Hcl) קראי את הקטע המובא להלן בנוגע לשאלתך : Pregnancy Category C. Falciparum malaria carries a higher risk of morbidity and mortality in pregnant women than in the general population. Maternal death and fetal loss are both known complications of falciparum malaria in pregnancy. In pregnant women who must travel to malaria-endemic areas, personal protection against mosquito bites should always be employed (see Information for Patients) in addition to antimalarials. Atovaquone was not teratogenic and did not cause reproductive toxicity in rats at maternal plasma concentrations up to 5 to 6.5 times the estimated human exposure during treatment of malaria. Following single-dose administration of 14C-labeled atovaquone to pregnant rats, concentrations of radiolabel in rat fetuses were 18% (mid-gestation) and 60% (late gestation) of concurrent maternal plasma concentrations. In rabbits, atovaquone caused maternal toxicity at plasma concentrations that were approximately 0.6 to 1.3 times the estimated human exposure during treatment of malaria. Adverse fetal effects in rabbits, including decreased fetal body lengths and increased early resorptions and post-implantation losses, were observed only in the presence of maternal toxicity. Concentrations of atovaquone in rabbit fetuses averaged 30% of the concurrent maternal plasma concentrations. The combination of atovaquone and proguanil hydrochloride was not teratogenic in rats at plasma concentrations up to 1.7 and 0.10 times, respectively, the estimated human exposure during treatment of malaria. In rabbits, the combination of atovaquone and proguanil hydrochloride was not teratogenic or embryotoxic to rabbit fetuses at plasma concentrations up to 0.34 and 0.82 times, respectively, the estimated human exposure during treatment of malaria. While there are no adequate and well-controlled studies of atovaquone and/or proguanil hydrochloride in pregnant women, MALARONE may be used if the potential benefit justifies the potential risk to the fetus. The proguanil component of MALARONE acts by inhibiting the parasitic dihydrofolate reductase (see CLINICAL PHARMACOLOGY: Microbiology: Mechanism of Action). However, there are no clinical data indicating that folate supplementation diminishes drug efficacy, and for women of childbearing age receiving folate supplements to prevent neural tube birth defects, such supplements may be continued while taking MALARONE. ואולי גם את הקטע הבא המובא ממקור אחר לגבי מלריה הריון והנקה: Pregnant women are discouraged by the World Health Organisation from travelling to malarious regions where there is chloroquine-resistant falciparum malaria, because malaria increases the risk of abortion, premature birth, still-birth and maternal death. Just as for children, an extra effort should be made to protect yourself from mosquitoes and malaria if you are obliged to travel. If you are planning to travel to a malarious region or have any other travel vaccines, it is very important that you tell your doctor if you are pregnant or planning to become pregnant. Medicines for pregnant women Both chloroquine and proguanil have no special risk for pregnant women, and should be administered together. Pregnant women who use proguanil should also take a daily folic acid supplement. In countries where resistance to chloroquine and proguanil is high, it may be necessary for your doctor to prescribe mefloquine. There is evidence that mefloquine may be associated with an increased risk of stillbirths, so it should only be used during pregnancy if the need for it is great. The decision to prescribe mefloquine is made after weighing up the benefits of preventing malaria, versus the risks of harmful effects on the foetus and the risk of contracting the disease. In scenarios where other medicines are not effective, the benefits of using mefloquine may outweigh the risks, but your doctor would need to decide this in conjunction with you. If pregnant women accidentally take mefloquine during pregnancy, there is no reason to terminate the pregnancy. Malarone should be avoided unless there is no suitable alternative. Pregnant women who use Malarone should also take a daily folic acid supplement. Doxycycline should not be taken by pregnant women. Medicines for breastfeeding mothers Breastfeeding mothers can safely take chloroquine and proguanil. However not enough of these medicines passes into the breast milk to provide protection for the child. Mefloquine, doxycycline and Malarone should not be taken by breastfeeding mothers. בהצלחה ונ.ב. - נא לשמור את המושג דחוף למצבים המתאימים לכותרת זאת. עניין של זילות המושג. חג שמח.