Pharmaceutical care for symptoms of allergy during pregnancy and lactation: rational choice and use of antihistamines
DOI:
https://doi.org/10.14739/2310-1210.2020.2.200594Keywords:
questionnaire survey, antihistamines, allergy, pregnancy, lactationAbstract
The aim of this study was to conduct a clinical-pharmaceutical evaluation of the rational choice and use of antihistamines during pregnancy and lactation by questionnaire survey.
Materials and methods. 95 respondents were questioned by a single specially designed protocol, taking into account the problematic issues associated with allergy symptoms during pregnancy/lactation. Methods applied: systematic approach, standardization, clinical-pharmaceutical, anonymous questionnaire, computer data processing, statistical.
Results. It has been established that 71 % of respondents developed symptoms of allergy during pregnancy and/or breastfeeding. Of the 57 women interviewed who reported breastfeeding, only 17 (30 %) had no allergy symptoms. It has been shown that there was no statistically significant difference between the occurrence of allergy symptoms in lactating and non-lactating women (Fischer’s exact criterion was 0.0084; P > 0.05). The most common manifestations of allergy reported by respondents were skin symptoms – 50 %, nose – 43 % and eyes – 16 %. The aforementioned conditions occurred in the first trimester of pregnancy in 26 % of women; during the entire pregnancy – in 25 % and in the II and III trimesters – in 18 %. As the reasons for the allergy symptoms development, 38 % of the respondents reported animal dander; 34 % – pollen of plants; 28 % – household chemicals, 16 % – insect bites and citrus. Regarding the treatment, drugs were prescribed by a doctor only in 39 % of the respondents; 30 % – practiced self-prescribing; 25 % – applied for pharmacist recommendation; 10 % of women used information from the Internet and 4 % – took advice from relatives.
Conclusions. As the majority of women surveyed practiced self-treatment (76 %), one third – self-prescription, we consider that the provision of high-quality pharmaceutical care by a pharmacist while dispensing antihistamines to patients with allergy symptoms during pregnancy and/or lactation, including appointment to a physician, is essential for maximizing the effectiveness and safety of pharmacotherapy. Patients should be consulted by specialists (physician, clinical pharmacist, and pharmacist) before taking any medication during pregnancy/lactation.
References
Kar, S., Krishnan, A., Preetha, K., & Mohankar, A. (2012). A review of antihistamines used during pregnancy. Journal of Pharmacology & Pharmacotherapeutics, 3(2), 105-108. https://doi.org/10.4103/0976-500X.95503
Pukhlik, B. M. (2014). Evolyutsiya allergologii Ukrainy [The evolution of allergology in Ukraine]. Novosti meditsiny i farmatsii, (5), 16-19. [in Russian].
Korchynska, O. O., Kostur, K. P., Kryvanych, N. V., Zhyla, M. M., Zultakova, S., & Galdunova, H. (2017). Osoblyvosti perebihu ta likuvannia alerhichnoho rynitu u vahitnykh [Peculiarities and treatment of allergic rhinitis during pregnancy]. Aktualni pytannia pediatrii, akusherstva ta hinekolohii, (1), 70-75. https://doi.org/10.11603/24116-4944.2017.1.7357 [in Ukrainian].
Pali-Schöll, I., Namazy, J., & Jensen-Jarolim, E. (2017). Allergic diseases and asthma in pregnancy, a secondary publication. World Allergy Organization Journal, 10(1), Article 10. https://doi.org/10.1186/s40413-017-0141-8
Al'oshina, R. M. (2010). Allergicheskie zabolevaniya i beremennost' [Allergic diseases and pregnancy]. Klinichna imunolohiia. Alerholohiia. Infektolohiia, (4), 39-49. https://kiai.com.ua/en-issue-article-470/Allergicheskie-zabolevaniya-i-beremennost. [in Russian].
(2015, March 27). Pollinoz i beremennost': osobennosti kliniki, diagnostiki, lecheniya, profilaktiki [Hay fever and pregnancy: clinical features, diagnosis, treatment, prevention]. Zdorovia Ukrainy. http://health-ua.com/article/15466-pollinoz-i-beremennost-osobennosti-kliniki-diagnostiki-lecheniya-profilakti. [in Russian].
Zaikov, S. V., & Mikhal'chuk, N. A. (2008). Ratsional'naya terapiya allergicheskikh zabolevanii u beremennykh [Rational therapy of allergic diseases in pregnant women]. Klinichna imunolohiia. Alerholohiia. Infektolohiia. Spetsialnyi nomer. Alerhiini zakhvoriuvannia v klinichnii praktytsi. https://kiai.com.ua/ru-issue-article-193/Racionalnaya-terapiya-allergicheskih-zabolevaniy-u-beremennyh. [in Russian].
Shekhtman, M. M. (2013). Rukovodstvo po ekstragenital'noi patologii u beremennykh [Manual on extragenital pathology in pregnant women] (6th ed.). Triada-Kh. [in Russian].
Incaudo, G. A. (2004). Diagnosis and Treatment of Allergic Rhinitis and Sinusitis During Pregnancy and Lactation. Clinical Reviews in Allergy & Immunology, 27(2), 159–178. https://doi.org/10.1385/criai:27:2:159
Department of Pharmaceutical Care (2018, September). Drug Use in Pregnancy & Lactation. Pharmacy & Therapeutic Committee. http://www.imc.med.sa/pharmacy/therapeutics/PBF.pdf.
Easy Fisher Exact Test Calculator. Social Science Statistics. https://www.socscistatistics.com/tests/fisher/default2.aspx
Derzhavnyi reiestr likarskykh zasobiv Ukrainy [State register of medicines of Ukraine]. http://www.drlz.com.ua/. [in Ukrainian].
Stephansson, O., Granath, F., Svensson, T., Haglund, B., Ekbom, A., & Kieler, H. (2011). Drug use during pregnancy in Sweden - assessed by the Prescribed Drug Register and the Medical Birth Register. Clinical epidemiology, 3, 43–50. https://doi.org/10.2147/CLEP.S16305
So, M., Bozzo, P., Inoue, M., & Einarson, A. (2010). Safety of antihistamines during pregnancy and lactation. Canadian family physician Medecin de famille canadien, 56(5), 427-429.
Uddin, S. (2018, May 11). Which oral antihistamines are safe to use whilst breastfeeding? NHS Evidence. Specialist Pharmacy Service. https://www.evidence.nhs.uk/document?id=2014492&returnUrl=search%3fom%3d%5b%7b%22srn%22%3a%5b%22Specialist+Pharmacy+Service%22%5d%7d%5d%26q%3dWhich%2boral%2bantihistamines%2bare%2bsafe%2bto%2buse%2bwhilst%2bbreastfeeding%26sp%3don&q=Which+oral+antihistamines+are+safe+to+use+whilst+breastfeeding.
Cetirizine (Rx, OTC). Medscape. https://reference.medscape.com/drug/quzyttir-zyrtec-cetirizine-343384#6.
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