Τόμος 5 (1987) – Τεύχος 3 – Άρθρο 1 – Επιθεώρηση Κλινικής Φαρμακολογίας και Φαρμακοκινητικής-Ελληνική Έκδοση – Volume 5 (1987) – Issue 3 – Article 1 – Epitheorese Klinikes Farmakologias και Farmakokinetikes-Greek Edition

5: 139-154 (1987)

PHARMAKON-Press: Epitheorese Klin. Farmakol. Farmakokinet.

5: 139-154 (1987)

Almost all drugs or pollutants appearing in nursing mother’s blood are also found in the breast milk in concentrations depending upon duration of exposure, route of administration, efficiency of biotransformation and excretory mecha­nisms, relative time between breastfee­ding and administration, interactions be­tween drugs or between a drug and ano­ther compound, previous ingestion or ex­posure, degree of binding to plasma pro­teins etc. On the other hand, absorption of drugs by the nursing infant depends on the functional readiness of the gastrointe­stinal tract and may be modified by factors such as gastric emptying time, GI motility, gastric pH, interaction of drugs with com­ponents of the GI tract, dietary factors, effective surface area etc. However, phy­siologic variations which occur in the first week of the life may limit or facilitate drug absorption. Excretion remains the most im­portant factor for the determination of drugs effects, because rates of drug meta­bolism are slower at the time of birth. Drugs taken by the mother for which breastfeeding is general contraindicated. Analgesics (long term use); anticoagulants (e.g. ethylbiscoumacetate, phenindione-ex­cept heparin and warfarin); antimicrobial agents (e.g. chlοramphenicοl, sulfonami­des, tetracyclines); antithyroid drugs (e.g. carbimazole, methimazole, thiouracil – ex­cept propylthiouracil); ergot and ergot deri­vatives (e.g. bromocriptine, ergotamine); antirheumatics (e.g. high doses of indome­thacin, gold preparations); immunosup­pressive-cytotoxic agents; hormonal ste­roids (e.g. oestrogen-progestogen combi­nation oral contraceptives); antianxiety-an­tipsychotic drugs (e.g. diazepam, lithium carbonate); cardiac drugs (e.g. reserpine, quinidine); radioactive drugs (e.g. iodine); social drugs (e.g. alcohol-excessive, can­nabis, cocaine, D-lysergic acid-LSD); cime­tidine; environmental pollutants (mercury, hexachlorobenzene, polyhalogenated bi­phenyls – PCΒ₅, ΡΒΒ₅); fava beans. Some drugs which have been reported to cause adverse effects in breast fed infants: Alcohol, caffeine, heroin, nicotine; antibacterial (e.g. ampicillin, benzylpenicil­lin, clindamycin, dapsone, metronidazole, nalidixic acid); anaesthetics (e.g. chloro­form); antiepileptic – antianxiety – antipsy­chotic drugs (e.g. diazepam, phenobarbito­ne, phenytoin, chloropramazine, lithium); laxatives (e.g. cascara, danthron, senna); miscellaneous: bethanechol, bromides, chloral hydrate, pregnane, reserpine, theo­phylline, vitamin D.

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