Designing drug regimens for special intensive care unit populations

Table 9 Implications of medications for the pregnant critically ill patient

Indication/class	Specific drug	FDA3	Comments1	Indication/class	Specific drug	FDA3	Comments1
Sedative	Propofol	B		Anticoagulant	Enoxaparin	B
	Midazolam	D			Heparin	C
	Lorazepam	D	Risk (1st and 3rd trimesters)		Fondaparinux	B
	Dexmedetomidine	C			Argatroban	B
Analgesic	Morphine	C	Risk (3rd trimester)	Corticosteroid	Methylprednisolone	C
	Fentanyl	C	Risk (3rd trimester)		Hydrocortisone	C	Data suggest risk
	Hydromorphone	C	Risk (3rd trimester)	Antifungal/antiviral	Voriconazole	D
Delirium	Quetiapine	C	Risk (1st and 3rd trimesters)		Fluconazole	D	Data suggest risk if > 400 mg/d
	Haloperidol	C			Micafungin	C
Pulmonary hypertension	Epoprostenol	B			Amphotericin	B
	Treprostinil	B			Acyclovir	B
	Iloprost	C		Antibiotic	Azithromycin	B
Bronchodilator	Tiotropium	C			Aztreonam	B
	Ipratropium	B			Cefazolin	B
	Albuterol	B			Cefepime	B
	Levalbuterol	C			Cefoxitin	B
Vasoactive	Epinephrine	C	Data suggest risk		Ceftriaxone	B
	Norepinephrine	C	Data suggest risk		Ciprofloxacin	C	Data suggest low risk
	Vasopressin	C			Clindamycin	B
	Phenylephrine	C	Data suggest risk		Linezolid	C
	Dopamine	C			Meropenem	B
	Dobutamine	B			Metronidazole	B	Data suggest low risk
	Milrinone	C			Moxifloxacin	C	Data suggest low risk
Antiarrhythmic	Diltiazem	C	Data suggest low risk		Piperacillin/tazobactam	B
	Amiodarone	D	Data suggest risk		Vancomycin	C
	Digoxin	C		Anti-seizure2	Levetiracetam	C
Antihypertensive	Labetalol	C	Data suggest low risk		Phenytoin	D
	Esmolol	C		Paralytic	Rocuronium	C
	Hydralazine	C	Risk (3rd trimester)		Cisatracurium	B
	Magnesium sulfate	D			Vecuronium	C
	Nitroglycerin	C	Data suggest low risk		Succinylcholine	C
	Sodium nitroprusside	C	Data suggest risk
	ACE-inhibitors	D	Data suggest risk (2nd and 3rd trimesters)
Diuretic	Furosemide	C	Data suggest low risk
	Mannitol	C
GI/antiemetic	Pantoprazole	B	Data suggest low risk
	Famotidine	B
	Ondansetron	B
	Metoclopramide	B
	Erythromycin (non-estolate)	B

¹Human data to suggest risk based on data from Briggs et al[23];

²Pregnant women exposed to AEDs should register with the North American Antiepileptic Drug Pregnancy Registry (888-233-2334);

³Refers to FDA pregnancy rating category. FDA: Food and Drug Administration; ACE: Angiotensin converting enzyme.