Dopegit during pregnancy

Dopegit during pregnancy is the number one remedy for the treatment of late gestosis. To fully understand the needs of this drug, you need to know about the causes of development of toxicoses of pregnant women.

Gestosis is a state of a woman that develops in connection with pregnancy and is caused by the presence of a fetal egg in the uterine cavity and has various clinical manifestations. By the time gestosis is divided into early and late. The earliest occur in the first half of pregnancy, and they are associated with the development and formation of the placenta. Fetus is an agent alien to the body of a woman, in fact 50% of the information it contains from the pope. The immune system of a woman perceives it as an antibody to some extent, therefore, until the moment of formation of its placenta with an individual barrier and blood flow, the child is the target. Therefore, there are a number of manifestations, which are called early gestosis. These include nausea, vomiting, hypersalivation, dermatosis. These manifestations do not require intensive medication if they do not violate the general condition of the woman. They usually pass themselves after the placenta has formed.

Late gestosis occurs in the second half of pregnancy. They are caused by polysystemic multi-organ reaction to fetal development. That is, it is the reaction of the maternal organism itself, which is a more serious and dangerous phenomenon requiring medical intervention. The late gestosis includes:

• NELP-syndrome is a symptom complex that includes intravascular hemolysis, elevation of hepatic enzymes, and a decrease in the number of platelets in the peripheral blood.
• Acute yellow fatty degeneration of the liver.
• Pre-eclampsia of mild, moderate and severe
• Eclampsia.

These conditions pose a direct threat to the life of women and children, therefore they require mandatory qualified intervention.

One such condition is pre-eclampsia - an increase in blood pressure in combination with proteinuria in a woman during pregnancy on late lines. It is necessary to distinguish between primary preeclampsia or gestational hypertension, which was not observed in a woman before and develops only during pregnancy not earlier than the 20th week, and chronic - pressure increase before the 20th week or hypertensive disease in a woman before pregnancy. The treatment of these two pathologies has distinctive features.

[1], [2], [3], [4]

The main characteristic of dopegit

Indications for the use of dopegita: this medication is prescribed for the treatment of hypertension in pregnant women. In older people, the drug is used to treat Parkinson's disease.

Form release : dopegit released in the form of tablets of 250 mg.

Pharmacokinetics and pharmacodynamics : dopegit or methyldopa is the central antihypertensive agent that reduces arterial pressure by stimulating alpha 2-adrenergic receptors. Stimulation of these receptors is accompanied by depression of the sympathetic nervous system and reduction of nerve impulses, which is manifested in the relaxation of peripheral arterial vessels. In addition, dopegit reduces the amount of renin in the plasma, which increases the blood flow in the kidneys and complements its antihypertensive effect. It also reduces the heart rate and cardiac output.

The drug begins to act four to six hours after admission, but its effect persists for almost a day or a half, which allows taking a daily dose of the whole time.

The drug is half absorbed in the gastrointestinal tract, and then about ten percent penetrate the blood-brain barrier, which corresponds to the maximum effect. Dopegit is excreted by the kidneys. The half-life of the substance is about two hours.

Contraindications and side effects of dopegitis during pregnancy : the main contraindications are liver pathology with cytolysis syndrome, acute renal failure, hepatitis, hemolytic hereditary anemia, the use of drugs acting on the central nervous system, acute and chronic cardiac pathologies in a state of decompensation.

The main side effects are :

• the state of the central nervous system in the form of inhibition, fatigue, mood changes, decreased efficiency, dizziness.
• pressure differences in the form of orthostatic hypertension in the first application.
• changes in internal organs: enlargement of the liver and spleen, jaundice, increase in the concentration of liver enzymes, nausea and vomiting, violation of intestinal motility.
• influence on hemopoiesis in the form of oppression of the hematopoietic germ.
• changes in the immune status and allergic manifestations.

Dopegit dose in pregnancy: the drug is prescribed for 250 milligrams, starting with the lowest dose, that is, one tablet. At the first time methyldopa is prescribed for the night, and then the amount of the drug is increased to the minimum dose, which effectively maintains the pressure level within the normative values. The optimal frequency of application is 3-4 times a day.

The maximum dose of dopegit during pregnancy is 3 grams per day.

It is necessary to cancel the medicine gradually, on the same principle as prescribed, leaving the smallest dose that controls the pressure.

An overdose of the drug is manifested by a decrease in blood pressure, weakness, hypodynamia, lethargy, a decrease in heart rate, drowsiness, decreased tone and intestinal motility.

Interaction of dopegit with other medications : The simultaneous use of methyldopa with drugs that affect the central nervous system (antidepressants, MAO inhibitors), as well as with similar alpha-adrenomimetics, can increase the side effects of the drug. Then, there can be severe conduction hypotension. Use with beta-blockers increases the risk of developing acute vascular insufficiency. And the simultaneous use of non-steroidal anti-inflammatory drugs reduces the antihypertensive effect of dopegit.

Conditions and periods of storage - the storage period is not more than 18 months, it is necessary to ensure a temperature regime of not more than twenty-five degrees and to protect from direct influence of low temperatures and humidity.

Whether it is possible dopegit at pregnancy?

The question of antihypertensive therapy during pregnancy is very important, because any medicines that are prescribed to the mother fall into the fetal bloodstream and affect its development. The question of the harm of medicines for a child is discussed very often, and a common opinion that can be expressed is that there are no medications that would not affect the fetus, but here it is necessary to choose the smallest of the two evils. That is, a drug whose effect on the fetus is not teratogenic, has an advantage in application.

Now it is necessary to understand what antihypertensive drugs are recommended for the treatment of preeclampsia.

In therapy, there are five main groups of antihypertensive agents - ACE inhibitors, angiotensin II receptor blockers, beta-blockers, diuretics and calcium antagonists. In pregnant women the principles of using these drugs are slightly different.

ACE inhibitors are categorically contraindicated in pregnant women, because they have an effect on the fetal kidneys - they depress their excretory function and contribute to the development of aridity, especially in the second and third trimester. If a woman before pregnancy took these drugs, then you should replace them with others. This same tactic is necessary in case of treatment with calcium antagonists.

Diuretics in pregnant women do not use, as they reduce BCC and prevent physiological fluid retention, which threatens the development of fetal hypoxia.

Beta-blockers negatively affect the fetus, but at the same time, do not have a teratogenic effect. They cause a delay in intrauterine development, the birth of a child with a small body weight. But these drugs are used as a backup therapy. The drug of choice is labetolol, which owns internal sympathomimetic activity, that is, it additionally dilates the blood vessels.

Pregnant women give an advantage to antihypertensive agents of central action. These include clonidine and dopegit. Therefore, it can be said for sure that dopegit can be used during pregnancy, it is a drug of choice.

If the symptoms of hypertension occurred before week 34, then starting from the 22nd or 24th week in parallel with the therapy of pre-eclampsia, prophylaxis of the respiratory distress syndrome of the fetus using dexamethasone or betaspan (beclomethasone). This is also an important stage of complex treatment. It is necessary during this period to conduct all the additional diagnostic methods for determining the fetal condition - cardiotocography, Doppler scanning and ultrasound scanning with the definition of utero-placental blood circulation.

Dopegit and other means

There are situations in which the use of methyldopa is contraindicated or there is a need to combine several different drugs, then they come to a choice of one more remedy.

With regard to the use of beta-blockers with dopegit during pregnancy, there is an opinion that this is not a very good combination, as beta-blockers show their main effect in the form of a reduction in the heart rate. A dopegit also has this effect, so hypotension can be so pronounced that a fetal hypoxia will occur that threatens the development of various complications.

It is better to use methyldopa with nifedipine. It manifests its effect in 40-60 minutes, which can be the initial stage of therapy, and then its action will show and dopegite, maintaining pressure throughout the day.

The use of dopegit with vasodilators (no-shpa, papaverine) also contributes to prolonged hypotension, but it is necessary to monitor the condition of the pregnant woman, since significant swelling may develop due to the concomitant expansion of arterioles and the deposition of blood in them.

Analogues of dopegit during pregnancy can be:

• clonidine (clofhellin);
• nifedipine 10 mg;
• labetolol;
• magnesia sulfate.

These drugs are in the next place after dopegit.

Dopegit during pregnancy is the drug of choice for the treatment of preeclampsia. Due to the proven absence of a bad effect on the fetus, it is successfully used to treat this pathology and shows good efficacy. But the appointment of this drug should be carried out only if there are strict indications, in spite of the clinical effect, it still has its side effects. When signs of high blood pressure, such as headache, pain in suits, nasal congestion, dizziness - a pregnant woman should consult a doctor, because timely treatment prevents the development of complications from the child and the mother during childbirth. Dopegit should be prescribed only by a personal doctor, do not rely on the advice of girlfriends, because in your hands, not only your health, but the health and life of your future baby. Dosage of dopegit is also individual and is selected by monitoring the condition of a woman and blood pressure. Following all the doctor's recommendations, you will save your pregnancy.

[5], [6], [7], [8]