Ethical Uses Of Nifedipines

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Nifedipine

Nifedipine is a common drug used to treat a variety of disorders from hypertension and angina to preventing premature labour in pregnancy (Aedla, N, et al. 2012). It originated in the early 1970’s from the works of Bayer, who developed the short-acting formulation that proved to be successful in controlling high blood pressure, however due to its side effects, was modified to a long-acting formula which produced fewer side effects and is commonly used in modern obstetric practice (Aedla, N, et al. 2012).

The use of Nifedipine is well established for controlling hypertension in those who struggle with hypertensive disorders, including pregnant women and the wider population, (Aedla, N, et al. 2012) although the focus of this assignment
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Category C drugs are suspected of causing fetal harm during pregnancy that may be reversible, however the use of category C drugs is somewhat contradicted and a risks verse benefits model of care should be consulted before the use of Nifedipine (Australia, M 2016 & Department of Health Therapeutic Goods Administration (TGA) 2011). Due to ethical limitations on drug trials in pregnancy, there is very limited evidence on the safety, efficacy and ideal dosing regime for many drugs in pregnancy. Hence why drug categorisation is a necessity during pregnancy to aid in the limitation of fetal exposure to potentially teratogenic substances (TGA …show more content…
Maternal contraindications for Nifedipine use include: hypotension (as this can be exacerbated by the effects of Nifedipine on smooth muscle and carries the potential for fetal hypoxia), advanced cervical dilation as birth is most likely imminent and should not be prevented, allergy to Nifedipine, cardiac disease, (which may also be exacerbated by the effects of Nifedipine), hepatic dysfunction, concurrent use of IV Salbutamol and the use of Magnesium Sulfate (SAMNCN 2014).

Similarly, fetal contraindications for the use of Nifedipine include: proven intrauterine infection, fetal compromise requiring prompt delivery which includes obstetric emergencies such as placental abruption, severe growth restriction, lethal fetal abnormalities and intrauterine fetal death (IUFD) (SAMNCN 2014). Nifedipine is contraindicated in the above scenarios, as it is safer for the baby to be delivered than to prolong the pregnancy and prevent labour, which would be considered more detrimental to the fetus or mother (SAMNCN

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