Tom 16, Nr 2 (2020)
Artykuł przeglądowy
Opublikowany online: 2020-06-30
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Leki przeciwpadaczkowe i bezpieczeństwo ich stosowania w okresie ciąży i karmienia piersią — przegląd aktualnych danych
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Pol. Przegl. Neurol 2020;16(2):88-104.
Streszczenie
Leczenie padaczki (epilepsji) u kobiety w ciąży to zadanie dla neurologa oraz ginekologa-położnika. Stosowanie leków przeciwpadaczkowych jest konieczne, mimo że może prowadzić do aberracji w przebiegu ciąży, ponieważ nieleczona padaczka stanowi zagrożenie dla matki i rozwijającego się płodu. FDA (Food and Drug Administration) oraz ADEC (Australian Drug Evaluation Comittee) wprowadziły klasyfikacje mające na celu określenie ryzyka uszkodzenia zarodka/płodu w wyniku stosowania leków. Najstarsze leki przeciwpadaczkowe (leki I-generacji) są bardzo skuteczne, jednakże wiadomo, ze ich stosowanie niesie ze sobą największe ryzyko indukcji anomalii u płodu. Dodatkowo, podobnie jak w przypadku stosowania benzodiazepin, istnieje ryzyko rozwoju u noworodków syndromu odstawienia. Leki II-generacji nie zostały dotychczas dokładnie przebadane pod kątem działania embriotoksycznego i teratogennego. Jednakże dostępne dane sugerują, że są to leki bezpieczniejsze. Benzodiazepiny stanowią odrębną grupę leków o potencjale przeciwdrgawkowym. Podawanie tych leków w okresie ciąży musi być wysoce uzasadnione, biorąc pod uwagę bilans korzyści i istotnych zagrożeń wynikających z ich stosowania.
Słowa kluczowe: leki przeciwpadaczkoweciążaokres laktacji
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