Pharmacist Counseling Pearls for Pregnant Patients

APRIL 02, 2015
Pharmacists can play an important role in counseling pregnant women.

For instance, pharmacists can ensure that pregnant patients are not receiving medications that are contraindicated during pregnancy, such as statins. Additionally, patients should take at least 400 mcg of folic acid daily for at least 1 month prior to becoming pregnant and at least 600 mcg of folic acid during pregnancy to prevent neural tube defects.1 

Taking a prenatal vitamin during pregnancy is essential, and they are available as prescription and OTC products. Most prescription prenatal vitamins contain 1 mg of folic acid. Additionally, pharmacists should recommend prenatal vitamins that contain at least 27 mg of iron.

Because prenatal vitamins generally do not contain an adequate amount of calcium, it is essential for pregnant patients to have dietary sources of calcium or take a supplement. In fact, pregnant women aged 19 and older should have 1000 mg of calcium per day.1
 
Both the American College of Obstetricians and Gynecologists and the US Centers for Disease Control and Prevention recommend that pregnant patients receive the inactivated influenza and pertussis (Tdap) vaccines.2,3 Pregnant women are at an increased risk of influenza-related complications, and infants receive immunity through these pregnancy vaccinations. Women should receive the Tdap vaccine between 27 and 36 weeks of each pregnancy and the influenza vaccine at any time during pregnancy.2,3
 
Through an interdisciplinary approach, pharmacists can be a great resource for pregnant patients.
 
References:
  1. The American College of Obstetricians and Gynecologists. Frequently asked questions FAQ001 pregnancy. Available at: http://www.acog.org/-/media/For-Patients/faq001.pdf?dmc=1&ts=20150402T1126130956. Accessed April 2, 2015.
  2. Centers for Disease Control and Prevention. US Department of Health and Human Services. Available at: http://www.cdc.gov/flu/pdf/professionals/providers-letter-pregnant-2014.pdf. Accessed April 2, 2015.
  3. The American College of Obstetricians and Gynecologists. Committee opinion. Available at: http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Update-on-Immunization-and-Pregnancy-Tetanus-Diphtheria-and-Pertussis-Vaccination. Accessed April 2, 2015.


Jennifer Gershman, PharmD, CPh
Jennifer Gershman, PharmD, CPh
Jennifer Gershman, PharmD, CPh, received her PharmD degree from Nova Southeastern University (NSU) College of Pharmacy in 2006 and completed a 2-year drug information residency. She served as a pharmacy professor at NSU’s College of Pharmacy for 6 years, managed the drug information center, and conducted medication therapy management reviews. Dr. Gershman has published research on prescription drug abuse, regulatory issues, and drug information in various scholarly journals. Additionally, she received the Sheriff’s Special Recognition Award for her collaboration with the Broward, Florida Sheriff’s Office to prevent prescription drug abuse through a drug disposal program. She has also presented at pharmacist and physician continuing education programs on topics that include medication errors, prescription drug abuse, and legal and regulatory issues. Dr. Gershman can be followed on Twitter @jgershman2
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