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[(drocodone)-213.8(and)-217.6(oxycodone)-213.8(also)-212.8(partially)-220.1(undergo)-216.2(metabolism)]TJ
T*
[(by)-244.1(CYP2D6)-251.1(to)-244.2(more)-248.7(potent)-244.2(metabolites,)-251(the)-246.5(parent)-245.2(drug)-246.3(also)]TJ
0 -1.1174 TD
[(exerts)-314.1(an)-308.6(analgesic)-319.9(effect)-309.7(and)-315.5(there)-313.2(is)-307.4(less)-310.6(concern)-316.4(over)-310.8(the)]TJ
0 -1.1116 TD
[(clinical)-283.5(effects)-287.5(of)-278.6(variation)-283.3(in)-278.8(metabolism.)]TJ
/F10 1 Tf
7.9702 0 0 7.9702 81.9779 644.2581 Tm
()Tj
/F8 1 Tf
9.843 0 0 9.843 90.822 642.9542 Tm
[(Hydrocodone.)-750.2(Hydrocodone)-741(has)-741.5(been)-744(used)-742.6(fre-)]TJ
T*
[(quently)-429.6(in)-417(breastfeeding)-433.7(mothers.)-422.4(Occasional)-425.6(cases)]TJ
0 -1.1174 TD
[(of)-595.4(neonatal)-594.3(sedation)-592.9(have)-594.2(been)-594.2(documented,)-595.3(but)]TJ
0 -1.1116 TD
[(these)-341.8(are)-345.4(rare)-340.7(and)-338.5(generally)-341.9(dose)-339.4(related.)]TJ
7.3823 0 0 6.5614 257.159 614.4376 Tm
(39,40)Tj
9.843 0 0 9.843 277.1149 610.0723 Tm
(Doses)Tj
-18.9264 -1.1116 TD
[(in)-324.9(breastfeeding)-324.2(mothers)-326.8(should)-323.3(be)-320.1(limited)-321.6(to)-324.9(30)-163.5(mg)]TJ
0 -1.1174 TD
[(per)-338.5(day.)]TJ
7.3823 0 0 6.5614 123.4771 592.5542 Tm
(40)Tj
9.843 0 0 9.843 134.1354 588.1321 Tm
(\(III\))Tj
/F10 1 Tf
7.9702 0 0 7.9702 81.9779 578.4943 Tm
()Tj
/F8 1 Tf
9.843 0 0 9.843 90.822 577.1904 Tm
[(Oxyco)-7.5(done.)-521.6(Oxycodone)-520(levels)-521.6(in)-520.7(milk)-524.3(have)-519.3(been)]TJ
0 -1.1116 TD
[(studie)-7.8(d,)-557.5(with)-558.5(a)-560.9(range)-560.7(of)-560.9(5226)]TJ
/F12 1 Tf
13.9039 0 TD
(l)Tj
/F8 1 Tf
.5529 0 TD
[(g/L)-563.3(\(RID)-559.2(up)-560.9(to)]TJ
-14.4569 -1.1116 TD
(8%\).)Tj
7.3823 0 0 6.5614 109.7007 559.6723 Tm
(41)Tj
9.843 0 0 9.843 121.1527 555.3069 Tm
[(One)-414.3(retrospective)-416.5(study)-414.4(showed)-411.6(that)-414.8(one)-413.4(in)]TJ
-3.0814 -1.1174 TD
[(ve)-257.7(breastfed)-260.9(infants)-262.3(with)-259(mothers)-257.7(taking)-255.7(oxycodone)]TJ
0 -1.1116 TD
[(experience)-11.2(d)-340.9(central)-351.2(nervous)-348.5(system)-348.6(depression.)-344.8(The)]TJ
T*
[(strong)-628.6(concordance)-634.2(between)-628.5(maternal)-630(and)-632.3(infant)]TJ
0 -1.1174 TD
[(symptoms)-356.6(may)-351.3(be)-354.7(used)-351(to)-353.7(identify)-350.2(infants)-354.5(at)-354.8(higher)]TJ
0 -1.1116 TD
[(risk.)-266.9(It)-261.5(is)-267.1(important)-260.3(to)-267.3(monitor)-262.6(these)-267(infants)-262.3(carefully)]TJ
T*
[(for)-780.8(drowsiness.)]TJ
7.3823 0 0 6.5614 156.1322 493.9085 Tm
(42)Tj
9.843 0 0 9.843 171.2125 489.5432 Tm
[(\(III\))-777.1(LactMed)-785.2(recommends)-782.8(a)]TJ
-8.1673 -1.1174 TD
[(maximum)-341(total)-341.1(daily)-341(dose)-339.4(of)-336.2(30)-169.2(mg,)]TJ
7.3823 0 0 6.5614 237.8267 482.9668 Tm
(43)Tj
9.843 0 0 9.843 248.5417 478.5447 Tm
[(and)-338.5(the)-338.7(AAP)]TJ
-16.0235 -1.1116 TD
[(advises)-378.4(against)-373(the)-373.2(use)-372.9(of)-370.8(the)-367.5(medication)-379(in)-370.9(breast-)]TJ
T*
[(feeding)-338.4(mothers.)]TJ
7.3823 0 0 6.5614 158.0031 461.0267 Tm
(11)Tj
9.843 0 0 9.843 168.7181 456.6613 Tm
(\(IV\))Tj
/F10 1 Tf
7.9702 0 0 7.9702 81.9779 446.9668 Tm
()Tj
/F8 1 Tf
9.843 0 0 9.843 90.822 445.7196 Tm
[(Codei)-7.8(ne.)-329.3(A)-336(report)-336.1(of)-330.5(a)-336.3(neonatal)-335.1(death)-336.3(following)-333.7(the)]TJ
0 -1.1174 TD
[(maternal)-537.9(use)-534.2(of)-532.1(codeine)-535.5(suggests)-533.7(that)-535.7(the)-534.5(use)-534.2(of)]TJ
0 -1.1116 TD
[(codei)-8(ne)-492.9(in)-491.9(breastfeeding)-502.8(mothers)-493.8(should)-496.1(be)-498.7(limit-)]TJ
T*
(ed.)Tj
7.3823 0 0 6.5614 102.6141 417.203 Tm
(44)Tj
9.843 0 0 9.843 114.4063 412.8377 Tm
[(Although)-447.7(rare,)-442.1(rapid)-444.5(metabolizers)-451.2(of)-445.7(codeine)]TJ
-2.396 -1.1174 TD
[(exist,)-436.4(and)-430.7(levels)-435.2(of)-434.1(morphine)-431.8(follow)-7.7(ing)-429.6(the)-430.8(use)-436.2(of)]TJ
0 -1.1116 TD
[(codei)-8(ne)-377.7(may)-385.8(be)-383.5(unexpectedly)-386.8(and)-378.8(signicantly)-384.3(ele-)]TJ
T*
[(vated)-8(,)-268.4(thus)-275(putting)-273(a)-273(breast)-8.8(feeding)-275.1(infant)-272.9(at)-274.2(risk.)-272.7(The)]TJ
0 -1.1174 TD
[(FDA)-390.8(in)-382.5(2017)-384.5(issued)-387.6(an)-383.5(advisory)-384.3(against)-390.2(the)-384.7(use)-384.4(of)]TJ
0 -1.1116 TD
[(the)-344.4(medication)-350.2(in)-342.1(breastfeeding)-353(mothers)-344.1(in)-342.1(the)-344.4(Uni-)]TJ
T*
[(ted)-488.4(States)]TJ
7.3823 0 0 6.5614 131.3008 351.4393 Tm
(45)Tj
9.843 0 0 9.843 138.7275 347.0739 Tm
[(;)-485(\(IV\))-489(it)-486.3(continues)-490.4(to)-486.1(be)-487.2(prescribed)-492.4(in)]TJ
-4.867 -1.1174 TD
[(other)-398.4(areas)-400.4(of)-393.8(the)-396.3(world,)-401.6(but)-395.1(other)-398.4(medications)-397.2(are)]TJ
0 -1.1116 TD
[(preferred)-341.6(when)-334.7(available.)]TJ
7.3823 0 0 6.5614 193.2094 329.4991 Tm
(12,46)Tj
/F10 1 Tf
7.9702 0 0 7.9702 81.9779 315.496 Tm
()Tj
/F8 1 Tf
9.843 0 0 9.843 90.822 314.192 Tm
[(Tra)11.7(mad)11.6(ol.)-351.3(Tr)13.9(ama)10.4(dol)-349(is)-353.5(a)-365.1(wea)16.5(k)-364(opi)13.8(oi)15(d)-364(wit)12.8(h)-358.2(a)0(n)-354.7(add)12.8(i-)]TJ
T*
[(tio)13.7(nal)-252.3(ac)12.8(tiv)13.7(ity)-251.2(at)-251.2(cen)11.7(tra)12.7(l)-254.7(nor)14(epi)12.7(nep)12.8(hri)19.6(ne)-256.8(and)-246.4(ser)13(oto)13.9(nin)]TJ
0 -1.1174 TD
[(rec)11.7(ept)12.7(ors)14.2(.)-239.6(Lik)12.7(e)-238.4(cod)12.8(ein)12.7(e,)-230.3(it)-238.6(nee)17.4(ds)-238.2(to)-232.7(be)-233.7(met)11.5(abo)12.8(liz)12.6(ed)-233.7(by)]TJ
0 -1.1116 TD
[(CYP)12.2(2D6)-246.1(to)-250(an)-245.3(act)11.5(ive)-240.7(met)11.5(abo)12.8(lit)13.6(e)-249.9(t)0(o)-250(exe)11.7(rt)-250(it)14.8(s)-254.3(ana)11.7(lge)12.7(sic)]TJ
T*
[(eff)12.9(ect)11.5(s.)-275(Wi)12.7(th)-273(an)-274.1(RID)-264.4(of)]TJ
/F11 1 Tf
9.7512 0 TD
(<)Tj
/F8 1 Tf
.5472 0 TD
[(1%)-274(of)-267.1(the)-269.5(act)11.5(ive)-269.5(me)12.7(tab)12.7(oli)13.7(te)]TJ
-10.2984 -1.1174 TD
[(and)-459.5(no)-463(rep)12.8(ort)13.9(ed)-464.1(eff)12.9(ec)12.8(ts)-462.9(in)-463.1(bre)12.8(ast)12.9(fed)-459.4(inf)13.9(an)13.9(ts,)-460.6(it)-463.2(has)]TJ
0 -1.1116 TD
[(pre)12.8(vio)13.8(usl)14(y)-358.2(bee)11.7(n)-352.4(con)12.8(sid)14(ere)11.7(d)-358.2(a)-353.6(saf)13(e)-359.4(cho)12.8(ice)-345.6(for)-348.8(bre)12.8(ast)12.9(-)]TJ
T*
[(fee)11.7(din)13.9(g)-277.6(m)0(o)13.8(the)12.7(rs.)]TJ
7.3823 0 0 6.5614 156.7559 241.8519 Tm
[(47)17(49)]TJ
9.843 0 0 9.843 177.7322 237.4866 Tm
[(How)12.2(eve)11.7(r,)-269.4(the)-263.8(FDA)-269.8(ha)13.9(s)-277.4(adv)12.8(ise)12.9(d)]TJ
-8.8296 -1.1174 TD
[(aga)11.7(ins)14(t)-456.2(the)-448.1(use)-453.5(of)-451.4(thi)13.7(s)-455.9(med)17.3(ica)11.5(tio)13.7(n)-456.1(i)0(n)-451.6(bre)12.8(ast)12.9(fee)11.7(din)13.8(g)]TJ
0 -1.1116 TD
[(mot)12.6(her)12.8(s)-329.2(i)0(n)-324.9(the)-315.6(Uni)13(ted)-321.4(Sta)12.8(tes)12.9(.)]TJ
7.3823 0 0 6.5614 207.2125 219.9117 Tm
(45)Tj
9.843 0 0 9.843 217.8141 215.5464 Tm
[(\(IV)13.2(\))]TJ
-14.814 -1.6703 TD
[(Regardless)-464.5(of)-462.9(the)-465.4(opioid)-461.9(chosen,)-461.4(the)-465.4(dose)-460.4(needs)-462.7(to)-463.1(be)]TJ
-1.0137 -1.1116 TD
[(carefully)-572.3(considered.)-570.8(Virtually)-576.9(any)-568.9(opioid)-565.6(may)-570.1(be)-567.8(used)]TJ
T*
[(transiently,)-369.5(but)-360.5(infants)-366(should)-363.6(be)-360.5(monitored)-369.6(for)-360.3(sedation,)]TJ
7.3823 0 0 6.5614 293.7259 181.5874 Tm
(13)Tj
9.843 0 0 9.843 62.022 166.2236 Tm
[(especially)-401.8(when)-398.1(these)-399.4(medications)-397.2(are)-397.3(used)-397(for)-400.7(more)-392.7(than)]TJ
T*
[(4)-237.2(days.)]TJ
7.3823 0 0 6.5614 89.8015 159.6472 Tm
(6)Tj
9.843 0 0 9.843 95.8677 155.2818 Tm
[(Note)-237(that)-242(mothers)-240.4(on)-238.3(chronic)-240.5(opioid)-237.3(therapy)-240.5(may)-241.8(be)]TJ
-3.4385 -1.1116 TD
[(using)-385.6(exceedingly)-391.4(high)-384.7(doses)-386.4(of)-388.1(hydrocodone,)-386.5(oxycodone,)]TJ
0 -1.1174 TD
[(methadone,)-473.2(and)-476.8(other)-473.3(opioid)-467.6(analg)-8(esics)-474.1(that)-472.4(were)-474.1(started)]TJ
0 -1.1116 TD
[(before)-233.5(or)-226.8(during)-225.6(pregnancy.)-229.9(Safety)-233.5(of)-226.8(breastfeeding)-232.1(for)-227.9(these)]TJ
T*
[(patients)-282(should)-283(be)-279.8(considered)-285.1(on)-278.7(an)-285.6(individual)-277.6(basis.)]TJ
/F2 1 Tf
8.9663 0 0 8.9663 72 89.4614 Tm
[(Nonsteroidal)-452.1(anti-inammatory)-445(drug)-451.7(analgesics.)]TJ
/F8 1 Tf
9.843 0 0 9.843 274.0535 89.4614 Tm
[(Use)-373.8(of)]TJ
-21.5413 -1.1174 TD
[(non)14(ste)12.9(roi)13.9(dal)-355.9(ant)12.7(i-i)13.8(na)18.7(mma)10.4(tor)13.9(y)-364(dru)14(gs)-359.1(\(NS)13.3(AID)12.3(s\))-364.8(al)13.8(one)-361.6(or)-359.3(in)]TJ
0 -1.1116 TD
[(com)11.6(bin)13.8(at)13.8(ion)-481.5(wit)12.8(h)-490.7(opi)13.8(oid)13.9(s)-490.5(a)0(f)13.9(ter)-482.6(sur)14.2(ger)12.8(y)-490.7(can)-483.7(im)13.7(pro)14(ve)-487.2(pai)12.7(n)]TJ
T*
[(con)12.8(tro)13.9(l)-202.8(due)-194.5(to)-203.9(the)12.7(ir)-198.1(ant)12.7(i-i)13.8(na)18.7(mma)10.4(tor)13.9(y)-202.7(pro)14(per)12.8(tie)12.6(s.)-200.2(NSA)12.4(ID)14.2(s)-208.3(are)]TJ
25.504 67.9242 TD
[(gen)12.8(era)11.7(lly)-360.7(saf)13(e)-370.9(for)-360.3(bre)12.8(ast)12.9(fee)11.7(din)13.8(g)-369.7(and)-361.6(can)-362.7(hel)12.7(p)-369.7(min)12.6(im)13.7(ize)-362.9(the)]TJ
0 -1.1174 TD
[(tot)13.7(al)-274.2(dos)14.2(e)-278.7(o)0(f)-278.6(opi)19.6(oid)-274.1(ne)13.9(ede)11.7(d)-277.6(t)0(o)-273(con)12.8(tro)13.9(l)-277.7(pai)12.7(n.)]TJ
7.3823 0 0 6.5614 483.0802 718.5825 Tm
[(50)17(,51)]TJ
9.843 0 0 9.843 502.2424 714.1605 Tm
[(\(II)14.1(I\))-272.8(In)-272.9(add)12.8(i-)]TJ
-19.2201 -1.1116 TD
[(tio)13.7(n,)-206.1(due)-200.3(to)-209.7(the)12.7(ir)-203.9(low)-200.1(lip)13.7(id)-203.9(sol)14(ubi)13.8(lit)13.6(y)-208.4(and)-206.1(hig)13.8(h)-208.4(pro)14(tei)12.6(n)-208.5(bin)13.9(din)13.8(g,)]TJ
T*
[(NSA)12.4(IDs)-176.7(hav)12.8(e)-186.6(lim)18.3(ite)12.6(d)-185.4(tra)12.7(nsf)14.2(er)-181.9(in)15(to)-180.9(bre)12.8(ast)-177.2(mil)12.5(k)-179.7(\(mi)12.6(lk)-180.9(to)-180.9(pla)18.4(sma)]TJ
T*
[(rat)12.7(ios)]TJ
/F11 1 Tf
2.4709 0 TD
(<)Tj
/F8 1 Tf
.5472 0 TD
(1\).)Tj
7.3823 0 0 6.5614 353.3102 685.7006 Tm
(52)Tj
9.843 0 0 9.843 363.2314 681.3352 Tm
[(Whi)11.6(le)-262.7(tra)12.7(nsf)14.2(er)-262.5(of)-261.4(NSA)18.2(IDs)-257.4(to)-261.5(bre)12.8(ast)-257.8(mil)12.5(k)-266(i)0(s)-261.3(low)13(,)]TJ
-5.0973 -1.1174 TD
[(thi)13.7(s)-317.7(cla)11.5(ss)-307.1(of)-307.4(med)11.6(ica)11.5(tio)13.7(ns)-307.3(sho)14.2(uld)-302.9(be)-308.6(avo)12.8(ide)12.7(d)-312.1(i)0(n)-307.6(mot)12.6(her)12.8(s)-311.9(wit)12.8(h)]TJ
0 -1.1116 TD
[(inf)13.9(ant)12.7(s)-277.4(who)-263.4(hav)12.8(e)-278.7(d)0(u)15.1(cta)11.5(l-d)13.9(epe)11.7(nde)12.8(nt)-267.3(car)11.7(dia)12.7(c)-273(les)12.9(ion)13.9(s.)]TJ
7.3823 0 0 6.5614 513.6377 663.7605 Tm
(11)Tj
/F10 1 Tf
7.9702 0 0 7.9702 323.0361 644.2581 Tm
()Tj
/F8 1 Tf
9.843 0 0 9.843 331.9369 642.9542 Tm
-.0217 Tc
[(I)-5.5(bup)-5.5(rof)-5.5(e)-.9(n.)-422.5(Ibu)-5.5(p).2(r)-5.5(o).2(fe)-6.7(n)-414.5(i)-5.7(s)-414.3(c)-6.7(ons)-5.3(id)-5.5(ere)-6.7(d)-414.4(a)-6.7(n)-414.4(i)-5.7(d).2(ea)-6.7(l,)-416.8(mo)-5.5(der)-5.5(a)-.9(te)-6.7(ly)]TJ
T*
[(ef)-5.4(fe)-6.6(cti)-5.5(v).3(e)-260(a)-.8(na)-6.6(lge)-6.6(s).5(ic)-6.6(.)-255.4(I)-5.4(ts)-258.6(tra)-6.6(n).3(s)-5.2(f).4(er)-258.8(to)-258.8(mi)-5.5(lk)-258.8(is)-258.6(lo)-5.4(w)-253.9(t)-5.5(o)-258.8(n).3(il)-5.5(.)]TJ
7.3823 0 0 6.5614 527.0739 636.3778 Tm
-.0315 Tc
(53)Tj
9.843 0 0 9.843 536.5416 632.0125 Tm
-.0162 Tc
[(\(I)5.8(II)5.8(\))]TJ
/F10 1 Tf
7.9702 0 0 7.9702 323.0361 622.3179 Tm
0 Tc
()Tj
/F8 1 Tf
9.843 0 0 9.843 331.9369 621.014 Tm
[(Ketorolac.)-484.5(Ketorolac)-475.3(is)-480.2(a)-474.6(potent)-480.3(analgesic)-481.2(in)-474.6(breast-)]TJ
T*
[(feeding)-453.6(mothers)-459.3(and)-453.7(increasingly)-454.6(popular)-458.2(when)-455.7(used)]TJ
T*
[(postoperatively.)-461.5(Its)-452.5(primary)-453.7(benet)-458.2(is)-451.4(excellent)-458.5(anal-)]TJ
0 -1.1174 TD
[(gesia,)-592.9(with)-593(no)-583.9(sedative)-594.1(properties.)-592.7(In)-589.6(addition,)-595.5(the)]TJ
0 -1.1116 TD
[(transfer)-598.5(of)-589.7(ketorolac)-595.4(into)-592.1(milk)-593.4(is)-595.4(extremely)-596.6(low.)]TJ
7.3823 0 0 6.5614 544.762 581.5558 Tm
(54)Tj
9.843 0 0 9.843 331.9369 566.2487 Tm
[(However,)-395.3(its)-395(use)-395.9(in)-394(postsurgical)-395.7(patients)-397.2(with)-391.4(hemor-)]TJ
T*
[(rhage)-382.2(may)-385.8(be)-383.5(risky)-379.8(as)-383.3(it)-382.6(inhibits)-383.5(platelet)-387.2(function,)-382.3(al-)]TJ
0 -1.1174 TD
[(though)-300.5(this)-304(is)-301.6(somewhat)-306.9(controversial.)-309.4(It)-301.8(should)-306(not)-297.2(be)]TJ
0 -1.1116 TD
[(used)-397(in)-399.7(patients)-397.2(with)-403(a)-393.9(history)-399.4(of)-399.6(gastritis,)-400.5(aspirin)-394.8(al-)]TJ
T*
[(lergy,)-568.9(or)-572.4(renal)-566.6(insufciency.)-573(If)-572.3(there)-572.4(is)-566.6(no)-566.6(risk)-568.7(of)]TJ
0 -1.1174 TD
[(hemorrhage,)-514.4(it)-509.3(carries)-517.9(few)-512.1(complications)-514.7(for)-510.1(breast-)]TJ
0 -1.1116 TD
[(feeding)-338.4(mothers)-332.6(and)-338.5(their)-335.2(infants.)-334.9(\(III\))]TJ
/F10 1 Tf
7.9702 0 0 7.9702 323.0361 490.8471 Tm
()Tj
/F8 1 Tf
9.843 0 0 9.843 331.9369 489.5432 Tm
[(Ce)18.6(le)19.6(c)15(o)0(x)20.8(i)0(b)20.7(.)-228.1(Ce)18.6(le)19.6(c)15(o)0(x)20.8(i)0(b)-221.2(t)0(r)20.7(a)15(ns)21(fe)19.7(r)-231.4(i)0(n)26.5(t)0(o)-221.2(m)0(i)19.5(l)16.1(k)-231.5(i)0(s)-221(e)15(xt)20.7(ra)19.7(or)20.9(di)20.7(na)25.4(ri)20.7(ly)]TJ
0 -1.1174 TD
[(lo)20.7(w)-313(\()]TJ
/F11 1 Tf
2.1138 0 TD
(<)Tj
/F8 1 Tf
.5414 0 TD
[(0.)24.3(3%)-302.8(of)-301.7(th)20.7(e)-313.3(w)0(e)18.8(i)0(g)20.7(h)0(t)20.7(-)0(a)25.5(d)0(j)20.7(u)0(s)21(t)0(e)19.5(d)-312.1(ma)18.4(te)25.3(rn)20.9(al)-303(do)20.8(se)19.9(\).)]TJ
7.3823 0 0 6.5614 532.1762 482.9668 Tm
(55)Tj
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[(at)-1162.8(https://toxnet.nlm.nih.gov/cgi-bin/sis/search2/f?./temp/)]TJ
/F14 1 Tf
0 -1.1284 TD
(*)Tj
/F8 1 Tf
1.0003 0 TD
[(BojiMV:1)-334.4(\(accessed)-340(May)-333.3(17,)-335.8(2017\).)]TJ
-2.7508 -1.1223 TD
[(23.)-500.5(Nakanishi)-424(R,)-419.7(Yoshimura)-422.3(M,)-420.3(Suno)-418.2(M,)-420.3(et)-418.7(al.)-424.8(Detection)-422.4(of)]TJ
1.7505 -1.1284 TD
[(dexmedetomidine)-754.4(in)-756(human)-754.7(breast)-754.2(milk)-755.3(using)-749.5(liquid)]TJ
0 -1.1223 TD
[(chromatography-tandem)-273(mass)-270.9(spectrometry:)-272.3(Application)-271.6(to)]TJ
0 -1.1284 TD
[(a)-358.1(study)-353(of)-356.4(drug)-356.7(safety)-351.7(in)-359.6(breastfeeding)-356.8(after)-360.9(cesarean)-359.1(sec-)]TJ
0 -1.1223 TD
(tion.)Tj
/F4 1 Tf
2.3665 0 TD
[(J)-559.4(Chromatogr)-560.5(B)-557.1(Analyt)-560.8(Technol)-554.6(Biomed)-563(Life)-555.5(Sci)]TJ
/F8 1 Tf
-2.3665 -1.1284 TD
(2017;1040:208213.)Tj
-1.7505 -1.1223 TD
[(24.)-500.5(U.S.)-590.4(Food)-582.9(and)-590.2(Drug)-590(Administration.)-591.6(FDA)-585.9(drug)-588.4(safety)]TJ
1.7505 -1.1284 TD
[(communication:)-255.5(FDA)-256.5(review)-256.6(results)-254.7(in)-249.8(new)-256.3(warnings)-251.8(about)]TJ
0 -1.1223 TD
[(using)-590.9(general)-600.9(anesthetics)-594.4(and)-596.3(sedation)-593.1(drugs)-593.8(in)-597.4(young)]TJ
0 -1.1284 TD
[(children)-321.8(and)-321.8(pregnant)-322.4(women.)-323.3(Updated)-327.6(2016.)-317.8(Available)-324.8(at)]TJ
0 -1.1223 TD
[(www.fda.gov/Drugs/DrugSafety/ucm532356.htm)-263.9(\(accessed)]TJ
0 -1.1284 TD
[(May)-333.3(20,)-335.8(2017\).)]TJ
-1.7505 -1.1223 TD
[(25.)-500.5(Fraser)-461.2(D,)-453.1(Turner)-462.9(JW.)-455.2(Myasthenia)-456.5(gravis)-463.4(and)-456(pregnancy.)]TJ
/F4 1 Tf
1.7505 -1.1284 TD
[(Proc)-335.1(R)-331.4(Soc)-334(Med)]TJ
/F8 1 Tf
7.1239 0 TD
(1963;56:379381.)Tj
-8.8744 -1.1223 TD
[(26.)-500.5(Ha)18.3(rd)21.8(el)20.5(l)-170.3(L)0(I)19.9(,)-170.8(Li)16.7(nd)24.1(s)12.9(t)0(r)16.3(o)0(m)-158.4(B)0(,)-163.6(L)0(o)22.2(n)0(n)24.1(e)0(r)17.6(h)0(o)24.1(l)0(m)-164(G)0(,)-160.4(e)0(t)-162.5(a)0(l)20.5(.)-170.8(Py)21.2(ri)16.3(do)24.1(s)12.9(t)0(i)19.2(g)0(m)18.5(i)12.6(ne)]TJ
1.7505 -1.1284 TD
-.013 Tc
[(in)-202.2(h)-13(u)11.1(ma)-13(n)-188.3(b)-13(r)8.8(e)-13(ast)-201.6(m)-.5(il)-13(k)5.6(.)]TJ
/F4 1 Tf
8.5877 0 TD
0 Tc
[(Br)-172.1(J)-187.3(C)0(l)19.9(i)12.6(n)-189.2(P)0(h)22.2(a)0(r)18.9(m)0(a)22.5(c)14(ol)]TJ
/F8 1 Tf
8.234 0 TD
[(19)18(82)24.1(;)12.6(1)0(4)18(:)12.6(56)18(5)24.1(56)24.1(7.)]TJ
-18.5722 -1.1223 TD
[(27.)-500.5(Merck)-608.4(&)-603.5(Co.)-602.9(I.)-600.3(Sugammadex)-607.7(prescribing)-610.3(information.)]TJ
1.7505 -1.1284 TD
[(Available)-562.7(at:)-564.6(www.merck.com/product/usa/pi_circulars/b/)]TJ
0 -1.1223 TD
[(bridion/bridion_pi.pdf)-336(\(accessed)-340(on)-329.6(May)-339.4(17,)-329.7(17\).)]TJ
-1.7505 -1.1284 TD
[(28.)-500.5(Cada)-642(DJ,)-647.6(Levien)-644.9(TL,)-644.6(Baker)-644.5(DE.)-638.2(Sugammadex.)]TJ
/F4 1 Tf
23.6223 0 TD
(Hosp)Tj
-21.8719 -1.1223 TD
(Pharm)Tj
/F8 1 Tf
3.0496 0 TD
(2016;51:585596.)Tj
-4.8001 -1.1284 TD
[(29.)-500.5(Sokol-Kobielska)-264.9(E.)-264.4(SugammadexIndications)-270.1(and)-260.8(clinical)]TJ
1.7505 -1.1223 TD
(use.)Tj
/F4 1 Tf
1.9152 0 TD
[(Anaesthesiol)-337.9(Intensive)-337.5(Ther)]TJ
/F8 1 Tf
11.6373 0 TD
(2013;45:106110.)Tj
-15.303 -1.1284 TD
[(30.)-500.5(National)-332.7(Library)-328.3(of)-332(Medicine.)-335.2(Prochlorperazine.)-331(In:)-331.5(Drugs)]TJ
1.7505 -1.1284 TD
[(and)-254.7(lactation)-249.5(database)-260.5(\(LactMed\).)-251(Updated)-254.4(2015.)-250.7(Available)]TJ
0 -1.1223 TD
[(at)-1162.8(https://toxnet.nlm.nih.gov/cgi-bin/sis/search2/f?./temp/)]TJ
/F14 1 Tf
0 -1.1284 TD
(*)Tj
/F8 1 Tf
1.0003 0 TD
[(7SuYzf:1)-334.8(\(accessed)-340(May)-333.3(17,)-335.8(2017\).)]TJ
-2.7508 -1.1223 TD
[(31.)-500.5(National)-271.7(Library)-267.3(of)-264.9(Medicine.)-268.1(Promethazine.)-272.4(In:)-264.4(Drugs)-266(and)]TJ
1.7505 -1.1284 TD
[(lactation)-597.2(database)-589.9(\(LactMed\).)-598.6(Updated)-589.9(2015.)-592.3(Available)]TJ
0 -1.1223 TD
.0118 Tc
[(at)-591.6(htt)11.8(p)-6.2(s:)11.8(/)-5.6(/to)5.6(xnet)11.8(.)-6.1(nl)11.8(m)-5.8(.)-.5(n)5.6(i)0(h.)5.6(go)5.6(v/cg)5.6(i-b)5.6(i)0(n)5.6(/)0(sis/)11.8(search)5.6(2/f?./)11.8(t)-5.6(e)1.4(mp)5.6(/)]TJ
/F14 1 Tf
0 -1.1284 TD
0 Tc
(*)Tj
/F8 1 Tf
1.0003 0 TD
[(vcQMox:1)-335(\(accessed)-340(May)-333.3(17,)-335.8(2017\).)]TJ
-2.7508 -1.1223 TD
[(32.)-500.5(National)-308.3(Library)-310(of)-307.6(Medicine.)-304.7(Scopolamine.)-314.5(In:)-301(Drugs)-308.7(and)]TJ
1.7505 -1.1284 TD
[(lactation)-597.2(database)-589.9(\(LactMed\).)-598.6(Updated)-589.9(2015.)-592.3(Available)]TJ
0 -1.1223 TD
[(at)-1162.8(https://toxnet.nlm.nih.gov/cgi-bin/sis/search2/f?./temp/)]TJ
/F14 1 Tf
0 -1.1284 TD
(*)Tj
/F8 1 Tf
1.0003 0 TD
[(HqD17Y:1.)-334.8(\(accessed)-340(May)-333.3(17,)-335.8(2017\).)]TJ
-2.7508 -1.1223 TD
[(33.)-500.5(Wittels)-506.5(B,)-499(Scott)-506.8(DT,)-504(Sinatra)-501.4(RS.)-502.1(Exogenous)-506.7(opioids)-499.1(in)]TJ
1.7505 -1.1284 TD
[(human)-461.9(breast)-467.6(milk)-462.5(and)-462.1(acute)-464.1(neonatal)-464(neurobehavior:)-469.5(A)]TJ
0 -1.1223 TD
[(preliminary)-335.8(study.)]TJ
/F4 1 Tf
7.7704 0 TD
(Anesthesiology)Tj
/F8 1 Tf
6.4042 0 TD
(1990;73:864869.)Tj
-15.9251 -1.1284 TD
[(34.)-500.5(Wittels)-378.4(B,)-371(Glosten)-376.8(B,)-371(Faure)-380.3(EA,)-369.8(et)-376(al.)-376(Postcesarean)-379.4(anal-)]TJ
1.7505 -1.1223 TD
[(gesia)-288.2(with)-293.8(both)-286.7(epidural)-291.3(morphine)-287.3(and)-291.3(intravenous)-290.9(patient-)]TJ
0 -1.1284 TD
[(controlled)-644.8(analgesia:)-643.9(Neurobehavioral)-652.3(outcomes)-642(among)]TJ
0 -1.1223 TD
[(nursing)-331.2(neonates.)]TJ
/F4 1 Tf
7.4289 0 TD
[(Anesth)-334.9(Analg)]TJ
/F8 1 Tf
5.7882 0 TD
(1997;85:600606.)Tj
12.0399 70.8975 TD
[(35.)-500.5(Leuschen)-246.6(MP,)-234.3(Wolf)-238.4(LJ,)-239.2(Rayburn)-238(WF.)-239.4(Fentanyl)-243.1(excretion)-240.8(in)]TJ
1.7505 -1.1223 TD
[(breast)-339.5(milk.)]TJ
/F4 1 Tf
5.16 0 TD
[(Clin)-333.6(Pharm)]TJ
/F8 1 Tf
5.1112 0 TD
(1990;9:336337.)Tj
-12.0216 -1.1284 TD
[(36.)-500.5(Madej)-245.7(TH,)-241.7(Strunin)-243(L.)-240(Comparison)-242.6(of)-240.5(epidural)-242.5(fentanyl)-242.5(with)]TJ
1.7505 -1.1223 TD
[(sufentanil.)-400(Analgesia)-397.7(and)-401.1(side)-393.7(effects)-401.1(after)-397.4(a)-394.7(single)-399.5(bolus)]TJ
0 -1.1283 TD
[(dose)-382.1(during)-374.7(elective)-382.2(caesarean)-387.8(section.)]TJ
/F4 1 Tf
16.474 0 TD
(Anaesthesia)Tj
/F8 1 Tf
5.2209 0 TD
(1987;)Tj
9.2951 0 0 9.2951 329.329 672.888 Tm
(42:11561161.)Tj
-1.7505 -1.1284 TD
[(37.)-500.5(Edwards)-601.7(JE,)-599.1(Rudy)-603.1(AC,)-598.3(Wermeling)-600.3(DP,)-602.6(et)-595.5(al.)-601.7(Hydro-)]TJ
1.7505 -1.1223 TD
[(morphone)-354.9(transfer)-350.5(into)-353.2(breast)-351.7(milk)-352.7(after)-354.8(intranasal)-355.3(admin-)]TJ
0 -1.1284 TD
(istration.)Tj
/F4 1 Tf
3.8791 0 TD
(Pharmacotherapy)Tj
/F8 1 Tf
7.563 0 TD
(2003;23:153158.)Tj
-13.1926 -1.1223 TD
[(38.)-500.5(Schultz)-291.7(ML,)-288.2(Kostic)-285.2(M,)-286.1(Kharasch)-291.3(S.)-283.7(A)-288.4(case)-292.9(of)-283.2(toxic)-290.4(breast-)]TJ
1.7505 -1.1284 TD
(feeding?)Tj
/F4 1 Tf
4.2939 0 TD
[(Pediatr)-840.7(Emerg)-830.9(Care)]TJ
/F8 1 Tf
10.1796 0 TD
[(2017.)-836.3(DOI:)-835(10.1097/)]TJ
-14.4735 -1.1223 TD
(PEC.0000000000001009.)Tj
-1.7505 -1.1284 TD
[(39.)-500.5(Anderson)-386.5(PO,)-383(Sauberan)-391(JB,)-382.4(Lane)-389(JR,)-382.4(et)-382.1(al.)-388.2(Hydrocodone)]TJ
1.7505 -1.1284 TD
[(excretion)-484.7(into)-481.3(breast)-479.8(milk:)-480.4(The)-476.2(rst)-480.1(two)-483.3(reported)-477.2(cases.)]TJ
/F4 1 Tf
0 -1.1223 TD
[(Breastfeed)-342.4(Med)]TJ
/F8 1 Tf
6.7397 0 TD
(2007;2:1014.)Tj
-8.4901 -1.1284 TD
[(40.)-500.5(Sauberan)-464.2(JB,)-455.6(Anderson)-459.7(PO,)-456.2(Lane)-462.2(JR,)-455.6(et)-455.3(al.)-461.4(Breast)-460.2(milk)]TJ
1.7505 -1.1223 TD
[(hydrocodone)-402.7(and)-395(hydromorphone)-400.7(levels)-397.6(in)-396.2(mothers)-402.1(using)]TJ
0 -1.1284 TD
[(hydrocodone)-482(for)-474.7(postpartum)-475.2(pain.)]TJ
/F4 1 Tf
14.7845 0 TD
[(Obstet)-480.4(Gynecol)]TJ
/F8 1 Tf
6.9104 0 TD
(2011;)Tj
-21.695 -1.1223 TD
(117:611617.)Tj
-1.7505 -1.1284 TD
[(41.)-500.5(Marx)-347.9(CM,)-352.1(Pucino)-349(F,)-344.7(Carlson)-346.3(JD,)-348.7(et)-351.6(al.)-345.5(Oxycodone)-346.8(excre-)]TJ
1.7505 -1.1223 TD
[(tion)-469.1(in)-469.3(human)-468(milk)-468.6(in)-469.3(the)-473.7(puerperium.)]TJ
/F4 1 Tf
17.084 0 TD
[(Drug)-464.8(Intell)-475.3(Clin)]TJ
-17.084 -1.1284 TD
(Pharm)Tj
/F8 1 Tf
3.0557 0 TD
(1986;20:474.)Tj
-4.8062 -1.1223 TD
[(42.)-500.5(Lam)-341.5(J,)-340.9(Kelly)-340.8(L,)-337.6(Ciszkowski)-338.5(C,)-340.5(et)-339.4(al.)-339.4(Central)-338.6(nervous)-342.1(sys-)]TJ
1.7505 -1.1284 TD
[(tem)-314.7(depression)-320.9(of)-313.7(neonates)-317.3(breastfed)-316(by)-311.3(mothers)-316.7(receiving)]TJ
0 -1.1223 TD
[(oxycodone)-400.1(for)-401.5(postpartum)-402(analgesia.)]TJ
/F4 1 Tf
15.6567 0 TD
[(J)-400.8(Pediatr)]TJ
/F8 1 Tf
4.2573 0 TD
(2012;160:)Tj
-19.914 -1.1284 TD
(3337.e2.)Tj
-1.7505 -1.1223 TD
[(43.)-500.5(National)-399.8(Library)-401.5(of)-393(Medicine.)-396.2(Oxycodone.)-401.7(In:)-392.5(Drugs)-400.2(and)]TJ
1.7505 -1.1284 TD
[(lactation)-377.6(database)-376.4(\(LactMed\).)-373(Updated)-376.4(2017.)-366.6(Available)-373.6(at)]TJ
0 -1.1223 TD
.0359 Tc
[(htt)5.8(p)-.8(s:)5.8(//t)5.8(ox)5.3(net.)5.3(nl)5.8(m.n)5.3(i)-.3(h)5.3(.)-.8(g)5.3(ov/)5.8(cgi)5.8(-)-3.2(b)5.3(i)-.3(n)5.3(/)-.3(sis)6.1(/)-.3(search2)5.3(/)-.3(f?./)5.8(temp)5.3(/)]TJ
/F14 1 Tf
0 -1.1284 TD
0 Tc
(*)Tj
/F8 1 Tf
1.0003 0 TD
[(r97Ebu:1)-334.2(\(accessed)-340(May)-333.3(17,)-335.8(2017\).)]TJ
-2.7508 -1.1223 TD
[(44.)-500.5(Koren)-344.3(G,)-337.2(Cairns)-340.1(J,)-334.8(Chitayat)-342(D,)-337.2(et)-339.4(al.)-339.5(Pharmacogenetics)-341.4(of)]TJ
1.7505 -1.1284 TD
[(morphine)-427.5(poisoning)-432.3(in)-426.7(a)-425.2(breastfed)-431.9(neonate)-427.8(of)-429.6(a)-425.2(codeine-)]TJ
0 -1.1223 TD
[(prescribed)-340.5(mother.)]TJ
/F4 1 Tf
7.9412 0 TD
(Lancet)Tj
/F8 1 Tf
3.0618 0 TD
(2006;368:704704.)Tj
-12.7535 -1.1284 TD
[(45.)-500.5(U.S.)-590.4(Food)-589(and)-584.1(Drug)-590(Administration.)-591.6(FDA)-585.9(drug)-588.4(safety)]TJ
1.7505 -1.1223 TD
[(communication:)-371.4(FDA)-366.3(restricts)-370.7(use)-369.7(of)-362.5(prescription)-372(codeine)]TJ
0 -1.1284 TD
[(pain)-339.7(and)-334(cough)-334.3(medicines)-334.7(and)-340.1(tramadol)-333.6(pain)-333.6(medicines)-340.8(in)]TJ
0 -1.1223 TD
[(children;)-290.9(recommends)-289.1(against)-288(use)-290.4(in)-286.4(breastfeeding)-289.7(women.)]TJ
0 -1.1284 TD
[(Updated)-803.3(2017.)-805.8(Available)-800.6(at)-802.9(www.fda.gov/Drugs/Drug)]TJ
0 -1.1223 TD
[(Safety/ucm549679.htm)-341.4(\(accessed)-340(May)-333.3(17,)-329.7(2017\).)]TJ
-1.7505 -1.1284 TD
[(46.)-500.5(Madadi)-349.5(P,)-344.7(Moretti)-346.6(M,)-347.1(Djokanovic)-345.8(N,)-343.3(et)-345.5(al.)-345.5(Guidelines)-350.4(for)]TJ
1.7505 -1.1223 TD
[(maternal)-709.8(codeine)-708.4(use)-705.2(during)-704(breastfeeding.)]TJ
/F4 1 Tf
19.7737 0 TD
[(Can)-700.5(Fam)]TJ
-19.7737 -1.1284 TD
(Physician)Tj
/F8 1 Tf
4.2939 0 TD
(2009;55:10771078.)Tj
-6.0443 -1.1223 TD
[(47.)-500.5(Ilett)-377.6(KF,)-376.9(Paech)-376.1(MJ,)-376.9(Page-Sharp)-378.3(M,)-371.5(et)-376(al.)-376(Use)-377.4(of)-374.7(a)-376.4(sparse)]TJ
1.7505 -1.1284 TD
[(sampling)-277.4(study)-267.6(design)-272(to)-268.1(assess)-274.1(transfer)-277.3(of)-271(tramadol)-272.6(and)-273(its)]TJ
0 -1.1223 TD
[(O-desmethyl)-365.2(metabolite)-365.1(into)-365.4(transitional)-362.5(breast)-363.9(milk.)]TJ
/F4 1 Tf
22.1646 0 TD
[(Br)-367.2(J)]TJ
-22.1646 -1.1284 TD
[(Clin)-339.7(Pharmacol)]TJ
/F8 1 Tf
6.8433 0 TD
(2008;65:661666.)Tj
-8.5938 -1.1284 TD
[(48.)-500.5(Salman)-371(S,)-369.1(Sy)-369.1(SK,)-370.8(Ilett)-371.5(KF,)-370.8(et)-369.9(al.)-369.9(Population)-366.7(pharmacoki-)]TJ
1.7505 -1.1223 TD
[(netic)-288.5(modeling)-290.5(of)-283.2(tramadol)-284.8(and)-291.3(its)-285.1(O-desmethyl)-285.9(metabolite)]TJ
0 -1.1284 TD
[(in)-304.7(plasma)-306.3(and)-303.5(breast)-302.9(milk.)]TJ
/F4 1 Tf
11.0762 0 TD
[(Eur)-306.4(J)-303.2(Clin)-303.1(Pharmacol)]TJ
/F8 1 Tf
9.3379 0 TD
(2011;67:)Tj
-20.4141 -1.1223 TD
(899908.)Tj
-1.7505 -1.1284 TD
[(49.)-500.5(National)-503.5(Library)-499.1(of)-496.6(Medicine.)-499.9(Tramadol.)-494.7(In:)-502.3(Drugs)-497.8(and)]TJ
1.7505 -1.1223 TD
[(lactation)-597.2(database)-596(\(LactMed\).)-592.5(Updated)-596(2017.)-592.3(Available)]TJ
0 -1.1284 TD
[(at)-1162.8(https://toxnet.nlm.nih.gov/cgi-bin/sis/search2/f?./temp/)]TJ
/F14 1 Tf
0 -1.1223 TD
(*)Tj
/F8 1 Tf
1.0003 0 TD
[(1vlzLz:1)-339.7(\(accessed)-340(May)-333.3(18,)-329.7(2017\).)]TJ
-2.7508 -1.1284 TD
[(50.)-500.5(Gadsden)-363.9(J,)-359.2(Hart)-361.9(S,)-356.9(Santos)-360.3(AC.)-360.5(Post-cesarean)-363.6(delivery)-364.5(an-)]TJ
1.7505 -1.1223 TD
(algesia.)Tj
/F4 1 Tf
3.379 0 TD
[(Anesth)-334.9(Analg)]TJ
/F8 1 Tf
5.7882 0 TD
(2005;101:S62S69.)Tj
-10.9176 -1.1284 TD
[(51.)-500.5(Sutton)-447.9(CD,)-452(Carvalho)-449.2(B.)-450.2(Optimal)-449.9(pain)-443.4(management)-456(after)]TJ
1.7505 -1.1223 TD
[(cesarean)-340.8(delivery.)]TJ
/F4 1 Tf
7.6667 0 TD
[(Anesthesiol)-337.8(Clin)]TJ
/F8 1 Tf
7.0202 0 TD
(2017;35:107124.)Tj
-16.4374 -1.1284 TD
[(52.)-500.5(Bloor)-397.6(M,)-402(Paech)-400.5(M.)-395.9(Nonsteroidal)-401.8(anti-inammatory)-397.5(drugs)]TJ
1.7505 -1.1223 TD
[(during)-514.9(pregnancy)-516.4(and)-510.9(the)-516.4(initiation)-514.5(of)-514.9(lactation.)]TJ
/F4 1 Tf
21.2497 0 TD
(Anesth)Tj
-21.2497 -1.1284 TD
(Analg)Tj
/F8 1 Tf
2.7325 0 TD
(2013;116:10631075.)Tj
-4.4829 -1.1223 TD
[(53.)-500.5(Weibert)-545.6(RT,)-543.8(Townsend)-544.7(RJ,)-547.1(Kaiser)-542.4(DG,)-546.3(et)-540.7(al.)-546.8(Lack)-541.5(of)]TJ
1.7505 -1.1284 TD
[(ibuprofen)-369.4(secretion)-368(into)-365.4(human)-370.5(milk.)]TJ
/F4 1 Tf
15.736 0 TD
[(Clin)-364.1(Pharm)]TJ
/F8 1 Tf
5.1782 0 TD
(1982;1:)Tj
-20.9143 -1.1223 TD
(457458.)Tj
/F5 1 Tf
8.9663 0 0 8.9663 62.022 749.6502 Tm
(6)Tj
46.3849 0 TD
[(ABM)-336(PROTOCOL)]TJ
ET
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