Psychiatric Disorders and Substance Abuse in Pregnancy AND DRUGS Flashcards
Approx half of suicides occur how long after giving birth?
Half suicides occur up to 12 weeks postnatally
Which condition predicts postnatal depression?
Anxiety
Why must you avoid benzos in pregnancy?
Can cause cleft lip/palate
Neonatal withdrawal
If you have bipolar, chances of baby being affected?
1 in 7
If mother has schizophrenia, what are the chances of child developing it?
10%
Which antipsychotics can you give for schizophrenia during pregnancy?
Haloperidol and
Chlorpromazine appear safe
Side effects of clozapine, olanzapine and risperidone in pregnancy?
Can cause gestational diabetes
IUGR
Anticholinergic drugs are often prescribed for extra-pyramidal symptoms, can they be used in pregnancy?
no
Effect of olanzapine in breastfed baby
Causes extra-pyramidal effects
Name 2 antipsychotics contraindicated in breast feeding
Clozapine
Lithium
If you prescribe haloperidol/chlorpromazine, what must you observe for in the baby?
Look for lethargy and sedation and whether they are reaching milestones or not
Complications of eating disorders in pregnancy?
IUGR, prematurity, hypokalaemia, hyponatraemia, metabolic alkalosis, miscarriage, premature delivery
Side effect of venlaxafine
Hypertension
Side effect of paroxetine
Cardiac abnormalities
Which anti-depressants pass into breast milk?
TCAs and SSRIs
-citalopram and fluoxetine especially (high levels)
Risk carries by all anti-depressants?
All antidepressants carry risk withdrawal or toxicity in neonates: usually self limiting and mild
Which TCAs are safe for pregnancy and breast feeding?
Amitryptiline and noritryptiline
When does post-natal depression start?
2-6 weeks after birth
Which drug can cause ebsteins anomaly?
Lithium
Which drug can lower IQ?
Valproate
Associated with neural tube defects?
Valproate
Can cause Steven-Johnsons syndrome if baby is breastfed while mother is on this drug
Lamotrigine
When do baby blues occur?
Days 3-10
Self-limiting
When does peurperal psychosis occur?
Usually presents within 2 weeks of delivery
Alcohol advice during pregnancy?
RCOG suggests abstinence best but no evidence that 2 units/ week detrimental
Risks of alcoholism in pregnancy?
Risks of miscarriage
FAS- facial deformities, lower IQ, neurodevelopmental delay, epilepsy, hearing, heart and kidney defects
Withdrawal
Risk Wernicke’s encephalopathy- 20% die (B1 deficiency)
Korsakoff Syndrome – permanent
Fetal alcohol syndrome
facial deformities, lower IQ, neurodevelopmental delay, epilepsy, hearing, heart and kidney defects
Teratogenic effects of cocaine, amphetamine and ecstasy?
Microcephaly
Cardiac, genitourinary, limb defects
Effects of opiates in pregnancy?
IUGR
Neonatal withdrawal
Stillbirth
SIDS
Effects of nicotine in pregnancy?
Miscarriages Abruption IUGR Stillbirth SIDS
When should hyperemesis resolve by?
Week 16
If someone has puerperal psychosis, risk of relapse?
50%
Can you let someone take diazepam in pregnancy?
LOL NO
-cause cleft lip and withdrawal
Side effect of benzodiazepines in pregnancy?
Cleft lip and palate
Neonatal withdrawal
This drug can cause: NTD Craniofacial defects CV abnormalities Reduced IQ Cleft lip/palate Genitourinary Anomalies
Valproate
This drug can cause finger nail hypoplasia
Carbamazepine
Associated with vitamin K deficiency and haemorrhagic disease of the newborn
Carbamazepine
This drug is associated with neonatal hypotonia,
hypothyroidism
hypoglycaemia
Lithium
Methyldopa mechanism of action
Alpha agonist
Labetalol mechanism of action
Alpha and beta agonist
Nifedipine mechanism of action
Ca2+ blocker
Hydralazine mechanism of action
Vasodilator
Methyldopa is contraindicated in which condition?
Depression
Labetalol is contraindicated in which condition?
Asthma
