Psychiatric Disorders and Substance Abuse in Pregnancy AND DRUGS

Question 1

Approx half of suicides occur how long after giving birth?

Answer 1

Half suicides occur up to 12 weeks postnatally

Question 2

Which condition predicts postnatal depression?

Answer 2

Anxiety

Question 3

Why must you avoid benzos in pregnancy?

Answer 3

Can cause cleft lip/palate

Neonatal withdrawal

Question 4

If you have bipolar, chances of baby being affected?

Answer 4

1 in 7

Question 5

If mother has schizophrenia, what are the chances of child developing it?

Answer 5

10%

Question 6

Which antipsychotics can you give for schizophrenia during pregnancy?

Answer 6

Haloperidol and

Chlorpromazine appear safe

Question 7

Side effects of clozapine, olanzapine and risperidone in pregnancy?

Answer 7

Can cause gestational diabetes

IUGR

Question 8

Anticholinergic drugs are often prescribed for extra-pyramidal symptoms, can they be used in pregnancy?

Answer 8

no

Question 9

Effect of olanzapine in breastfed baby

Answer 9

Causes extra-pyramidal effects

Question 10

Name 2 antipsychotics contraindicated in breast feeding

Answer 10

Clozapine

Lithium

Question 11

If you prescribe haloperidol/chlorpromazine, what must you observe for in the baby?

Answer 11

Look for lethargy and sedation and whether they are reaching milestones or not

Question 12

Complications of eating disorders in pregnancy?

Answer 12

IUGR, prematurity, hypokalaemia, hyponatraemia, metabolic alkalosis, miscarriage, premature delivery

Question 13

Side effect of venlaxafine

Answer 13

Hypertension

Question 14

Side effect of paroxetine

Answer 14

Cardiac abnormalities

Question 15

Which anti-depressants pass into breast milk?

Answer 15

TCAs and SSRIs

-citalopram and fluoxetine especially (high levels)

Question 16

Risk carries by all anti-depressants?

Answer 16

All antidepressants carry risk withdrawal or toxicity in neonates: usually self limiting and mild

Question 17

Which TCAs are safe for pregnancy and breast feeding?

Answer 17

Amitryptiline and noritryptiline

Question 18

When does post-natal depression start?

Answer 18

2-6 weeks after birth

Question 19

Which drug can cause ebsteins anomaly?

Answer 19

Lithium

Question 20

Which drug can lower IQ?

Answer 20

Valproate

Question 21

Associated with neural tube defects?

Answer 21

Valproate

Question 22

Can cause Steven-Johnsons syndrome if baby is breastfed while mother is on this drug

Answer 22

Lamotrigine

Question 23

When do baby blues occur?

Answer 23

Days 3-10

Self-limiting

Question 24

When does peurperal psychosis occur?

Answer 24

Usually presents within 2 weeks of delivery

Question 25

Alcohol advice during pregnancy?

Answer 25

RCOG suggests abstinence best but no evidence that 2 units/ week detrimental

Question 26

Risks of alcoholism in pregnancy?

Answer 26

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

Question 27

Fetal alcohol syndrome

Answer 27

facial deformities, lower IQ, neurodevelopmental delay, epilepsy, hearing, heart and kidney defects

Question 28

Teratogenic effects of cocaine, amphetamine and ecstasy?

Answer 28

Microcephaly | Cardiac, genitourinary, limb defects

Question 29

Effects of opiates in pregnancy?

Answer 29

IUGR Neonatal withdrawal Stillbirth SIDS

Question 30

Effects of nicotine in pregnancy?

Answer 30

``` Miscarriages Abruption IUGR Stillbirth SIDS ```

Question 31

When should hyperemesis resolve by?

Answer 31

Week 16

Question 32

If someone has puerperal psychosis, risk of relapse?

Answer 32

50%

Question 33

Can you let someone take diazepam in pregnancy?

Answer 33

LOL NO | -cause cleft lip and withdrawal

Question 34

Side effect of benzodiazepines in pregnancy?

Answer 34

Cleft lip and palate | Neonatal withdrawal

Question 35

``` This drug can cause: NTD Craniofacial defects CV abnormalities Reduced IQ Cleft lip/palate Genitourinary Anomalies ```

Answer 35

Valproate

Question 36

This drug can cause finger nail hypoplasia

Answer 36

Carbamazepine

Question 37

Associated with vitamin K deficiency and haemorrhagic disease of the newborn

Answer 37

Carbamazepine

Question 38

This drug is associated with neonatal hypotonia, hypothyroidism hypoglycaemia

Answer 38

Lithium

Question 39

Methyldopa mechanism of action

Answer 39

Alpha agonist

Question 40

Labetalol mechanism of action

Answer 40

Alpha and beta agonist

Question 41

Nifedipine mechanism of action

Answer 41

Ca2+ blocker

Question 42

Hydralazine mechanism of action

Answer 42

Vasodilator

Question 43

Methyldopa is contraindicated in which condition?

Answer 43

Depression

Question 44

Labetalol is contraindicated in which condition?

Answer 44

Asthma