Psychiatric Disorders and Substance Abuse in Pregnancy Flashcards
what are the principles of Tx of psychiatric disorders in pregnancy
Drugs with low risk to both mother and fetus
Lowest dose monotherapy (avoid depot)
Increase screening of fetus- cardio and growth
Encourage breastfeeding whenever possible
what drug used in anxiety disorders should be avoided in pregnancy and why
benzodiazepams
causes cleft palate, and neonatal withdrawal
what side effects can anticonvulsants [used as mood stabilisers] cause = valproate
Neural tube defects craniofacial defects CV abnormalities IUGR reduced IQ cleft palate genitourinary anomalies
what side effects can anticonvulsants [used as mood stabilisers] cause = carbamazepine
facial dysmorphism
cardiac anomalies
fingernail hypoplasia
Neural Tube Defects
vitamin K deficiency»_space; haemorrhagic disease of newborn
what side effects can anticonvulsants [used as mood stabilisers] cause = lamotrigine
Steven Johnson syndrome to baby if breast fed
what side effects can Lithium [used as mood stabilisers] cause
Cardiac abnormalities
risk maternal toxicity
Ebstein’s anomaly [congenital heart defect]
Neonatal hypotonia, hypothyroidism, hypoglycaemia
what is lithium contraindicated in
breast feeding
are antipsychotics considered safe in pregnancy
yes
what side effects do typical antipsychotics have
gest diabetes, IUGR
what drugs in the Tx of schizophrenia should not be used in pregnancy
Anticholinergic drugs [used to Tx extrapyramidal side effects]
what atypical antipsychotic is consider contra indicated in breast feeding
clozapine
what drug is associated with an increased risk of inducing extrapyramidal reactions in breast fed babies
olanzapine
what TCA and SSRI can be used in breast feeding mothers
sertraline
amitriptilline
when is the onset of post natal depression
2-6 weeks postnatal
Sx of postnatal depression
Tearfulness, irritable, anxiety, lack of enjoyment and poor sleep, weight loss
Tx for postnatal depression
Mild- mod: self help, counselling
Mod-severe: psychotherapy and antidepressants
what is ‘baby blues’
brief period of emotional instability
tearful, irritable, anxiety + poor sleep
self limiting = day 3-10
what are Sx of puerperal psychosis
sleep disturbance and confusion, irrational ideas
Mania, delusions, hallucinations, confusion
when is usually the onset of puerperal psychosis
usually within 2 weeks of delivery
Tx of puerperal psychosis
is an emergency
need admission
antidepressants, antipsychotics, mood stabilisers
what are features of Fetal Alcohol Syndrome
facial deformities lower IQ neurodevelopmental delay epilepsy hearing, heart + kidney defects
what do opiates cause
maternal deaths neonatal withdrawal IUGR SIDS stillbirth
what does nicotine cause
miscarriages, abruption, IUGR, stillbirths and SIDS
what is SIDS
sudden infant death syndrome
