Psychiatry and Drugs in Pregnancy Flashcards
what can valproate cause
NTD, craniofacial defects, CV abnormality, IUGR, reduced IQ, cleft, genitourinary abnormalities
what can carbamazepine cause
vit K deficiency-haemorrhagic disease of the newborn, facial dysmorphism, cardiac anomalies, fingernail hypoplasia, NTD
what can lamotrigine cause
cleft, SJS to baby f breast fed
if on anticonvulsants can you breast feed
yes there is only rare side effects
what can lithium cause
neonatal hypotonia, hypothyroidism, hypoglycaemia
is lithium contraindicated in breast feeding
yes
if on lithium and find out you are preganant what is recommended
stop lithium gradually ?Switch to SSRI
do schizophrenia patients require maintenance meds throughout pregnancy
yes
what appear safer in pregnancy typical or atypical antipsychotics
typical antipsychotics-haloperidol, chlorpromazine
what can atypical antipsychotics cause
gestational diabete, IUGR
what can antipsychotics cause and therefore what should babies be monitored for
observed for lethargy, sedation and appropriate developmental milestones as they are sedating with very long half lives
why is clozapine contraindicated in breast-fed babies
liability of inducing potential life threatening events in the infant
what is olanzapine associated with an increased risk of
extrapyramidal reactions
can anticholinergic drugs be used in pregnancy
no
what can bulimia nervosa cause in pregnancy
IUGR, prematurity, hypokalaemia, hyponatraemia, metabolic alkalosis, miscarriage, premature delivery
if depressed should you keep them on their medications
if mild consider stopping but some meds safe in pregnancy
which SSRIs have high levels in breast milk
citalopram and fluoxetine
which SSRI can you breast feed on
sertraline
which TCAs are safe in pregnancy and okay for breast feeding
amitriptyline, nortryptilline
what do antidepressants carry risk of
withdrawal or toxicity in neonates
when does postnatal depression tend to present
2-6 weeks postnatally-lasts weeks to months
if get postnatal depression what is lifetime risk of depression
70%
what is baby blues
brief period of emotional instability
tearful, irritable, anxiety and poor sleep
day 3-10 self limiting
support and reassurance
what are the early symptoms of puerperal psychosis
sleep disturbance, confusion, irrational ideas
mania, delusions, hallucinations and confusion
