Peripartum & meds
not much is known
contraindicated during pregnancy d/t hypertension
Typically avoided in pregnancy
MAOIs
Name the mood stabilizers discussed in peripartum lecture primarily used for bipolar?
Lithium
Carbamazepine
Lamotrigine
Name the medication:
assoc with Ebstein's anomaly (cardia arrest) if given in 1st trimester
low risk for cardiac disorders
need to monitor levels closely
may need to increase dose d/t increased Glomerular Filtration Rate during pregnancy with IMEDIATE decrease after pregnancy dose or 2/3 postpartum
Lithium
The PMHNP knows to monitor which labs and how often?
Lithium level
thyroid
renal
weekly
__________ causes malformations with exposure
Risperidone
What medications are assoc with the following? (3)
not asoc with increased risk of structural fetal malformations
low birth wt
preterm birth
Buproprion
trazodone
Venlafaxine
Name this medication:
recommended NOT to be used in women of child being age and in pregnancy d/t Neuronal tube defects (NTDs)
increased risk of Autism
other defeats:
cranial facial
cleft palate
polydactyly ( extra fingers or toes)
hepatic dysfunction
neonatal toxicity
lower IQ
Valproic Acid
Lithium is a protective against fatal ETHOH syndrome but still considered __________
Neurotoxic
assoc with cleft lip/palate
increased risk of stillbirth or miscarriage
no neurodevelopmental delays
Lamotrigine
________ is the most effective and has the most safety data
Haloperidol
This medication has been associated with increased risk for ADHD in children exposed to it in utero
Bupropion
If using Valproic Acid during breastfeeding the PNMHP should be concerned and monitor what in the infant?
Hepatic and and platelet count
*** low transmission breastmilk
What are the sxm of floppy baby syndrome and assoc with lithium?
hypotonicity problems with eating, respiratory problems, poor reflexes, and cardiac issues
***assoc with 3rd trimester and postpartum
Lamotrigine crosses into breastmilk at ______ %
and considered to be _________
Still at risk for _____ _______ _______
in infants
30, safe
SJS
True or False
There is no difference between GGAs & SGAs when using during pregnancy
True
______ , ______ , ________ use is not considered to pose risk for serious adverse events in the perinatal period
SSRIs , SNRIs, bupropion
Name this medication:
Not recommended during pregnancy
assoc with NTD
low birth rate
decreased head circumference
Carbamazepine
The s/s of neonatal lithium toxicity are?
lethergy
poor sucking reflex
tachypnea
tachycardia
respiratory distress
hypotonia
cyanosis
_______ generation antipsychotics are commonly prescribed for depression, bipolar, and psychotic disorders
Second
Name the medication:
rates of premature births, spontaneous abortion, and congenital abnormaliites did not differ from general population
Olanzepine
The PMHNP should ALWAYS to a ______ ______ ______ weighing risk of untreated mental health illness
Risk Benefit Analysis
If prescribing Carbamazepine for postpartum the PMHNP knows:
amount varies transferred in breastmilk varies
overall itis safe
monitor serum levels and hepatic fxn
True or false:
There is no evidence that lithium exposure during pregnancy has negative effects on neurodevelopment, cognition, and behavior of exposed children
True
***** 30-50% is secreted in breastmilk
Taking antipsychotics during pregnancy causes increased risk of ?
gestational diabetes and obesity in pregnancy
low birth rate
preterm birth
cardiac defects
True or False
Infants exposed to olanzapine through breastmilk had no adverse rxn
True
4% had somnolence, insomnia, tremor