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Teratology
Psychiatric Meds
| Question | Answer |
|---|---|
| Maternal prenatal stress/depression is associated with.. | low infant birth weight and prematurity, also temperament and behavior |
| Women with schizophrenia or a major affective disorder have an increased risk for... | fetal distress, abruptio placenta, IUGR, and babies with heart defects |
| When compaired to babies whose mothers were depressed but took no meds, babies exposed to SSRIs had... | lower birth weight, gestational age, respiratory distress, jaundice and feeding problems |
| Antidepressants and pregnancy: SSRIs (and tricyclics) | Low risk for malformations, risk for problems in newborn period |
| Antidepressants and pregnancy: Paxil | small increase risk for heart defects (~1%), significant problems for newborn adaptation |
| Antidepressants and pregnancy: Effexor | significant problems with newborn adaptation |
| Antidepressants and pregnancy is a... | continued area of study, risk is unlikely to be large but unlikely to be zero |
| SSRIs and neonatal adaption: neonatal behaviorial syndrome | CNS (Irritability and agitation), Motor (tremors, increased muscle tone), respiratory distress, GI difficulties, onset between birth and 3 weeks and typically lasts less than two weeks |
| Neonatal behaviorial syndrome most implicated with what 3 drugs | Paxil, Prozac and Effexor |
| Medical management for Neonatal adaptation syndrome | Supportive care in the NICU, toxicity versus withdrawal.. occasionally small doses of the maternal medication are administered |
| FDA says (with SSRIs) 3rd trimester exposure leads to... | 20-30% risk for neonatal behavioral syndrome and 1% risk for PPHN |
| Lithium | (~1%) risk for Ebstein's anomaly, fetal echocardiogram at 20 weeks is recommended. 3rd trimester has been associated with LOTS OF stuff... |
| Lithium in 3rd trimester... | neonatal cyanosis, hypotonia, cardiac rhythm disturbances, diabetes insipidus and hypothyroidism |
| Antipsychotics: Haldol | limb defects, extrapyramidal effects in third trimester |
| Antipsychotics: Risperdal | Reassuring!!!! |
| Antipscyhotics: Zyprexa | Reassuring. But maternal weight gain may lead to OB complications |
| Infants and breastfeeding: Long term effects of psychotropics on neurocognitive development are... | largely unknown |
| Infants and breastfeeding: Potential acute efects of SSRIs on infants | |
| Maternal prenatal stress/depression is associated with.. | low infant birth weight and prematurity, also temperament and behavior |
| Women with schizophrenia or a major affective disorder have an increased risk for... | fetal distress, abruptio placenta, IUGR, and babies with heart defects |
| When compaired to babies whose mothers were depressed but took no meds, babies exposed to SSRIs had... | lower birth weight, gestational age, respiratory distress, jaundice and feeding problems |
| Antidepressants and pregnancy: SSRIs (and tricyclics) | Low risk for malformations, risk for problems in newborn period |
| Antidepressants and pregnancy: Paxil | small increase risk for heart defects (~1%), significant problems for newborn adaptation |
| Antidepressants and pregnancy: Effexor | significant problems with newborn adaptation |
| Antidepressants and pregnancy is a... | continued area of study, risk is unlikely to be large but unlikely to be zero |
| SSRIs and neonatal adaption: neonatal behaviorial syndrome | CNS (Irritability and agitation), Motor (tremors, increased muscle tone), respiratory distress, GI difficulties, onset between birth and 3 weeks and typically lasts less than two weeks |
| Neonatal behaviorial syndrome most implicated with what 3 drugs | Paxil, Prozac and Effexor |
| Medical management for Neonatal adaptation syndrome | Supportive care in the NICU, toxicity versus withdrawal.. occasionally small doses of the maternal medication are administered |
| FDA says (with SSRIs) 3rd trimester exposure leads to... | 20-30% risk for neonatal behavioral syndrome and 1% risk for PPHN |
| Lithium | (~1%) risk for Ebstein's anomaly, fetal echocardiogram at 20 weeks is recommended. 3rd trimester has been associated with LOTS OF stuff... |
| Lithium in 3rd trimester... | neonatal cyanosis, hypotonia, cardiac rhythm disturbances, diabetes insipidus and hypothyroidism |
| Antipsychotics: Haldol | limb defects, extrapyramidal effects in third trimester |
| Antipsychotics: Risperdal | Reassuring!!!! |
| Antipscyhotics: Zyprexa | Reassuring. But maternal weight gain may lead to OB complications |
| Infants and breastfeeding: Long term effects of psychotropics on neurocognitive development are... | largely unknown |
| Infants and breastfeeding: Potential acute efects of SSRIs on infants | GI Disturbances (Prozac), irritability, somnolence |
| Potential long term effects of SSRIs while breastfeeding | Neurobehavioral changes, decreased wt gain |
| Mood stabilizers | American Academy of Pediatrics classifies lithium as not compatible with breastfeeding |