PMH-C Medications Exam Questions & Answers
100% Correct!!
There are two patients - ANSWER-Treatment can benefit both mom and baby
No treatment poses risk to both mom and baby
"Exposure always occurs, be it to treatment or illness"
Prevalence - ANSWER-13% of pg women were prescribed antidepressants
50% of pregnancies are unplanned - early exposure has often occurred
PMAD tx guidelines (APA & ACOG) - ANSWER-Mild - moderate:
- psychotherapy first line
- continue meds if needed
Severe/Recurrent
- continue meds
Suicidal/Psychotic
- immediate referral to hospital or psychiatric care provider
- medications
First option for medication - ANSWER-Is often Sertraline/Zoloft
No single med is "safest" or "best" for use during pregnancy/postpartum/lactation
Why so much conflicting data on meds in perinatal - ANSWER-No randomized, double-blind, placebo-
controlled trials
Many studies are retrospective database and case-control studies
- may involve voluntary reporting
- confounds (esp illness exposure)
, Confounding variables in assessing risk - ANSWER-Other prescription/non-prescription meds
Nutrition
ETOH/cigarettes
Genetics
Obesity
Method of delivery
Environmental toxins
Maternal/paternal age
Length of gestation
Stress
Socioeconomic status
(Commonly used for Bipolar and MDD)
Paxil was thought to produce a risk of cardiac malformation but this has been refuted
Preterm/Low birth weight - ANSWER-Slight increased risk - same as untreated depression
~average = 5-7 early
- less than 97grams below average
NAS - ANSWER-10-30% incidence
sx: jitters, irritability, hypertonia, feeding difficulties, tremor, GI/Sleep disturbance, high pitched cry,
tachypnea
sx are transient/self-limited, last ≤2 wks
BFing may be protective
Not dose dependent
*No benefit in changing does or discontinuing meds in 3T
PPHN - ANSWER-Very low increased risk
100% Correct!!
There are two patients - ANSWER-Treatment can benefit both mom and baby
No treatment poses risk to both mom and baby
"Exposure always occurs, be it to treatment or illness"
Prevalence - ANSWER-13% of pg women were prescribed antidepressants
50% of pregnancies are unplanned - early exposure has often occurred
PMAD tx guidelines (APA & ACOG) - ANSWER-Mild - moderate:
- psychotherapy first line
- continue meds if needed
Severe/Recurrent
- continue meds
Suicidal/Psychotic
- immediate referral to hospital or psychiatric care provider
- medications
First option for medication - ANSWER-Is often Sertraline/Zoloft
No single med is "safest" or "best" for use during pregnancy/postpartum/lactation
Why so much conflicting data on meds in perinatal - ANSWER-No randomized, double-blind, placebo-
controlled trials
Many studies are retrospective database and case-control studies
- may involve voluntary reporting
- confounds (esp illness exposure)
, Confounding variables in assessing risk - ANSWER-Other prescription/non-prescription meds
Nutrition
ETOH/cigarettes
Genetics
Obesity
Method of delivery
Environmental toxins
Maternal/paternal age
Length of gestation
Stress
Socioeconomic status
(Commonly used for Bipolar and MDD)
Paxil was thought to produce a risk of cardiac malformation but this has been refuted
Preterm/Low birth weight - ANSWER-Slight increased risk - same as untreated depression
~average = 5-7 early
- less than 97grams below average
NAS - ANSWER-10-30% incidence
sx: jitters, irritability, hypertonia, feeding difficulties, tremor, GI/Sleep disturbance, high pitched cry,
tachypnea
sx are transient/self-limited, last ≤2 wks
BFing may be protective
Not dose dependent
*No benefit in changing does or discontinuing meds in 3T
PPHN - ANSWER-Very low increased risk
