PMH-C Medications Exam Questions With Verified And Updated Solutions.

PMH-C Medications Exam Questions With Verified And Updated Solutions. There are two patients - answerTreatment 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 - answer13% of pg women were prescribed antidepressants 50% of pregnancies are unplanned - early exposure has often occurred PMAD tx guidelines (APA & ACOG) - answerMild - 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 - answerIs 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 - answerNo 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 - answerOther prescription/non-prescription meds Nutrition ETOH/cigarettes Genetics Obesity Method of delivery Environmental toxins Maternal/paternal age Length of gestation Stress Socioeconomic status Golden rules of pharmacological tx - answerKeep it simple - monotherapy where possible, don't change what's working Ask about and document all known exposure to medications/supplements/herbals/OTC Encourage psychotherapy & social support Parental concerns around perinatal medication - answerMiscarriage congenital malformation preterm delivery / low birth weight NAS - Neonatal Abstinence/Adaptation Syndrome PPHN - Persistent Pulmonary Hypertension of the Newborn Long term neurobehavioural effects Autism Risk of miscarriage - answernot a true risk when adequate controls are utilized - no increased risk with SSRIs Risk of congenital abnormalities - answerSSRIs -> no consistent fetal malformations General population risk is 3% - SSRIs don't increase this SSRIs/SNRIs are not teratogenic Contraindicated medications - answerVALPROIC ACID (Epival, Depakene, Depakote) in pregnancy