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Flashcards in child Deck (47):
1

Placenta Drug Barrier

Non-existent. Fetus tends to have same blood level of drug as mother

2

Risks of psychoactive meds to fetus

(1)Teratogenic (structural damage) (2) Behavioral abnormalities (3) Neonatal toxicity from medication acquired during breast feeding

3

Risk of not treating maternal illness

(1) Poor compliance with prenatal care, poor nutrition, exposure to undesired drugs, increased intake of self medication, deficits in mother-infant bonding, disruptions in family environment

4

T/F Depression during pregnancy decreases risk of postpatrum depression

FALSE

5

Potential cause for heightened risk during first trimester of pregnancy

Using more than one anti-depressant

6

SSRI Discontinuation Syndrome (a) In what population (b) Symptoms (c) Potentail course of action to avoid it

(a) Present in offspring of mothers who used SSRI antidepressants during third trimester (b) irritability, constant crying, sleep distrubances, hyperactive reflexes, breathing and feeding difficulties (c) Mothers are recommended to take Prozac as soon as pregnancy is confirmed but stop during third trimester, instead using non-phramologic intervnections and/or OMEGA 3 FA

7

Untreated BP in Mom

Impulsivity, impaired judgement, drug abuse, manic episodes, interpersonal life disruptions

8

Risk of Lithium use

Cardiac malformations

9

Risk of Valproic Acid

HIGH. Only used if absolutely necessary. High impcat on cognitiion and congenital malformations

10

Risk of Topiramate

High risk of congenital malformations such as oral clefts

11

High Risk Mood Stabilizers

Lithium, Valproic, Topiramate

12

Low Risk Mood Stabilizers

Carabamazepine, Lamotrigine, Neurontin

13

Atypical antipsych treatment

Schizo. BP, PTSD, BPD

14

Risk of atypical antipsychs in pregnancy

Offspring can be large for gestational age, diabetes, jitteriness/irritability/feeding problems

15

Why child psychpharm is underdeveloped

Barely have first textbook written (2009)

16

Key risk analysis for pre-school aged children

Weighing risk of medication with risk of not-intervening

17

Challenge associated with ADHD in kids

ADHD symptoms vary across a lifespan... also comorbidity with anxiety/communication disorders varies

18

Usual treatment for ADHD in preschoolers

Ritilan-->Adderall-->Discontinue if nothing after 6 m.o.

19

Treatment for disruptive behaviors in preschoolers

No good meds. Often antipsychs used but recommended to use them in conjunction with psychotherapy which they never are

20

Treatment of depression in preschoolers

It is common [trauma, mother with depression]. Manifests if ways like looking sad when playing games, appetite loss, sleep problems..psychoterpahy recommended

21

Treatment of Anxiety in Preschool children

Therapy for 3 m.o. if no change then maybe use Prozac.

22

Common Anxiety disorders in children

PTSD [psych therapy suggested] and OCD [therapy recommended]

23

Autism v.s. Aspergers

Austism must be present before age 3...

24

Medical treatments for Autism

Aytpical antispychs (risperidone and abilify) can help

25

What psychotropic drugs do to alter austim spectrum disorder

Impact aggression, self injury, anxiety, repetitive behaviors, mood dysregulation

26

Side effects of autism drugs

Weight gain, glucose intolerance, high cholestoral

27

Omega 3's and Autism

FA deficines impliaced in neurocognitive disorders like autism...

28

Problem associated with diagnosis of rage disorders

symptoms cut across many other diagnoses (ADHD, autism, PTSD, Bipolar Disorder).

29

Treatments for aggressive disorders

(1) Mood stabilizers and atypical antispychs WITH therapy (2) Lithium for cases of severe depression (3) Valproic acid (4) Psychostimulants (5) SSRIs (6) Benzoids OVERALL NO FDA APPROVED MEDICATION FOR AGGRESIVE DISORDER IN CHILDREN

30

Theory of underlining cause of ADHD

Alterations in dopaminergic activity in the PFC. Leisions of PFC can cause distractability, forgetfuness, impulsivity, poor planning and locomotor hyperactivity

31

Effectiveness of Stimulant treatment for ADHD

Good at improving ADHD symptoms but not so much at attacking the functional impairments

32

Findings of MTA study on ADHD

(1) 33% still used meds (2) Third had antisocial behavior (3) 78% of subjects continue to have ADHD

33

Medications for ADHD in kids

(1) Ritalin [90% of all ADHD meds] ..rapid onset but short duration (2) Concerta: extended release of ritalin... (3) Dexedrine/.Adderall

34

Side effects of Stimulants

Insomnia, high BP, growth suppression, cardiac complications....aggresion, manic symptoms

35

ALternative meds for ADHD

(1) Selective Norepinehrine reputake inhibitis (2) DA agnoist

36

Complementary treatments of depression

(1) SJW (2) omega-3-FA (3) Light therapy (4) Exercise

37

Symptoms of GAD

Restlessnesss, fatigue, difficulty concentrating, irrtaibilty, muscle tension

38

Treatment of OCD

CBT + Single SSRI

39

Prodrome

Early symptoms that might indicate start of a disease before specific symptoms occur

40

Prodormal symptoms of BP

agitation, anxiety, stubborness, bold and bossy behavior, decrease concentration

41

Distinct about children with BP

rapid flucations, comorbid with ADHD, disruptive behavioral disorders

42

Manic state treatments for BP

Lithium, anticonvulsants, aytpicals

43

Treatment for Pediatric BP

Lamotrigine and Omega-3-FA

44

EPA impact on DP

EPA show to be effective...want high EPA/DHA ratio for BP

45

Treatment for schizo

ATypical antipsychs... Haloperidal and phenthiazines, are good btu EPS.... atypicals are good but can cause weight gain

46

Gray matter and BP

Lower Grey matter in early onset adolsecents

47

Impact of OMega-3-FA on psychtoic disroders

omega-3-treatment may offer safe strategy for prevention