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Flashcards in Psychiatric disorders and substance abuse Deck (33):
1

half suicides occur when

up to 12 weeks post natally

2

mental illness is a leading cause of what in the uk

maternal death

3

principles of treatment

drugs with low risk to bother mother and fetus
lowest dose monotherapy to avoid depot
encourage breast feeding whenever possible
increase screening of fetas-cardio and growth

4

anxiety disorders - what should be avoided and why

benzos - sedation in baby, cleft, neonatal withdrawal

5

BPD in how many women
risk of episode post natally
risk of what
when is the baby affected

1%
50% without rx
suicide
genetic risk 1/7

6

anti convulsants for BPD valproate SE

neural tube defects
craniofacial defects
CV abnormality
IUGR
reduced IQ
cleft
genitourinary anomalities

7

BPD carbamazepine SE

facial dysmorphism
cardiac anomalities
fingernail hyperplasia
NTD
Vit k deificieny - haemorrhagic disease of the newborn

8

Lamotrigine (safest one) SE for BPD

SJS if breast feeding - rare

9

BPD lithium SE
contraindicated in what
switch to what if on TCA

cardiac abnormalities, maternal toxicity, ebsteins anomaly, neonatal hypotonia, hypothyroidism, hypoglycaemia

in breast feeing

in preg should be stopped gradually

if on TCA switch to SSRIs
also start on SSRIs

10

schiz in how many women
risk of schiz to child

1%
10%

11

treatment of schiz in preg

anti psychotics are safe
mostly topical ones used

12

what should babies be observed for in anti psychotics

they are all sedating drugs so
lethargy, sedation, and appropriate developmental milestones

13

clozapine contra indicated in what and why

breast feeding
life threatening events in baby

14

olanzapine has an increased risk of what

extra pyramidal reactions in breast fed baby

15

anticholinergic drugs safe?

not in preg

16

eating disorders BN
anorexia
risks

1%
0.2%
IUGR, prematurity, hypokalaemia, hyponatraemia, met alk, miscarriage, premature delivery

17

mild - mod depression
mod-severe

psychological treatment
pharmacological

18

venlafaxine for depression

causes hypertension

19

paroxtetine for depression

cardiac abnormalities

20

SSRIs in depression

use with caution after 20 weeks may lead to pulmonary hypertension in child

21

TCA and SSRI in breast milk can lead to what

sedation
use low dose

22

what do all anti depressants carry a risk of

withdrawel or toxicity in neonates which is usually self limiting and mild

23

which are safer for an overdose SSRI or TCAs

SSRIs

24

post natal depression how many women
onset
mild-mod
mod-severe

10%. 1/3 lasts more than 1 yr
2-6 weeks postnatally, lasts weeks to months

self help, counselling

psychotherapy/anti depressants/admission

25% risk of reoccurrence
70& life time risk of depression

25

baby blues how many women
when

50%
days 3-10 and it is self limiting
usually due to hormone surges

26

puerperal psychosis when
symptoms
how many women
cx
risk factors for it
ddx

within 2 weeks of delivery

sleep disturbance, confusion, irrational ideas
mania, delusions, hallucinations, confusion

0.1%

5% suicide risk and 4% infanticide

bipolar (50%), previous puerperal psychosis, 1st degree relative

bpd, depression, schiz, organic brain dysfunction

27

PPS management

admission
antidepressants anti psychotics, mood stabilisers, ECT

80% 10 yr recurrence rate
25% develop bpd

28

how many women have alcohol dependancy
how many have illicit drug dependance

4.7%
2.2%

29

alcoholism risks

miscarriage
facial deformaties, lower IW, neurodevelopment delay, epilepsy, heart and kidney defects, hearing
withdrawel
wenickes encephalopathy
korsakoff syndrome

30

cocaine, amphetamine, ecstasy
lead to death via what

risks

stroke and arrhythmias

teratogenic
PET
abruption
IUGR
PTL
miscarriage
developmental delay, withdrawel

31

what do opiates cause

maternal deaths 1-2%
neonatal withdrawal
IUGR
SIDS
stillbirth

32

what does nicotine cause

miscarriage
abruption
IUGR
stillbirths
SIDs

33

substance abuse in preg managemetn

methadone programme
child protection and social services
smear hhx
breastfeeding but not if alcohol >8units/week, HIV, cocaine