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Antipsychotics/Mood stabilizers - ANSWER -Haloperidal
(Haldol)
Risperidone (Risperdal)
Quetiapine (Seroquel)
Aripiprazole (Abilify)
Ziprasidone ((Geodon)
Olanzapine (Zyprexa)
Lithium -- LACTATION - use with CAUTION
Valproate/Valproic Acid (Depakote) - CONTRAINDICATED FOR
PREGNANCY Lamotrigine (Lamictal)
Bipolar disorder - ANSWER -Mood
stabilizers:
Lithium
Antiepileptic
meds:
- carbamazepine
(Tegretol)
- lamotrigine (Lamictal)
*lowest risk
- Oxcarbazepine
(Trileptal)
,Antipsychotics
Benzos
Lithium - ANSWER -Is considered "ok" during pregnancy if
it has worked to
stabilize
client
Risk of cardiac malformation (forms during days 18-55) --> but
it's usually not
possible to avoid using lithium during specific days
of pregnancy
Recommend u/s monitoring/fetal ecg during use
Monitor for polyhydramnios
- shortness of breath
- uterine enlargement
Lithium dosing strategies in pregnancy - ANSWER -monitor
blood levels and
increase as body water volume
increases thru pg
- levels tend to decrease T1, T2; slightly increase T3
& more PP
, consider divided dose to reduce toxic peak
consider reduced dose at labour onset (or 48 hrs pre
scheduled c/s) to reduce
maternal/infant
toxicity
Lithium neonatal side effects - ANSWER -flaccidity, cyanosis,
lethargy, hypotonia, poor feeding, abnormal breathing, cardia
arrhythmias, poor myocardial contractility
Lithium and breastfeeding - ANSWER -Excretion into
breastmilk is highly variable
Contraindicated *at one time* by AAP - now advised to give
with caution
can monitor serum and milk lithium levels
Lamotrigine (Lamictal) in pregnancy - ANSWER -rates of
malformation in line
with gen
pop
lowest risk of the anticonvulsants
Medications & Psychosis - ANSWER -May require multiple
meds
ECT, hospitalization may be necessary