Perinatal Mental Health Certification - Pharmacology:
Questions And Answers
How is hydroxazine used in perinatal populations? Right Ans - Used for
anxiety in labor. In the short term, no effect on contractions or adverse
neonatal effects. In the long term, adverse effects on neonatal seizures at high
dose.
Possible increase in neonatal sedation but not common. No studies on long
term use/effects in pregnancy or breastfeeding.
FDA has 5 categories for pregnancy labeling (A,B,C,D,X). What should be
understood in this categorization? Right Ans - Risk does not necessarily
increase from category A to B and so on. Studies are based on animal trials
and do not include randomized, double blind placebo trials
What are the recommendations for perinatal benzodiazepine use? Right
Ans - 1) Use sparingly
2) Avoid abrupt withdrawal when possible
3) Avoid high doses
4) Use flumazepil when needed for fetal/neonatal toxicity
Nearly all studies find an increased risk of _________ after SSRI exposure in late
pregnancy. Right Ans - Neonatal Persistent Pulmonary Hypertension
(PPHN). Risk only with serotonergic antidepressants
Which antidepressant is less likely to cause nausea? Right Ans - -
mirtazaprine (Remeron) an SSRI, atypical antidepressant. Can be
administered as dissolving tablet.
-Side effects weight gain and sedation.
What are the risks of hypnotic benzodiazepine receptor agonists in
pregnancy? Right Ans - Increased risk of low birth weight and preterm
labor. NO increased risk of malformations.
What are the risks of congenital anomalies when taking antidepressants
pregnancy? Right Ans - 3% in general population. SSRIs do not increase
Questions And Answers
How is hydroxazine used in perinatal populations? Right Ans - Used for
anxiety in labor. In the short term, no effect on contractions or adverse
neonatal effects. In the long term, adverse effects on neonatal seizures at high
dose.
Possible increase in neonatal sedation but not common. No studies on long
term use/effects in pregnancy or breastfeeding.
FDA has 5 categories for pregnancy labeling (A,B,C,D,X). What should be
understood in this categorization? Right Ans - Risk does not necessarily
increase from category A to B and so on. Studies are based on animal trials
and do not include randomized, double blind placebo trials
What are the recommendations for perinatal benzodiazepine use? Right
Ans - 1) Use sparingly
2) Avoid abrupt withdrawal when possible
3) Avoid high doses
4) Use flumazepil when needed for fetal/neonatal toxicity
Nearly all studies find an increased risk of _________ after SSRI exposure in late
pregnancy. Right Ans - Neonatal Persistent Pulmonary Hypertension
(PPHN). Risk only with serotonergic antidepressants
Which antidepressant is less likely to cause nausea? Right Ans - -
mirtazaprine (Remeron) an SSRI, atypical antidepressant. Can be
administered as dissolving tablet.
-Side effects weight gain and sedation.
What are the risks of hypnotic benzodiazepine receptor agonists in
pregnancy? Right Ans - Increased risk of low birth weight and preterm
labor. NO increased risk of malformations.
What are the risks of congenital anomalies when taking antidepressants
pregnancy? Right Ans - 3% in general population. SSRIs do not increase
