Lithium salt feature products ...

Lithium salts lithium feature of drugs is that they are not metabolized in the body. Their pharmacokinetics determined by the intensity of excretion by the kidneys, the level of which changes during pregnancy. This leads to the need to modify the scheme of using the drug in pregnant women. Thus, increased renal clearance of lithium requires increasing doses to maintain its optimum concentration in the blood. At the same time a sharp decline in glomerular filtration and clearance of lithium after birth can lead to intoxication [1,6]. It is believed that a single dose of lithium for pregnant should not exceed 300 mg, and the level of therapeutic blood concentrations should be maintained at the expense of the reception frequency. Monitoring drug concentrations in blood should be performed weekly. In general, however, especially the use of lithium during pregnancy are determined mainly by the risk of pathogenic effects on the fetus. Lithium is relatively easy to pass through the placenta and is found in fetal blood. Data on the effects of lithium during pregnancy in women more systematically compared with those of other psychopharmacological agents. In order to systematize this has been introduced so-called lithium-sensitive (Lithium Register). According to him, the level of the anomalies of the cardiovascular system and, in particular, Ebstein anomaly (severe tricuspid insufficiency) is significantly higher in cases of drinking by women during pregnancy in lithium than in the general population [20]. Thus, lithium is contraindicated in the first trimester of pregnancy, but its use in this dangerous period can not serve as an absolute indication for abortion. So, for the control of the cardiovascular system (16 weeks) and Ebstein anomaly diagnosis (23 weeks) may be used echocardiography [2.20]. Neonatal lithium intoxication may be manifested in the form of so-called syndrome of flaccid child. In children, a decline of muscle tone, drowsiness, shallow breathing, cyanosis, inhibition of sucking and grasping reflex, and absence of Moro reflex [6,8]. Reported effects can last up to 10 days after birth. As an alternative drug for the prevention of mood phases can be used carbamazepine. This drug is considered to be reliable enough when alone, but the risk of congenital malformations increases significantly when it is combined with other anticonvulsants [6]. Neuroleptics Neuroleptics penetrate easily through the placenta and rapidly detected in the tissues of the fetus and amniotic fluid. However, as a rule, preparations of this group do not cause major malformations in children born to mothers who took it during pregnancy [14]. Reports of congenital anomalies in their use are scarce and can not be clear systematization. This is especially important that a number of drugs in this group (etaperazin, haloperidol) is sometimes appointed by the obstetricians in small doses in early pregnancy as an antiemetic.