Target Audience: Pharmacist, Pharmacy Technician 1.5 Credits Activity Release Date: 8/27/2021 12:00:00 AM Activity Expiration Date: 8/19/2024 12:00:00 AM Pharmacology
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Course Summary
Bipolar disorder is a common and serious psychiatric condition that often has disabling consequences for those afflicted by it. During pregnancy and the postpartum period, lithium has been identified as an effective treatment to control symptoms of bipolar disorder and as prevention for a relapse of symptoms. Fluctuations in serum lithium levels may occur during pregnancy and the postpartum period that can lead to subtherapeutic or supratherapeutic lithium levels. In addition, there are risks with lithium use during pregnancy for the mother and fetus. During the first trimester of pregnancy, there is a potential for congenital malformations due to lithium exposure in utero. There may also be an increased risk for miscarriage from lithium use. The decision to prescribe lithium during pregnancy should be determined by considering the risk factors from using lithium and balancing them with the mother’s risk of mood dysregulation and psychosis. Continuing lithium use during pregnancy requires close monitoring during the perinatal period, including frequent testing of lithium serum levels. Consideration must also be made for mothers who intend to breastfeed.
Course Objectives
  • Identify the efficacy and safety of lithium use during pregnancy and when breastfeeding
  • Describe the potential fluctuations in serum lithium levels that may lead to subtherapeutic or supratherapeutic levels during and after pregnancy
  • Compare the use of lithium in child-bearing women to other drugs that may be used to treat affective (mood) disorders
  • Identify the teratogenic risks for the fetus, and the risk of miscarriage in women using lithium during pregnancy
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Course Syllabus

I. Introduction

II. To Treat or Not to Treat? A Clinical Conundrum

  1. Efficacy of Prescribing Lithium in Childbearing Women
  2. Potential Risks from Lithium Use During Pregnancy

III. Management of Lithium During Pregnancy and Postpartum

  1. Managing Teratogenic Risks
  2. Managing the Risk of Miscarriage
  3. Lithium Dosing Adjustments During Pregnancy
  4. Lithium and Breastfeeding
  5. ACOG Guidelines
  6. Alternative Drugs During Pregnancy

IV. Lithium Use During Pregnancy Case Reports

  1. Case Report I
  2. Case Report II
  3. Case Report III
  4. Case Report IV
  5. Key Points

V. Summary

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