foreve.nbme4 block 1 q8 - fcbarcelna

[ArchivalUser]

i thought may be haloperidol is contraindicated in pregnancy so marked valproic acid.....so in preganancy is lithium the only drug that is contraindicated??.so haloperidol can be given?

[ArchivalUser]

Both are contraindicated in pregnancy.
That answer is ..E, arrange abortion and resume haloperidol, as patient insists to do so.(think as competent)

[ArchivalUser]

omg!..i never thought to abort her...are u sure shes competent!!..she thinks it an evil baby coz angelic voices tell her to do so.....TO ABORT...??

[ArchivalUser]

From Wikipedia:

"Data from animal experiments indicate haloperidol is not teratogenic, but is embryotoxic in high doses. In humans, no controlled studies exist. Unconfirmed studies in pregnant women revealed possible damage to the fetus, although most of the women were exposed to multiple drugs during pregnancy. Following accepted general principles, haloperidol should only be given during pregnancy if the benefit to the mother clearly outweighs the potential fetal risk."

The correct answer is to defer abortion and give haloperidol. I'm sure about this answer because I gave NBME 4 with feedback form (it shows you which answers you got wrong) and I didn't get this question wrong.

[ArchivalUser]

Also, on Valproate:

"Valproate causes birth defects: exposure during pregnancy is associated with about three times as many major anomalies as usual, mainly spina bifida and, more rarely, with several other defects, possibly including a "valproate syndrome".[18] Characteristics of this valproate syndrome include facial features that tend to evolve with age, including trigonocephaly, tall forehead with bifrontal narrowing, epicanthic folds, medial deficiency of eyebrows, flat nasal bridge, broad nasal root, antiverted nares, shallow philtrum, long upper lip and thin vermillion borders, thick lower lip and small downturned mout"


Valproate is definitely avoided in pregnancy if possible. IF it must be given, supplement with high doses of Folate to decrease risk of NTDs, and screen with AFP.

[ArchivalUser]

Yes, The correct answer is to defer abortion and give haloperidol... i also checked with extended review.