True about anticonvulsants: (PGI Nov 2009)
Ans: C (Monotherapy is recommended) Phenytoin, Carbamazepine. Valproate and Phenoharhital all have been associated with teratogenic effects^Very recent reports suggest a higher than expected incidence of cleft lip with the use of lamotrigine- during pregnancy.Preganant women shoul be maintained on effective drug therapy preferably on monotherapy" at the lowest effective dose, especially during the first trimester.Patients should also take folateQ (1-4 mg/d) to prevent neural tube defects.The risk of teratogenicity increases with the number of medications'9 used (e.g. 10% risk of malformations with three drugs).Vit. K is given during last month of pregnancy: to prevent coagulopathy & intracerebral haemorrhage in newborn (common with antiseizure drugs that induce CYPs)
Carbamazepine safe in pregnancy
Lamotrigine is safe
Monotherapy is recommended
Newer drugs are safe
C.N.S