WELCOME TO THE NEW ZEALAND FORMULARY The NZF is an independent resource providing healthcare professionals with clinically validated medicines information and guidance on best practice, enabling healthcare professionals to select safe and effective medicines for individual patients. Updates to the online NZ Formulary are published monthly on the 1st working day of each calendar month. It is vital to use the most recent release of the NZF for making clinical decisions. Kratom was on the U.S. Drug Enforcement Agency’s (DEA) list of drugs of concern since 20051 and was almost reclassified as a Schedule I drug in 2016. Seafood Consumption During Pregnancy and Breastfeeding The benefits of fish and shellfish, collectively termed “seafood” as part of a balanced, healthy diet have been described. Seafood is low in saturated fat and a good source of high-quality protein and micronutrients including vitamin B12, vitamin D, calcium, iron, and zinc. Breastfeeding and Lead Contamination
Lead is an environmental pollutant that serves no useful purpose in the body and tends to accumulate in the body's bony structures based on their exposure. Some studies show that the half-life of lead in bone is approximately 27 years. Thus you may never get rid of all the lead you have absorbed during your life without chelation therapy. At present there is enormous concern about the birth defects believed associated with infections for an old virus called Zika during pregnancy.Information concerning the Zika Virus and its implication in microcephaly has been reported in many countries, including the USA. Influenza Virus in Pregnancy Influenza is a viral infection that affects the respiratory tract. It is especially risky in pregnant women and increases the risk of premature delivery, abortion, and stillbirth. (1) Pregnant women are also at an increased risk of complications from the virus. Breastfeeding is recommended by the American Academy of Pediatrics as the exclusive source of nutrition for feeding young infants for the first six months of life.
Data suggest that not only are there psychological benefits from its use, but nutritional, gastrointestinal, and host defense benefits as well. Non-Drug Treatments for Depression Sarah has had depression on and off throughout most of her adult life. She finally found an antidepressant that worked for her. But now she’s pregnant and she’s been hearing all the awful things about antidepressants during pregnancy. She’s talked with her doctor about it, and he has assured her that the risk of problems is very small. But he is willing to consider other approaches.... During pregnancy there is an increased demand for certain vitamins and nutrients to ensure proper and adequate growth of the fetus. Prenatal vitamins generally contain higher levels of folic acid, iron, and calcium to meet this increased need. Zuclopenthixol (Cisordinol, Clopixol, Acuphase), also known as zuclopentixol, is a typical antipsychotic drug of the thioxanthene class. It was introduced in 1976 by Lundbeck.
[1] It is the cis-isomer of clopenthixol. Zuclopenthixol is a D1 and D2, α1-adrenergic and 5-HT2 agonist. It is not approved for use in the United States. Zuclopenthixol is available in three major preparations: It is also used in the treatment of acute bipolar mania. As a long acting injection, zuclopenthixol decanoate comes in a 200 mg and 500 mg ampoule. Doses can vary from 50 mg weekly to the maximum licensed dose of 600 mg weekly. In general, the lowest effective dose to prevent relapse is preferred. The interval may be shorter as a patient starts on the medication before extending to 3 weekly intervals subsequently. The dose should be reviewed and reduced if side effects occur, though in the short term an anticholinergic medication benztropine may be helpful for tremor and stiffness, while diazepam may be helpful for akathisia. 100 mg of zuclopenthixol decanoate is roughly equivalent to 20 mg of flupentixol decanoate or 12.5 mg of fluphenazine decanoate. In acutely psychotic and agitated inpatients, 50 – 200 mg of zuclopenthixol acetate may be given for a calming effect over the subsequent three days, with a maximum dose of 400 mg in total to be given.
As it is a long-acting medication, care must be taken not to give an excessive dose. In oral form zuclopenthixol is available in 10, 25 and 40 mg tablets, with a dose range of 20–60 mg daily. Zuclopenthixol antagonises both dopamine D1 and D2 receptors, α1-adrenoceptors and 5-HT2 receptors with a high affinity, but has no affinity for cholinergic muscarine receptors. It weakly antagonises the histamine (H1) receptor but has no α2-adrenoceptor blocking activity. Evidence from in vitro work and clinical sources (i.e. therapeutic drug monitoring databases) suggests that both CYP2D6 and CYP3A4 play important roles in zuclopenthixol metabolism. Chronic administration of zuclopenthixol (30 mg/kg/day for two years) in rats resulted in small, but significant, increases in the incidence of thyroid parafollicular carcinomas and, in females, of mammary adenocarcinomas and of pancreatic islet cell adenomas and carcinomas. An increase in the incidence of mammary adenocarcinomas is a common finding for D2 antagonists which increase prolactin secretion when administered to rats.
An increase in the incidence of pancreatic islet cell tumours has been observed for some other D2 antagonists. The physiological differences between rats and humans with regard to prolactin make the clinical significance of these findings unclear. Other permanent side effects are similar to many other typical antipsychotics, namely extrapyramidal symptoms as a result of dopamine blockade in subcortical areas of the brain. This may result in symptoms similar to those seen in Parkinson's disease and include a restlessness and inability to sit still known as akathisia, a slow tremor and stiffness of the limbs.[8] Zuclopenthixol is thought to be more sedating than the related flupentixol, though possibly less likely to induce extrapyramidal symptoms than other typical depots.[5] As with other dopamine antagonists, zuclopenthixol may sometimes elevate prolactin levels; this may occasionally result in amenorrhoea or galactorrhoea in severe cases. Neuroleptic malignant syndrome is a rare but potentially fatal side effect.