Rovich Diagnostic Services Enugu
MEANING OF THERAPY
A therapy or medical treatment (often abbreviated tx, Tx, or Tx) is the attempted remediation of a health problem, usually following a medical diagnosis.
As a rule, each therapy has indications and contraindications. There are many different types of therapy. Not all therapies are effective. Many therapies can produce unwanted adverse effects.
Medical treatment and therapy are generally considered synonyms. However, in the context of mental health, the term therapy may refer specifically to psychotherapy.
TYPES OF THERAPIES
1. PSYCHOANALYSIS AND PSYCHODYNAMIC THERAPIES
This approach focuses on changing problematic behaviors, feelings, and thoughts by discovering their unconscious meanings and motivations. Patients learn about themselves by exploring their interactions in the therapeutic relationship.
2. BEHAVIOR THERAPY
This approach focuses on learning’s role in developing both normal and abnormal behaviors.
3. COGNITIVE THERAPY
Cognitive therapy emphasizes what people think rather than what they do.
Cognitive therapists believe that it’s dysfunctional thinking that leads to dysfunctional emotions or behaviors. By changing their thoughts, people can change how they feel and what they do.
4. HUMANISTIC THERAPY
This approach emphasizes people’s capacity to make rational choices and develop to their maximum potential. Concern and respect for others are also important themes. Three types of humanistic therapy are especially influential.
- Client-centered therapy
- Gestalt therapy
- Existential therapy
5. INTEGRATIVE OR HOLISTIC THERAPY
Many therapists don’t tie themselves to any one approach. Instead, they blend elements from different approaches and tailor their treatment according to each client’s needs.
BEST MEDICAL THERAPY FOR NURSING MOTHERS (BREAST FEEDING MOTHERS)
Prescribing medications for a breast-feeding mother requires weighing the benefits of medication use for the mother against the risk of not breast-feeding the infant or the potential risk of exposing the infant to medications. A drug that is safe for use during pregnancy may not be safe for the nursing infant. The transfer of medications into breast milk depends on a concentration gradient that allows passive diffusion of nonionized, non-protein-bound drugs. The infant’s medication exposure can be limited by prescribing medications to the breast-feeding mother that are poorly absorbed orally, by avoiding breast-feeding during times of peak maternal serum drug concentration and by prescribing topical therapy when possible. Mothers of premature or otherwise compromised infants may require altered dosing to avoid drug accumulation and toxicity in these infants. The most accurate and up-to-date sources of information, including Internet resources and telephone consultations, should be used.
ANTIBIOTICS
Penicillins and cephalosporins, which are excreted in milk in trace amounts, are compatible with breast-feeding. A remote possibility exists that the child will experience an allergic reaction to the antibiotic or develop diarrhea caused by changes in gut flora. Trimethoprim-sulfamethoxazole (Bactrim, Septra) is compatible with breast-feeding, but its use should be avoided when nursing infants are younger than two months because of its potential for causing increased bilirubin levels. Rovich Diagnostic Services Enugu
Tetracycline is excreted in small amounts in breast milk, but the calcium in breast milk limits its absorption. Although tetracycline is compatible with breast-feeding, other antibiotics are preferred, especially for long-term use. Newer derivatives such as doxycycline (Vibramycin) or minocycline (Minocin) should be avoided because of higher absorption by infants and toxicity in children (e.g., dental staining, decreased bone growth).
ANTIDEPRESSANTS
Maternal depression is known to have an adverse effect on parenting and infant development. Tricyclic antidepressants have been shown to have little to no effect on the breastfeeding infant, although the AAP finds most tricyclic agents to be of possible concern. Taking a single daily dose at bedtime will limit the infant’s exposure to the medication. The selective serotonin reuptake inhibitors (SSRIs) are generally the first choice of treatment for depression. Sertraline (Zoloft) is likely to be the safest choice among them because it has been studied extensively and because drug levels found in nursing infants are usually minimal.
Fluoxetine (Prozac) use during pregnancy has been well-studied, and many new mothers are already taking it at delivery. Its use during breast-feeding is controversial, however. Fluoxetine’s long half-life and potential for accumulation in breast milk has prompted some recommendations to avoid its use in women who are breast-feeding young infants. Colic and fussiness have been attributed to elevated serum concentrations of fluoxetine and its metabolite in nursing infants.
ANALGESICS
Of the nonsteroidal anti-inflammatory drugs (NSAIDs), ibuprofen (Motrin) is the preferred choice because it has poor transfer into milk and has been well-studied in children. Long half-life NSAIDs such as naproxen (Naprosyn), sulindac (Clinoril) and piroxicam (Feldene) can accumulate in the infant with prolonged use.
Epidural use of bupivacaine (Marcaine), lidocaine (Xylocaine), morphine, fentanyl (Sublimaze) and sufentanil (Sufenta) is generally safe in breast-feeding mothers. Morphine, codeine and hydrocodone are considered compatible with breast-feeding by the AAP.
Meperidine (Demerol) is not the preferred analgesic for use in breast-feeding women because of the long half-life of its metabolite in infants. Repeated exposure to analgesic agents, especially meperidine, may result in drug accumulation and toxic effects in young or compromised infants because of their underdeveloped hepatic conjugation. Rovich Diagnostic Services Enugu
CONTRACEPTIVE AGENTS
Hormones contained in combination oral contraceptive pills (OCPs) are not harmful to infants but, because estrogen diminishes the maternal milk supply, these products should be avoided in breast-feeding mothers whenever possible, especially during the first two months of breast-feeding. Progestin-only contraceptives are preferable, although these also may decrease milk supply. Delaying the use of OCPs, including the progestin-only mini-pill, until six weeks after starting breast-feeding and then using a progestin-only mini-pill (such as Micronor) will allow the mother to assess the drug’s effect on her milk supply. If the medication is well-tolerated, repository medroxyprogesterone (Depo-Provera) can be used.
ANESTHETIC AGENTS
Although limited information is available regarding anesthetic agents and their compatibility with breast-feeding, use of propofol (Diprivan), thiopental sodium (Pentothal) and enflurane (Ethrane), should result in negligible amounts of drug exposure to the nursing infant. In general, the healthy term infant can safely nurse as soon after surgery as the mother is awake and alert. Rovich Diagnostic Services Enugu
CONCLUSION
In short, breast-feeding has so many benefits for mothers and infants. Breast-feeding helps infants with developing their immune system. Also, breastfeeding can save parents a lot of money. Even with help by the government, not all parents qualify for help. Lastly, breast-feeding can promote closeness between mother and infant. This is why breast-feeding is more beneficial than formula feeding. Although mothers are still being judged for breastfeeding in public today, women should still feel a sense of hope that there are people who support them. Also, the infant’s health is the most important thing.
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