1.7 MTB Step 3 - The Newborn (Neonatal Withdrawal)

Question 1

SUBSTANCE ABUSE & NEONATAL WITHDRAWAL

NEONATAL WITHDRAWAL

What are (13) possible Presentations of Neonatal Withdrawal?

Answer 1

1. Hyperactivity
2. Irritability
3. Fever
4. Diarrhea
5. Tremors/Jitters
6. High-Pitched Crying
7. Sneezing
8. Restlessness
9. Vomiting
10. Nasal Stuffiness
11. Poor Feeding
12. Seizures
13. Tachypnea

Question 2

SUBSTANCE ABUSE & NEONATAL WITHDRAWAL

NEONATAL WITHDRAWAL

1. How long AFTER Birth does Neonatal Withdrawal occur to the drugs Heroin, Cocaine, Amphetamine, and Alchohol?
2. How long AFTER Birth does Neonatal Withdrawal occur to the drug Methadone?

Answer 2

1. Withdrawal from Heroin, Cocaine, Amphetamine, & Alcohol:
   
   • Presents within the first 48 hours of life
2. Withdrawal from Methadone:
   
   1. Presents within the first 96 hours of life (upto 2 weeks)
   2. Methadone is associated withHigher risk of Seizures

Question 3

SUBSTANCE ABUSE & NEONATAL WITHDRAWAL

COMPLICATIONS

What (4) Complications are Infants of Addicted Mothers at a Higher Risk for?

Answer 3

1. Low Birth Weight (LBW)
2. Intrauterine Growth Restriction (IUGR)
3. Congenital Anomalies (Alcohol, Cocaine)
4. Sudden Infant Death Syndrome (SIDS)

Question 4

SUBSTANCE ABUSE & NEONATAL WITHDRAWAL

COMPLICATIONS

What (5) Complications of the Mother’s Conditions should you watch out for in Infants of Addicted Mothers?

Answer 4

1. Sexually Transmitted Diseases (STDs)
2. Toxemia
3. Breech
4. Abruption
5. Intraventricular Hemorrhage (cocaine)

Question 5

SUBSTANCE ABUSE & NEONATAL WITHDRAWAL

MANAGEMENT

What are the (2) Best INITIAL Treatments for Infants of Addicted Mothers?

Answer 5

OPIOIDS

and

PHENOBARBITAL

*Prescribe OPIOIDS (especially if specific prenatal opioid use was known)​*

Question 6

SUBSTANCE ABUSE & NEONATAL WITHDRAWAL

MANAGEMENT

Why should you NEVER give Naloxone to an Infant of an Addicted Mother?

Answer 6

Naloxone may Precipitate SUDDEN Withdrawal

• Including Seizures