Addiction: Smoking Addiction/Substance Abuse in Pregnancy Flashcards
What is the pathophysiology of nicotine?
- stimulates nicotinic receptors in the brain to release dopamine and epinephrine causing vasoconstriction
- increases mental alertness, cognitive ability, eventually depresses those responses
- often have difficulty falling asleep because nicotine acts as a stimulant
- Nicotine dependence results from chronic use
What are some withdrawal symptoms of nicotine addiction?
- craving
- nervousness
- restlessness
- Irritability
- Impatience
- Increased hostility
- Insomnia
- Weight gain
How much does secondhand smoke exposure increase lung cancer risk?
by 20-30%
What are the risk factors for nicotine addiction?
- emotions
- social pressure
- lack of education
- Alcohol use
- age
- Lower socioeconomic status
What are some ways to prevent tobacco use?
- counter-advertising mass-media campaigns
- school-based tobacco use prevention policies and programs
- Community interventions that reduce tobacco advertising
- Higher costs for tobacco products through increased excise taxes
What are some signs and symptoms of tobacco/nicotine usage?
- increased risk for heart disease, cancers of many types, COPD, HTN, stroke, macular degeneration, cataracts, PVD
- Deep voice from trauma to vocal cords
- Chronic cough
What does nicotine replacement therapy involve?
- relieves physiological effects of withdrawal
- transdermal patches
- gums
- nicotine inhalers
- Nasal Sprays
What complementary therapy could be used to help stop smoking?
- hypnotherapy
- acupuncture
- Yoga
- Massage
What nursing interventions are there for patients who have a nicotine addiction?
- serve as a role model by not smoking
- provide education information regarding dangers of smoking
- Help make smoking socially unacceptable
- Suggest resources
- Help young adults recognize, resist marketing efforts of tobacco industry
What are some teratogens?
- pesticides, viruses, medications
2. tobacco, alcohol, and illicit drugs
When is the greatest risk for abnormalities if a pregnant woman is exposed to a teratogen?
during the first trimester
What are some substances that are commonly abused during pregnancy?
- caffeine (coffee, teas, colas, chocolate)
- alcohol
- cocaine and crack
- marijuana
- Phencyclidine
- MDMA (Ecstasy)
- Heroin
- Methadone
- Tobacco
What are some things to remember about alcohol being abused during pregnancy?
- birth defects related to exposure occur during the first 3-8 weeks of gestation
- Fetal alcohol spectrum disorders
- Maternal health can be affected
- Alcohol is excreted in breast milk
What are some things to remember about cocaine and crack being abused during pregnancy?
- powerful stimulant that acts at the nerve terminals to prevent the reuptake of dopamine and norepinephrine
- Results in Vasoconstriction, tachycardia, and HTN
- IV injection or snorting powdered form
- Crack can be smoked
What are some things to remember about marijuana being abused during pregnancy?
- no strong evidence marijuana has teratogenic effects on the fetus
- Associated with newborn’s increased startles and tremors
What are some things to remember about Phencyclidine (PCP) and MDMA abuse during pregnancy?
Phencyclidine (PCP): hallucinogen; causes confusion, delirium and feelings of euphoria
MDMA: produces euphoria; little is known about the effect on the fetus
What are some things to remember about Heroin abuse during pregnancy?
- CNS depressant narcotic
- alters perception
- produces euphoria
- Fetus at increased risk for IUGR, meconium aspiration, and hypoxia
What are some things to remember about methadone abuse during pregnancy?
- blocks withdrawal symptoms
- Reduces or eliminates craving for narcotics
- Neonatal abstinence syndrome
What are some things to remember about tobacco abuse during pregnancy?
- Greater difficulty conceiving
- more likely to miscarry
- More likely to go into early labor and give birth prematurely
- Reduced birth weight
- Epigenetic studies indicated that maternal smoking alters fetal DNA and microRNA
What are the risk factors for substance abuse during pregnancy?
- low attachment
- extreme economic deprivation
- family hx of problem behavior and management problems
- Family conflict and parental attitudes
- Alienation/rebellion
- Friends with problem behavior
- Favorable attitudes to problem behavior
- early initiate of problem behavior
- early/persistent antisocial behavior
- academic failure
- lack of commitment to school
What are the classifications of medications for use during pregnancy?
- Category A: No associated fetal risk
- Category B: animal studies show no risk
- Category C: No adequate studies, or teratogenic effects in animals
- Category D: Evidence of human risk exists
- Category X: Fetal risks clearly outweigh possible benefits
-What are some ways to prevent substance abuse during pregnancy?
- identify high-risk pregnant women, promote abstinence, refer to treatment, and follow-up
- Provide public education on hazards
- Facilitate training and education of professionals
What are the clinical manifestations of cocaine abuse during pregnancy?
- placental abruption, fetal demise
- Cardiovascular and CNS effects
- Nasal and sinus diseases
What are the clinical manifestations of alcohol abuse during pregnancy?
- increased risk of miscarriage/stillbirth
- low birth weight infant
- learning, attention, and language disorders
- Fetal alcohol syndrome
What are the manifestations of nicotine abuse during pregnancy?
- miscarriage
- placental abruption
- PROM
- premature birth, low birth weight
- child may smoke later in life
- premature aging of the placenta
- arterial spasm
- polycythemia in the fetus
