Module 6 Unit C Flashcards
Substance
Compare and contrast the ability of urine, mcconium, and hair samples to determine prenatal and pernatal drug use.
Urine will show only current and recent use, and will not detect synthetic drugs, some benzos and designer drugs.
Hair follicles can detect use in the past 90 days.
Meconium in the newborn, if positive, relates to the past 4-5 months.
What effect does nicotine have on fetal and newborn growth?
Tobacco exposure is strongly associated with fetal growth restriction and stillbirth in a dose‐dependent relationship.
What effect does nicotine exposure have on fetal anomalies?
Cleft lip and palate Musculoskeletal defects (clubfoot, craniosynostosis) Gastrointestinal defects (gastroschisis, hernia) Asthma and other atopic diseases Middle ear infections Neurological development deficits Sudden Infant Death Syndrome Reduced head circumference Altered brainstem development Cognitive, emotional, and behavioral problems Altered lung structure Cerebral palsy
Do newborns expose to nicotine in utero go through withdrawal through withdrawal?
Yes
What type of neural behavior do newborns exposed to nicotine in utero display?
Prenatal exposure to nicotine desensitizes neurotransmitter actions in the fetus. The resulting symptoms of depression, inattention, and hyperactivity in adolescents and adults appear to be partially corrected by nicotine use, suggesting a biologic basis for future smoking addiction.
How does nicotine exposure affect newborn cognition?
Delayed or impaired brain development cognitive, emotional,or behavioral problems.
What effect does alcohol have on fetal and newborn growth?
Growth deficiency or FGR
CNS dysfunction with developmental disability or brain damage
characteristic facial dimorphisms of short philtrum, thin upper lip, and short distance between the inner and outer eye canthus
What effect does alcohol exposure have on fetal anomalies?
CNS dysfunction with developmental disability or brain damage
characteristic facial dimorphisms of short philtrum, thin upper lip, and short distance between the inner and outer eye canthus
Do newborns expose to alcohol in utero go through withdrawal?
Yes. Symptoms include high-pitched cry, jitteriness, and seizures.
What type of neurobehavior do newborns expose to alcohol in utero display?
Intellectual, behavioral, and learning disabilities and problems with behavior and learning, characterized by academic difficulties with math, memory, attention, judgment, and poor impulse control.
How does alcoholic exposure affect newborn cognition?
Intellectual problems
learning disabilities
academic difficulties with math
What is fatal alcohol syndrome?
Fetal alcohol syndrome is the most severe effect of drinking during pregnancy. It causes death, abnormalities of the face, growth and central nervous system problems, and learning and mental disabilities.
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What is the safe amount of alcohol use in pregnancy or while trying to get pregnant?
Women who are pregnant or trying to get pregnant should avoid the use of alcohol.
What effect do opiates (heroin, oxycontin) have on fetal and newborn growth?
Fetal growth restriction, low birth weight
What effect does opiate exposure have on fetal anomalies?
Possibly heart defects, neural tube defects, and gastroschisis.
Do newborns expose to opioids in utero go through withdrawal?
Yes
What type of neurobehaviors do newborns exposed to opioids in utero display?
NAS
What effect does marijuana have on fetal and newborn growth?
May affect brain development
What effect does marijuana exposure have on fetal anomalies?
None
Do newborns expose to marijuana in utero go through withdrawal?
No
What type of neuro behavior do newborns exposed to marijuana in utero display?
Deficits in attention span
How does marijuana exposure affect newborn cognition?
Attention deficits
What effect does methamphetamine have on fetal and newborn growth?
IUGR, SGA
What effect does myth amphetamine exposure have on fetal anomalies?
Some isolated defects
Do newborns exposed to methamphetamine in utero go through withdrawal?
Yes
What type of neural behaviors do newborns expose to methamphetamine in utero display? How does methamphetamine exposure affect newborn cognition?
Neurobehavioral and cognitive defects
What is neonatal abstinence syndrome?
The term neonatal abstinence syndrome (NAS) refers to the constellation of signs and symptoms displayed by a neonate exposed to opiates in utero.
What substances are associated with neonatal abstinence syndrome?
Opioids
What newborn symptoms are suggestive of NAS?
Restlessness, tremors, high‐pitched cry, increased muscle tone, irritability, and exaggerated Moro reflex. Seizures occur in 2–11% of infants withdrawing from opioids if untreated. Sleep pattern disturbance, irritability, and hypertonia may last for 4–6 months
What environmental factors help a newborn with NAS?
Keep infant in a quiet and dimly lit room
Handle infant in a soft, slow manner.
Swaddling, pacifiers
Rooming in with mom can be effective in reducing the need for pharmacologic treatment.
What drug category are current in NAS algorithms specific for?
Opioids
What potential complication can occur when narcan is given to an opioid dependent infant?
Hospitals may have a fear of inadvertently precipitating neonatal withdrawal in infants delivered to previously unrecognized opioid abusers.
What drugs does the American Academy of pediatrics consider contra indications to breastfeeding?
Cocaine, illicit opioids, marijuana, methamphetamine
What complications are associated with opioid dependence and treatment in pregnancy?
Heart defects, neural tube defects, gastoschisis, IUGR, preterm birth, low birth weight, intrauterine fetal demise
When should substance use screening be done and how should patience be screened?
Universal screening for substance abuse allows the healthcare provider to discuss the risks of alcohol, drug, and tobacco use with every pregnant woman, eliminating provider bias in determining who is screened. Early screening at the first prenatal visit enables timely intervention and referral to treatment for pregnant women with a substance use disorder, and maximizes efforts at harm reduction. Screening should be done with a caring and respectful approach using a validated screening instrument.
What are available treatment programs for opioid dependence?
Office‐based treatment includes behavioral treatment for substance use with or without medication. For OUD, medication may consist of buprenorphine/naloxone, buprenorphine monotherapy, or naltrexone. Methadone maintenance programs combine behavioral treatment with daily observed treatment with methadone. Intensive outpatient programs (IOPs) offer substance use treatment several days of the week for a standard number of hours on an outpatient basis. Residential treatment programs offer daily, intensive substance use treatment in a residential setting. Some residential programs are gender‐specific. A few residential programs are also equipped to accommodate children whose mothers are seeking treatment.
