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These guidelines have been developed to enable professionals to assist women who are pregnant, or have recently had a child, and who use alcohol or drugs or who have a substance use disorder, to achieve healthy outcomes for themselves and their fetus or infant. They have been developed in response to requests from organizations, institutions and individuals for technical guidance on the identification and management of alcohol, and other substance use and substance use disorders in pregnant women. They were developed in tandem with the WHO recommendations for the prevention and management of tobacco use and second-hand smoke exposure in pregnancy.
Clinics in Developmental Medicine No. 188 This book documents the consequences of the exposure of infants to the influence of intrauterine chemicals. In setting out the evidence for these outcomes, the authors demonstrate that decisions about care and management can and should be made as early as possible. This should allow professionals to provide protective management and prevent the delays that are so often seen in this area of medical and social care. The international team of contributors sets out to inform the reader of the potential risks to infants exposed to a range of intrauterine chemicals that are potentially neuroactive, including medicinal drugs such as antiepileptics, antidepressants and antipsychotics, as well as drugs of abuse, including alcohol, opiates, and recreational drugs such as cannabis and tobacco. They review the teratogenic action of some of the chemical processes and the relationship of exposure to the stage of pregnancy. Some agents alter anatomic structure; others alter the chemical balance of neurotransmitters and may thus alter the regulation of brain function, with profound effects on the child's behaviour and propensity to behavioural disturbances. The book explores strategies to support these children and those who care for them, including statutory agencies. Readership Paediatricians, neonatologists, obstetricians, gynaecologists, child and adolescent psychiatrists and psychologists, those working in child care and child protection.
Gain guidance and support when treating the high-risk population of women confronting (or battling) opioid-use disorders during pregnancy.
Abstract: This book addresses the use of drug groups for various clinical indications during pregnancy. In general, non-pharmacologic remedies are recommended if these will suffice before drug therapy is instituted. Known adverse effects of drugs are documented and caution is advised because of the many unknowns about long-term effects of drug exposure to the developing fetus. Drugs used for the common cold, antituberculosis agents, antihypertensives, anticonvulsants, and marijuana and cocaine are included.
Clinical Pharmacology During Pregnancy is written for clinicians, physicians, midwives, nurses, pharmacists and other medical professionals directly involved in the care of women during pregnancy. This book focuses on the impact of pregnancy on drug disposition and also includes coverage of treatments for diseases of specific body systems, as well as essential content on dosing and efficacy. Written in a clear and practical manner, this reference provides easily accessible information and clinical guidance on how best to treat women with medications during pregnancy.
This book is an introduction to the harmful effects of alcohol, tobacco, and drugs.
It sounds simple: Women who drink while pregnant may give birth to children with defects, so women should not drink during pregnancy. Yet in the 20 years since it was first described in the medical literature, fetal alcohol syndrome (FAS) has proved to be a stubborn problem, with consequences as serious as those of the more widely publicized "crack babies." This volume discusses FAS and other possibly alcohol-related effects from two broad perspectives: diagnosis and surveillance, and prevention and treatment. In addition, it includes several real-life vignettes of FAS children. The committee examines fundamental concepts for setting diagnostic criteria in general, reviews and updates the diagnostic criteria for FAS and related conditions, and explores current research findings and problems associated with FAS epidemiology and surveillance. In addition, the book describes an integrated multidisciplinary approach to research on the prevention and treatment of FAS. The committee: Discusses levels of preventive intervention. Reviews available data about women and alcohol abuse and treatment among pregnant women. Explores the psychological and behavioral consequences of FAS at different ages. Examines the current state of knowledge about medical and therapeutic interventions, education efforts, and family support programs. This volume will be of special interest to physicians, nurses, mental health practitioners, school and public health officials, policymakers, researchers, educators, and anyone else involved in serving families and children, especially in high risk populations.
An A-Z listing of drugs by generic name. Each monograph summarizes the known and/or possible effects of the drug on the fetus. It also summarizes the known/possible passage of the drug into the human breast milk. A careful and exhaustive summarization of the world literature as it relates to drugs in pregnancy and lacation. Each monograph contains six parts: generic US name, Pharmacologic class, Risk factor, Fetal risk summary, Breast feeding summary, References
Alcohol use disorder (AUD) is a major public health problem in the United States. The estimated 12-month and lifetime prevalence values for AUD are 13.9% and 29.1%, respectively, with approximately half of individuals with lifetime AUD having a severe disorder. AUD and its sequelae also account for significant excess mortality and cost the United States more than $200 billion annually. Despite its high prevalence and numerous negative consequences, AUD remains undertreated. In fact, fewer than 1 in 10 individuals in the United States with a 12-month diagnosis of AUD receive any treatment. Nevertheless, effective and evidence-based interventions are available, and treatment is associated with reductions in the risk of relapse and AUD-associated mortality. The American Psychiatric Association Practice Guideline for the Pharmacological Treatment of Patients With Alcohol Use Disorder seeks to reduce these substantial psychosocial and public health consequences of AUD for millions of affected individuals. The guideline focuses specifically on evidence-based pharmacological treatments for AUD in outpatient settings and includes additional information on assessment and treatment planning, which are an integral part of using pharmacotherapy to treat AUD. In addition to reviewing the available evidence on the use of AUD pharmacotherapy, the guideline offers clear, concise, and actionable recommendation statements, each of which is given a rating that reflects the level of confidence that potential benefits of an intervention outweigh potential harms. The guideline provides guidance on implementing these recommendations into clinical practice, with the goal of improving quality of care and treatment outcomes of AUD.
Significant changes have taken place in the policy landscape surrounding cannabis legalization, production, and use. During the past 20 years, 25 states and the District of Columbia have legalized cannabis and/or cannabidiol (a component of cannabis) for medical conditions or retail sales at the state level and 4 states have legalized both the medical and recreational use of cannabis. These landmark changes in policy have impacted cannabis use patterns and perceived levels of risk. However, despite this changing landscape, evidence regarding the short- and long-term health effects of cannabis use remains elusive. While a myriad of studies have examined cannabis use in all its various forms, often these research conclusions are not appropriately synthesized, translated for, or communicated to policy makers, health care providers, state health officials, or other stakeholders who have been charged with influencing and enacting policies, procedures, and laws related to cannabis use. Unlike other controlled substances such as alcohol or tobacco, no accepted standards for safe use or appropriate dose are available to help guide individuals as they make choices regarding the issues of if, when, where, and how to use cannabis safely and, in regard to therapeutic uses, effectively. Shifting public sentiment, conflicting and impeded scientific research, and legislative battles have fueled the debate about what, if any, harms or benefits can be attributed to the use of cannabis or its derivatives, and this lack of aggregated knowledge has broad public health implications. The Health Effects of Cannabis and Cannabinoids provides a comprehensive review of scientific evidence related to the health effects and potential therapeutic benefits of cannabis. This report provides a research agendaâ€"outlining gaps in current knowledge and opportunities for providing additional insight into these issuesâ€"that summarizes and prioritizes pressing research needs.