Methadone trough levels in pregnancy

Drozdick, John; Berghella, Vincenzo; Hill, Mary Kay; Kaltenbach, Karol

doi:10.1067/mob.2002.127132

Cited by 55 publications

(35 citation statements)

References 12 publications

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“…The best explanation for why methadone dose and length of treatment are unrelated is because methadone metabolism is enhanced to variable degrees in the pregnancy (15). In fact methadone trough levels do not correlate well with maternal dosage (24), so that maternal methadone dose should be decided based on maternal symptoms, with no predetermined maximum. Positive results may also be achieved in women who undergo supervised withdrawal to doses less than 20 mg daily (8,10).…”

Section: Commentmentioning

confidence: 99%

Predicting length of treatment for neonatal abstinence syndrome in methadone-exposed neonates

Seligman

Salva

Hayes

et al. 2008

American Journal of Obstetrics and Gynecology

113

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Section: Commentmentioning

confidence: 99%

Predicting length of treatment for neonatal abstinence syndrome in methadone-exposed neonates

Seligman

Salva

Hayes

et al. 2008

American Journal of Obstetrics and Gynecology

113

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“…The most appropriate methadone dose in pregnancy is still debated. Some practitioners favour higher doses to limit illicit drug use and counteract the increased methadone clearance in pregnancy, which may necessitate a dose increase in the third trimester (Drozdick et al, 2002;Wolff et al, 2005). Others favour lower doses to try to reduce the incidence of neonatal abstinence syndrome (NAS) (Dashe et al, 2004) or using the lowest doses compatible with stability (Dryden et al, 2009).…”

Section: Opioidsmentioning

confidence: 99%

BAP updated guidelines: evidence-based guidelines for the pharmacological management of substance abuse, harmful use, addiction and comorbidity: recommendations from BAP

Welch²,

et al. 2012

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The British Association for Psychopharmacology guidelines for the treatment of substance abuse, harmful use, addiction and comorbidity with psychiatric disorders primarily focus on their pharmacological management. They are based explicitly on the available evidence and presented as recommendations to aid clinical decision making for practitioners alongside a detailed review of the evidence. A consensus meeting, involving experts in the treatment of these disorders, reviewed key areas and considered the strength of the evidence and clinical implications. The guidelines were drawn up after feedback from participants. The guidelines primarily cover the pharmacological management of withdrawal, short-and long-term substitution, maintenance of abstinence and prevention of complications, where appropriate, for substance abuse or harmful use or addiction as well management in pregnancy, comorbidity with psychiatric disorders and in younger and older people. KeywordsSubstance misuse, addiction, guidelines, pharmacotherapy, comorbidity 1 Imperial College London, CNWL NHS Foundation Trust, London, UK 2 Gether NHS Foundation Trust, Gloucester, UK 3 Pennine Care NHS Foundation Trust, Ashton-under-Lyne, UKOther invited participants at the consensus meeting who contributed to the discussion and commented on the guidelines were Drummond C, Farrell M, Gilvarry E, Strang J. John, a user representative, read and commented on the written guidelines. Prof W van den Brink reviewed the written guidelines.

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“…67 Another potential explanatory factor is the significant interindividual variability in maternal methadone metabolism. 75 As a result, cumulative fetal exposure can be expected to vary among infants born to mothers on equivalent methadone regimens.…”

mentioning

confidence: 99%

Neonatal Drug Withdrawal

Hudak¹,

Tan²,

Frattarelli³

et al. 2012

Pediatrics

742

608

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Maternal use of certain drugs during pregnancy can result in transient neonatal signs consistent with withdrawal or acute toxicity or cause sustained signs consistent with a lasting drug effect. In addition, hospitalized infants who are treated with opioids or benzodiazepines to provide analgesia or sedation may be at risk for manifesting signs of withdrawal. This statement updates information about the clinical presentation of infants exposed to intrauterine drugs and the therapeutic options for treatment of withdrawal and is expanded to include evidence-based approaches to the management of the hospitalized infant who requires weaning from analgesics or sedatives.

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Methadone trough levels in pregnancy

Cited by 55 publications

References 12 publications

Predicting length of treatment for neonatal abstinence syndrome in methadone-exposed neonates

Predicting length of treatment for neonatal abstinence syndrome in methadone-exposed neonates

BAP updated guidelines: evidence-based guidelines for the pharmacological management of substance abuse, harmful use, addiction and comorbidity: recommendations from BAP

Neonatal Drug Withdrawal

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