Transfer of methadone across the dually perfused preterm human placental lobule

Nanovskaya, Tatiana; Nekhayeva, Ilona; Hankins, Gary D.V.; Ahmed, Mahmoud S.

doi:10.1016/j.ajog.2007.06.073

Cited by 77 publications

(69 citation statements)

References 20 publications

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“…87 The incidence and severity of withdrawal is less extensive in preterm neonates. 88 Various factors explain the decreased incidence in preterm neonates, including decreased cumulative exposure, 88 decreased transmission across the placenta during early gestation, 71 decreased morphine clearance, 89 decreased excretion because of immaturity of the kidneys and liver, decreased fatty tissues in preterm infants (methadone is accumulated in fatty tissue), decreased receptor development, and decreased receptor sensitivity. 76,90 Withdrawal symptoms among neonates whose mothers took an SSRI or SNRI may result from excess serotonin and noradrenaline.…”

Section: Pathophysiologymentioning

confidence: 99%

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Neonatal Abstinence Syndrome

2014

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Neonatal abstinence syndrome (NAS) is a result of the sudden discontinuation of fetal exposure to substances that were used or abused by the mother during pregnancy. Withdrawal from licit or illicit substances is becoming more common among neonates in both developed and developing countries. NAS continues to be an important clinical entity throughout much of the world. NAS leads to a constellation of signs and symptoms involving multiple systems. The pathophysiology of NAS is not completely understood. Urine or meconium confirmation may assist the diagnosis and management of NAS. The Finnegan scoring system is commonly used to assess the severity of NAS; scoring can be helpful for initiating, monitoring, and terminating treatment in neonates. Nonpharmacological care is the initial treatment option, and pharmacological treatment is required if an improvement is not observed after nonpharmacological measures or if the infant develops severe withdrawal. Morphine is the most commonly used drug in the treatment of NAS secondary to opioids. An algorithmic approach to the management of infants with NAS is suggested. Breastfeeding is not contraindicated in NAS, unless the mother is taking street drugs, is involved in polydrug abuse, or is infected with HIV. Future studies are required to assess the long-term effects of NAS on children after prenatal exposure.

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Section: Pathophysiologymentioning

confidence: 99%

“…The transmission of opioids across the placenta increases as gestation increases. 71 Synthetic opiates cross the placenta more easily compared with semisynthetic opiates. 72 The combination of cocaine or heroin with methadone further increases the permeability of methadone across the placenta.…”

Section: Pathophysiologymentioning

confidence: 99%

Neonatal Abstinence Syndrome

2014

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“…A final explanation is increased placental transfer of methadone to the neonatal circulation at term (21). The effect intravenous medications have on length of treatment when oral feedings are held should be considered.…”

Section: Commentmentioning

confidence: 99%

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

Seligman

Hayes

OʼNeill

et al. 2007

American Journal of Obstetrics and Gynecology

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“…The in vitro perfusion model provided valuable information on transplacental transport of nutrients such as amino acids (Schneider et al 1979;Schneider et al 1987), fatty acids (Dancis et al 1974;Dancis et al 1973), hormones (insulin (Boskovic et al 2003;Menon et al 1990), vitamins (biotin, thiamin) (Schenker et al 1990;Schenker et al 1992) and various drugs, such as anesthetics drugs (Ala-Kokko et al 1995;Giroux et al 1997), antidiabetic related drugs (Elliott et al 1991;Elliott et al 1994;Holmes et al 2006;Nanovskaya et al 2006;Kovo et al 2008a;Kovo et al 2008b), HIV protease inhibitors (Olivero et al 1999;Forestier et al 2001), antiepileptic drugs (Pienimaki et al 1997;Myllynen et al 2003), abused drugs (Malek et al 1995;Nanovskaya et al 2008) and antibiotics (Polachek et al 2005 (Bourget et al 1995;Myren et al 2007). In addition, we can learn from such perfusion experiments about the effect of exogenous compounds on the placental transfer of endogenous compounds.…”

Section: Placental Transfer Of Substancementioning

confidence: 99%

In Vitro Models Using the Human Placenta to Study Fetal Exposure to Drugs

Kovo

Golan

2008

Clinical medicine. Reproductive health

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Over the recent years there has been a gradual rise in the use of pharmaceuticals during pregnancy. Knowledge on placental drug transfer and metabolism has increased during the past decades as well. Investigation of the transplacental transfer of any therapeutically useful drug is essential to the understanding of its metabolic processes and is a prerequisite for its use during pregnancy. The purpose of this review is to give insight on the various techniques that have been developed to evaluate transplacental transfer of drugs and xenobiotics.

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Transfer of methadone across the dually perfused preterm human placental lobule

Cited by 77 publications

References 20 publications

Neonatal Abstinence Syndrome

Neonatal Abstinence Syndrome

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

In Vitro Models Using the Human Placenta to Study Fetal Exposure to Drugs

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