Neonatal_cocaine_testing

Neonatal_cocaine_testing - Laboratory Methods for Detecting...

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Laboratory Methods for Detecting Prenatal Exposure to Cocaine Roger L. Bertholf, Ph.D. Associate Professor of Pathology University of Florida College of Medicine Health Science Center/Jacksonville
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Why test babies for cocaine? Prevalence of maternal cocaine use Effect of in utero cocaine exposure on fetal and postnatal development Medical/social/legal interventions
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Prevalence of maternal cocaine use 1998 Household Survey revealed that 1.8 million Americans use cocaine (0.8% of population >12 years old) 2% of 18-25 year-olds; 1.2% of 26-35 year-olds 0.5% of women are cocaine users Estimates of the prevalence of cocaine use during pregnancy range from less than 2% to more than 15% Reasons for variations Geographic/socioeconomic/racial Methods used to detect use
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Is prenatal cocaine exposure harmful? Extensive literature on clinical effects of prenatal cocaine exposure Confounding factors are almost always present Poor prenatal care Concomitant drug use (alcohol, nicotine) Reliable animal models do not exist Sheep Pig Rodent
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Well documented physiological effects of cocaine Vasoconstriction Decreases uterine blood flow in sheep Cerebral vasodilation and hypertension in newborn sheep and pigs Neurotransmitter deficiencies ACTH and corticosterone response in rats Dopamine transporter binding in mice Consistent observations in cocaine exposed neonates Intrauterine growth retardation (LBW) Prematurity Complications/LOS
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Does cocaine cross the placenta? Studies in pregnant sheep and rodents indicate that both cocaine and its metabolites cross the placenta Fetal levels approximately 15% of maternal There is also evidence that the placenta has AChE activity May have a protective effect
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This note was uploaded on 09/18/2011 for the course MED 6566 taught by Professor Staff during the Summer '11 term at University of Florida.

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Neonatal_cocaine_testing - Laboratory Methods for Detecting...

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