How does drug use affect the unborn child & pregnant mothers during pregnancy

How does drug use affect the unborn child (foetus )during pregnancy A foetus is very sensitive to drugs and cannot eliminate drugs as effectively as adults. The chemicals can build up to extremely high levels in the foetal system and can cause permanent damage.

What are the risks of drug use during pregnancy Risks depend on : Type of drug Trimester of the pregnancy Frequency of drug use Ingested dose of the drug

DRUGS TRANSFERATION DEPEND ON SEVERAL FACTORS CHEMICAL PROPERTY OF THE DRUG MOLECULAR WEIGHT. PROTEIN BINDING CAPABILITIES. CHEMICAL CONFIGURATION. LIPID SOLUBILITY. PERIOD OF TIME DRUG REMAINS IN MATERNAL BLOODSTREAM HALFLIFE OF THE DRUG.

Certain types of drugs cause abnormalities in pregnant mothers Paracetamol Insulin Iron Folic acid

Drugs cause following harmful effects to the unborn child Miscarriages Stillbirth Small in size Low birth weight Premature birth Birth defects Sudden infant death syndrome(SIDS) Mental retardation, learning disabilities of the child

Paracetamol Overdose in Pregnancy There is evidence that the foetal liver begins to broken down paracetamol from 18 weeks gestation on wards, therefore the foetus may also be at risk for liver toxicity following maternal paracetamol overdose.

Insulin in pregnancy Insulin is safe to use under normal therapeutic conditions in pregnancy and does not cross the placenta.

Iron Overdose in Pregnancy Iron overdose can be fatal in large doses. Iron requirements increase during pregnancy and the use of iron supplements is common, particularly in the second and third trimesters.

Folic acid in Pregnancy Folic acid is necessary for the normal production of blood cells and genetic material.  Current data does not suggest an increase in adverse pregnancy outcome following use of high dose folic acid

Cholesterol lowering drugs in pregnancy Current guidelines recommend that women wishing to become pregnant stop use of above drugs three months prior to attempting to conceive. Or as soon as pregnancy is confirmed, due to the theoretical risk of foetal abnormality because foetus wants cholesterol to develop organs.

Other Agents affecting the foetus in pregnancy Cigarette smoking Alcohol Narcotics -Heroin, Cocaine, Marjuana ,Hashis

Cigarette smoking Carbon monoxide and nicotine cause low oxygen levels in blood and high blood pressure, premature labour, and stillbirth(born dead).

Alcohol Increases risk of spontaneous abortions. With regular drinking, decrease the birth weight by about 1 to 1.3Kg Foetal growth restriction, facial and cardiovascular defects, nerve dysfunction. Alcohol easily passes into breast milk and develop problems with mental development.

Narcotics-Heroin, cocaine etc. Miscarriage and foetal death This can be transmitted to the baby through breast milk. Increase risk for early delivery. Deliver a stillborn baby or a baby with growth problems.

Special care A drug overdose shortly before or during pregnancy seems to be associated with a substantially increased risk of miscarriage.

Childhood poisoning

Most common agents involve in childhood poisoning Household products, (bleachers, disinfectants, detergents, toilet cleaners, mosquito coils) Cosmetics and other personal care products Kerosene and automobile fluids (break fluids, gasoline, anti-freezer, coolant) Poisonous plants (Endaru, olinda seeds, ornamental plants as habarala) Foreign objects (batteries and toys) Paint, thinner and utilities of drawing arts Pharmaceuticals

Some rules to follow when using repellents  Never use repellents on wounds or irritated skin. If using creams, apply it only to exposed skin. Do not inhale or ingest repellents or do not get them into the eye. Avoid spraying repellents that children gathering areas. Do not use mosquito repellents in closed rooms at night. Do not use mosquito repellants if persons can’t tolerate the smell or when starting cough. If a suspected reaction occur, wash treated skin and seek medical advice.

First aid for poisoning Skin exposure Remove contaminated clothes carefully. Wash the skin with running water for at least 15 minutes. Do not use any local application without seeking medical advice.   Eye exposure Wash eyes with running water for at least 15 minutes. Do not use any eye drops without seeking medical advice. If there is visual impairment seek medical advice from an eye specialist.

First aid Cont, Inhalation Remove the patient away from the source and encourage deep breathing of fresh air.   Ingestion Do not induce vomiting because some pesticides have corrosive effects and some may contain hydrocarbons as solvents. (kerosene oil) If patient is semiconscious or unconscious keep the patient in Neck extended position. Do not give salt water, coconut milk and other home remedies to induce vomiting.

To reduce the risk of poisoning involving medicines: Keep all medications out of the reach of children. Store all medicines in their original containers. Never take medicine in front of a child. Read all instructions before administering medication to a child. Dispose of all unneeded or outdated medicines.

To reduce the risk for accidental poisoning Store all products in their original containers, out of the reach of children. Do not store or use household products in food containers. Never mix cleaning agents or chemical bottles together with drugs. Make sure the area is well-ventilated when using chemicals. Do not spray chemicals (including pesticides) when children are in the area. Teach children never to smell or taste a container to identify what is inside.

Risk of Accidental Poisoning

Harmful effects of lead poisoning Mental retardation Growth retardation Learning difficulties Loss of hearing

To reduce the risk for other types of poisoning in children: Don’t apply lead paint in your home. Follow safe handling recommendations for all foods. Remove the toxic plants in your home or garden. Discuss with children about the dangers of using illegal drugs which selling in streets. eg: Barbul,Beeda

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