Notes in L14 Extremes of Age, Reproductive and Perinatal Populations/2nd half

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Published	06/22/2023	What is Fertility? The ability to {{c1::reproduce}}
Published	06/22/2023	Can Toxins affect Fertility? {{c1::yes }}
Published	06/22/2023	• Toxins can affect both {{c1::male and female}} fertility
Published	06/22/2023	What is the history of Diethylestibesterol (DES)? Given to {{c1::prevent spontaneous abortions}} – not effective Associated with increased mat…
Published	06/22/2023	{{c1::Teratogens}} are toxins or toxicants that are affecting the developing fetus, and usually doesnt have an effect on the mother
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Published	06/22/2023	In pregnancy there is increased {{c1::perfusion}} out to the skin, you might see increased {{c1::absorption}}, so you might see a faster ons…
Published	06/22/2023	In pregnancy things don't go through the same/ {{c1::quite as fast}} which can lead too delays of peaks plasma concentrations,
Published	06/22/2023	In pregnancy there is a {{c1::decrease}} in overall residual lung volume and this actually leads to an {{c1::increase}} of inhalation, asfar as s…
Published	06/22/2023	In pregnant woman, you can see there's overall {{c1::decrease}} of albumin inside the blood, so that can be important for protein binding of different…
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Published	06/22/2023	What factors impact a drug 'Crossing the Placenta'?Dependent on {{c1::Lipophilicity}}Lipophilic xenobiotics readily {{c2::cross}} the placenta {{…
Published	06/22/2023	Carbamazepine:Leads to {{c1::neural tube}} defectsFetal {{c1::CBZ}} syndrome: Craniofacial changes and Hypoblastic nails
Published	06/22/2023	What is Phenytoin "Fetal Hydrantoin Syndrome"?It leads to {{c1::Craniofacial}} changes, {{c1::Mental}} retardation and has a similar look to fetal CBZ…
Published	06/22/2023	An antiepileptic also used for mood stabilizers is {{c1::valproic acid}}, and in pregnant women it can cause "Neural tube defects" and "Craniofacial c…
Published	06/22/2023	In order to develop true fetal alcohol syndrome, the mother has to have more than {{c1::five drinks}} per day, that's referring to standard drinks
Published	06/22/2023	What do we see in Fetal Alcohol Syndrome?{{c1::Craniofacial}} changes Intrauterine and Post natal Growth {{c1::Retardation}}Decreased {{c1::intel…
Published	06/22/2023	What does toxicity from Methyl Mercury resemble?{{c1::Cerebral palsy}} like sydromeMothers in Minmata Japan exposed from eating contaminated fish from…
Published	06/22/2023	If a mother gets sick with Iron toxicity it will affect her more than the child.If needed we use {{c1::defuroxamine}} to save the mother but very litt…
Published	06/22/2023	Cocaine use during pregnancy causes what? {{c1::Placental}} disruption
Published	06/22/2023	What is placental disruption? That is when the placenta will pull away from the wall of the uterus leading to {{c1::blood}} forming in between the pla…
Published	06/22/2023	Why is placental disruption detrimental?It can cause {{c1::decreased}} blood flow to the fetus and hemorrhaging of the mother
Published	06/22/2023	Do children whose parents have taken cocaine have withdrawal syndromes? {{c1::NO }}
Published	06/22/2023	Opioids in Pregnancy:Many have teratogenic effects Most experience is with methadone = safe WHO recommends {{c1::buprenorphine}} or {{c1::me…
Published	06/22/2023	What is associated with Neonatal Abstinence Syndrome?{{c1::Sedative}} hypnotics: days to weeks post partum{{c1::ETOH}} (Alchohol): Typically hours pos…
Published	06/22/2023	What are these symptoms associated with? {{c1::Neonatal Abstinence}} Syndromes
Published	06/22/2023	What are risks vs benefits of exposure to medication through BreastFeeding?All sorts of different substances can move into breast milk largely by {{c1…
Published	06/22/2023	If one has taken drugs and they need to pump and discard, where do they get guidelines from? {{c1::Drug and Lactation Database (LactMed)}}
Published	06/22/2023	What is Carbon monoxide poisoning like in mothers and what fatalities does it cause? • Leading cause of poison fatalities • {{c1::Fetal risk}} >…
Published	06/22/2023	What are some confounders of Substance Abuse reporting? • Multiple confounders affect research- i.e. socioeconomic status, prenatal care • Self-re…
Published	06/22/2023	What occurs with Neonates in regards to substance abuse? Have {{c1::slower}} GI absorption Thin epidermis = {{c2::increased}} skin absorption…
Published	06/22/2023	Pediatric Poisoning Facts: • Over 60% of all poison exposures are {{c1::pediatric}} patients (0-18y) • Bimodal Distribution • {{c2::80%}} are…
Published	06/22/2023	WHat are the top 3 most common substances that cause Pediatric exposures?- {{c1::Cosmetics and Personal Care}} products - {{c1::Analgesics}}- {{c…
Published	06/22/2023	What is the GOOD NEWS in regards to Pediatic poisining? • Exploratory intent + smaller volume + less toxic substances = {{c1::Better}} outcomes • …
Published	06/22/2023	What is the Bad News in regards to Pediatric Poisining? • Some medications are very potent even in {{c1::small}} doses  • Children are (gen…
Published	06/22/2023	Pathophysiologic Differences: Toxicokinetics in Children • Alterations in drug {{c1::metabolism}} • P450, ADH, hepatic glucuronidation • Codeine…
Published	06/22/2023	Risk Factors for Pediatric Poisoning • {{c1::Child}} factors • {{c1::Poison}} factors • {{c1::Environmental}} factors
Published	06/22/2023	What are the Child-associated Risk Factors? • {{c1::Age}}: 1-4 years • {{c1::Gender}}: Boys > girls• {{c1::Temperament}}: Impulsivity, hyperact…
Published	06/22/2023	What are Poison-associated Risk Factors? • {{c1::Attractiveness, Palatability}} • {{c1::Ease}} of Access • {{c1::Child-resistant}} closures • …
Published	06/22/2023	Environmental Risk Factors • {{c1::Family}} Composition • {{c1::Toxin}} Availability • Household {{c1::guests }}
Published	06/22/2023	Case “2 yo girl drank juice and complained that her tongue "felt weird”. Patient took a nap. She was found cold, limp and barely breathing afte…
Published	06/22/2023	“One Pill Can Kill” • CCBs • Beta blockers • Sulfonylureas • TCAs • {{c1::Opioids}} • Anticonvulsants • Methylsalicylate • Alcohols • Benzocain…
Published	06/22/2023	Case • 2yo arrives in ED pale, with massive hematemesis • Cardiac arrest • Cannot be resuscitatedWhat did he ingest? He ingested a {{c1::button …
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