( neonatal drug wit hdrawal syndrome) ,,, 3 %, 50 % [1 5 ], 3 % 11 % 5 % [6 ] Milhorn ,,, 55 % 94 % [1 ] ] A [ ] (2000)

Transcription

1 Chin J Contemp Pediatr Vol. 2 No. 1 Feb [ ] ; [ ] R96 ;R996 [ ] A [ ] (2000) ( neonatal drug wit hdrawal syndrome) ( ) %11 % 3 % 50 % 5 ] 5 % [6 ] 1 ] Milhorn ] (1) 2 ] ; 1 ] 11 ] ] ] ; 5 ] 221 ] 55 %94 % ] [ ] 1956 [ ]

2 2 1 (morphine) (methadone) (codeine) (pethidine) (heroin) (fentynal) (propoxyphine) (hydromorphone) (oxcodone) (pentazocine) (buprenorphine) (nalbuphine) (butorphanol) (phenobarbital) (amobarbital) (secobarbital) (diazepam) (oxazepam) (flurazepam) (estazolam) (chlordiazepoxide) (methaqualone) (glutethimide) (methyprylon) (ethchlorvynol) (ethinamate) (chloral hydrate) (bromide) (meprobamate) (impramine) (clomipramine) (desipramine) (hydroxyzine) (doxepin) (haloperid) (marijuana) (hashish) (lysergic acid diethylamine) ( psilocyn) (psilocybin) ( dimethyl2 tryptamine) (diethyltryptamine) (mescaline) (peyote) ( methylenedioxyamphetamine ) ( methoxy2 dimethylenedioxyamphetamine) (dimethylenedioxy - methamphetamine) (dimethylenedioxyethamphetamine) (nitrites) (nitrous oxide) (amphetamine) (dextroamphetamine) (methamphetamine) (benzphetamine) (diethylpropion) (fenfluramine) (mazindol) (phentermine) (phenypropanolamine) (phenmetrazine) (phendimetrazine) ( cocaine ) ( coffeine ) ( pemoline ) ( phencyclidines) (methylphenidate) 5 11 ] ] ; ( ) ( ) 3 ( ) ; ] ] 312h ; 4872 h ] 4 ; 47 d 114 d ; 12 d 58

3 1 : 21 ; 5 11 ] : : ; ; : ] : 9 20 ] ] 5 ] : : : : : : 5 11 ] : : 3. 3 : 1 Finnegan 31 ] : [9 Ostrea 6 ] : ] [22 Lipsitz 11 ] (2) : ( ) 8 < : > 4 ( 77 %) ; 59

4 ] cal/ kg 8 ] ] ] ] ] 11 ] ] Finnegan (tincture of opium) 2 ] ] 10 mg/ ml [22 ] mg/ kg ] / ] ; ] : 25 (0. 4 mg/ ml) mg/ kg ] (paregoric)

5 1 : mg/ ml 25 ] 13d 1 : (isoquinoline) (phenobarbital) (noscapine) (papaverine) ; (camphor) ; ; 11 (ethanol) ] 16 mg/ (anise oil) ; (benzyl alcohol) ( benzoicacid) 510 mg/ kg 24 h 46 mg/ kg 24 h 2345 d 72 h 15 % ( morphine) 13 mg/ kg [23 ] 10g/ ml (sodium bisulfite) (phenol) (diazepam) 2mg/ ml 4mg/ ml [8 ] ] : 10 % 1 ; ; ] (propylene glycol) (chlorpromazine) (methadone) mg/ kg 6 8 % 1 26h ] mg/ kg mg/ kg mg/ [24 25 kg ] (clonidine) 2 ] mg/ kg 35 mg/ kg ng/ ml ] kg 1520g/ ml mg/ kg 8 1 (sodium sulfite) ] 5 8 ]

6 2 6 / 330. / [2730 ] [ ] ] American Academy of Pediatrics Committee on Drugs. Neonatal drug withdrawal. Pediatrics 1998 ; 101 : [2 ] Substance Abuse and Mental Health Services Administration Of2 fice of Applied Studies Preliminary results from the 1996 national household servey on drug abuse Washington DC : US Dept of Health and Human Service [ 3 ] Milhorn HT Pharmacologic management of acute abstinence syn2 droms. Am Fam Physician 1992 ; 45 : [ 4 ] Khalsa J H Gfroerer J Epidemiology and health consequences of drug among pregnant woman Semin Perinatol 1991 ; 15 : ] Bean X Maternal substance abuse. In. Taeusch HW Ballard RA Avery ME. eds. Schaffer and Avery s Disease of the newborn 6th ed. Philadelphia : Saunders : [6 ] Kiegman RM Behrman RE. Substance abuse and withdrawals. In. Behrman RE Kliegman RM Nelson WE et al. Eds. Nel2 son Textbook of Pediatrics 14 thed : Philadelphia : saunders. [ 7 ] Rosenberg AA Battaglia FC. Infants of mothers who abuse drugs. In. Hathaway WE Groothuis J R Hay Jr WW et al. Current Pe2 diatric Diagnosis & Treatment 10th ed. Norwalk Connecticut Cali2 fornia : Appleton & Lange : [8 ] Pildes RS Srinivasan G. Infants of drug - dependent mothers. In. Gellis SS Kagan BM. eds. Current Pediatric Therapy Vol 13 Philadelphia : Saunders : [9 ] Ostrea EM. Infants of drug - dependent mothers. In. Burg FD Ingelfinger J R Wald ER. eds. Current Pediatric Therapy Vol : ] Committee on Substance Abuse Academy of Pediatrics. Sub2 stance abuse Pediatrics 1990 ; 86 : [ 11 ] Finnegan L P Neonatal abstinece. In. Nelson NM. Ed. Current Therapy in Neonatal - Perinatal Medicine. Toronto : BC Deck2 er : ] Finnegan L Kaltenbach K Weiner S et al. Neonatal cocaine 62 exposure assessment of risk scale. Pediatr Res : 10A. 3 ] Ryan RM Wagner CL Schultz J M et al. Meconium analysis for improved identification of infants exposed to cocaine in utero. J Pediatr 1994 ; 125 : ] Horowitz RM Drug use in pregnancy : to test to tell : Legal implications for the physician. Semin Perinatol 1991 ; 15 : 324 [ 15 ] King TA Perlman J M Laptook AR ed. Neurologic manifesta2 tions of in utero cocaine exposure in near - term and term in2 fants. Pediatrics 1995 ; 96 : ] Napiorkowski B Lester BM Freier MC et al. Effects of in utero substances exposure on infant neurobehavior Pediatrics 1996 ; 98 : [ 17 ] Tromick EZ Frand DA Cabral H et al. Late dose - responds of prenatal cocaine exposure on newborn neurobehavioral perfor2 mance Pediatrics 1996 ; 98 : [ 18 ] Mayer LC granger RH Frank M et al. Neurobehavioral Pro2 files of neonates exposed to cocaine prenatally. Pediatrics 1993 ; 91 : ] Singer L Arendt R Minnes S. Neurodevelopmental effects of cocaine. Clin Perinatol 1993 ; 20 : [ 20 ] Zuckerman B Bresnahan K. Developmental and behavioral con2 sequences of drug and alcohol exposurs. Pediatr Chin North Am 1991 ; 38 : [ 21 ] Behnke M Eyler FD Conlon M et al. Incidence and descrip2 tion of structual brain abnormalities in newborn exposed to co2 caine. J Pediatr 1998 ; 132 : [22 ] Lipsitz PJ. Aproposed narcotic withdrawal score for use with newborn infants. a pragmatic evaluation of its efficacy. Clin Pe2 diatr 1975 ; 14 : [ 23 ] Wijburg FA Kleine MJ Fleury P et al. Morphine as an anti - epileptic drug in neonatal abstinence syndrome. Scand ; 80 : Acta Pediatr [24 ] Anand KJ Amold J H. Opioid tolerance and dependence in in2 fants and children. Crit Care Med 1994 ; 22 : [ 25 ] Tobias JD Schieien CL Haun SE. Methadone as treatment for iatrogenic narcotic dependency in pediatric intensive care unit pa2 tients. Crit Care Med 1990 ; 18 : [ 26 ] Baumgartner GR Rowen RC. Transdermal clonidine versus chlor2 diazepam in alcohol withdrawal : a randomized controlled clinical tri2 al. South Med J 1991 ; 84 : [ 27 ] Ashery R Robertson E Kumpfer KL. eds. Drug Abuse Prevention Trough Family Intervention. Rockville MD : NIH Pub [ 28 ] Johnson JL Leff M. Children of substance abusers : Overview of research findings. Pediatrics 1999 ; 103 : [29 ] Werner MJ Joffe A Graham AV. Screening early identification and office - based intervention with children and youth living in sub2 stance - abusing families. Pediatrics 1999 ; 103 : [ 30 ] Kumpfer KL. Outcome measures of interventions in the study of children of substance - abusing parents. Pediatrics 1999 ; 103 : ( : : ) ( : )