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Can buprenorphine be induced on pregnant women who use fentanyl?

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Buprenorphine induction can be successfully done on pregnant women who use fentanyl, as demonstrated in a case where a 24-year-old pregnant woman with opioid use disorder (OUD) was initiated on buprenorphine/naloxone through a low-dose induction protocol while continuing to use fentanyl/heroin . This case highlights the potential of buprenorphine for managing cancer-related pain in pregnant patients, showcasing a rapid buprenorphine induction using a microdosing regimen in a pregnant patient . Additionally, studies emphasize the importance of exploring buprenorphine as an alternative to methadone for treating OUD in pregnant women, given its unique pharmacokinetics and clinical benefits . Therefore, buprenorphine induction can be a viable option for pregnant women using fentanyl, offering a promising alternative for medication-assisted treatment during pregnancy.

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Journal Article•DOI Transgenerational effects of opioids on cardiovascular outcomes of the rat offspring Nermin Ahmed, Analia S. Loria - Show less +1 more 01 May 2023-Physiology	Not addressed in the paper.
Journal Article•DOI Can buprenorphine be used for opioid use disorder during pregnancy Serene Philip, Brooke Griffin - Show less +1 more 01 Aug 2021-JAAPA : official journal of the American Academy of Physician Assistants	Not addressed in the paper.
Journal Article•DOI Rapid Buprenorphine Induction for Cancer Pain in Pregnancy. Madison N. Irwin, Ketti S Petersen, Michael A. Smith - Show less +2 more 01 Aug 2021-Journal of Palliative Medicine 4 Citations	Not addressed in the paper.
Open access•Journal Article•DOI Successful Buprenorphine/Naloxone Low-dose Induction in Pregnancy: A Case Report Ivo Beck 02 Aug 2022-Journal of Addiction Medicine 1 Citations	Yes, buprenorphine can be successfully induced in pregnant women who use fentanyl, as demonstrated in the case report utilizing a low-dose induction protocol.
Journal Article•DOI Successful Buprenorphine/Naloxone Low-dose Induction in Pregnancy: A Case Report Rebecca Coish, Janine Hardial - Show less +1 more 02 Aug 2022-Journal of Addiction Medicine	Yes, buprenorphine can be successfully induced in pregnant women who use fentanyl, as demonstrated in the case report utilizing a low-dose induction protocol without precipitated withdrawal.

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Use of drugs in pregnancy?4 answersThe use of drugs in pregnancy is a complex issue due to concerns about teratogenicity and potential harm to the fetus. Physiological changes during pregnancy can alter drug pharmacokinetics, affecting absorption, distribution, metabolism, and excretion. It is generally advised to avoid drug use during pregnancy, especially in the first trimester when organogenesis occurs. While some drugs are considered safe for use in pregnancy, caution is necessary as the fetus may metabolize drugs differently from the mother, leading to potential accumulation and harm. Studies emphasize the importance of understanding drug effects on the fetus and recommend using safer drugs whenever possible. Continuous surveillance of drug utilization during pregnancy is crucial to ensure informed decision-making and avoid risks associated with inadequate data.

Can a pregnant woman take Paracetamol?5 answersPregnant women can take Paracetamol, but caution is advised due to potential risks associated with its use during pregnancy. Studies suggest that long-term exposure to Paracetamol in utero may lead to adverse neurodevelopmental outcomes in children, indicating a dose-response effect. Despite being considered safe when used as directed, Paracetamol's prenatal exposure has been linked to potential alterations in fetal development, urging the need for further research and caution in its use during pregnancy. The World Health Organization recommends Paracetamol as a first-line treatment for pain, but its use during pregnancy, even in optimal doses, has been associated with an increased risk of neurodevelopmental disorders in infants, such as ADHD and autism. Therefore, pregnant women should ideally use Paracetamol only when necessary to treat conditions that might harm the fetus, like severe pain or high fever.

What is the rate of fentanyl mixed with stimulants?5 answersThe rate of fentanyl mixed with stimulants has significantly increased in recent years. Studies show that the percentage of US overdose deaths involving both fentanyl and stimulants concurrently rose nearly 60-fold from 0.6% in 2010 to 32.3% in 2021. Additionally, behavioral economic demand analyses suggest that the co-use of cocaine and fentanyl may increase the risk for developing a substance use disorder. Furthermore, data collected from social media platforms indicate a steady increase in mentions of stimulants, particularly methamphetamine, among people who use opioids, closely resembling the growth in overdose deaths involving opioids and stimulants. Lastly, a cross-sectional study of urine drug test results found a significant increase in the rate of nonprescribed fentanyl positivity among cocaine-positive results, highlighting the emerging combination of fentanyl with other illicit drugs like stimulants.

Was there a rise in marijuana use in pregnant women after legalization?5 answersThere was a rise in marijuana use in pregnant women after legalization. Studies showed that the prevalence of cannabis use during the preconception period increased significantly after legalization, with higher odds of cannabis use in the post-legalization period. However, the increase in cannabis use during pregnancy was not statistically significant. The rate of acute care related to cannabis use during pregnancy almost doubled after legalization, although absolute increases were small. These findings highlight the need for interventions to reduce cannabis use during pregnancy in jurisdictions pursuing legalization. It is important for healthcare providers to discuss cannabis use with pregnant patients and provide counseling regarding the potential effects on fetal development.

Does paracetamol use during pregnancy affect the fetus?5 answersParacetamol use during pregnancy has been associated with potential risks to the fetus. Long-term exposure to paracetamol in utero has been linked to adverse neurodevelopmental outcomes in children, indicating a dose-response effect. However, short-term exposure to paracetamol does not seem to carry the same risks. Paracetamol crosses the placenta through passive diffusion, and there are several possible mechanisms by which it may affect fetal brain development. Studies have also suggested that paracetamol exposure during pregnancy may alter fetal development and interfere with the immunologic development of the brain. However, other studies have not found an increased risk of perinatal outcomes associated with paracetamol use during pregnancy. The evidence regarding the effects of paracetamol on fetal sexual development is mixed, with some studies reporting associations with certain urogenital/reproductive disorders in offspring. Overall, while the evidence is limited and conflicting, a precautionary attitude towards paracetamol usage during pregnancy may be warranted.

What are the factors that increase risk of fentanyl linked overdose?10 answers

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