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Teratogenicity01:07

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The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...
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Ganglionic stimulants activate NM nicotinic receptors in autonomic ganglia, falling into two categories: nicotine mimetics [e.g., lobeline, dimethylpiperazine, tetramethylammonium] and muscarinic receptor agonists [e.g., muscarine, methacholine]. The first category's action is rapid and blocked by nicotinic receptor antagonists, while the second category's action is delayed and blocked by atropine-like agents. Nicotine, an alkaloid, affects the heart rate by stimulating...
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Drugs Affecting Neurotransmitter Synthesis01:29

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Drugs affecting neurotransmitter synthesis can impact the adrenergic neuron and the synthesis of neurotransmitters. For example, α-methyltyrosine and carbidopa target specific enzymes involved in catecholamine synthesis. α-methyltyrosine inhibits the enzyme tyrosine hydroxylase, which converts tyrosine into dopamine. By blocking this enzyme, α-methyltyrosine reduces dopamine production and other catecholamines. Carbidopa, on the other hand, inhibits the enzyme dopa decarboxylase,...
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Adrenergic Agonists: Indirect-Acting Agents01:25

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Indirect-acting adrenergic agonists potentiate the effects of endogenous catecholamines through different mechanisms without directly binding to adrenoceptors.
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CNS Stimulants: Cocaine, Amphetamines and Cannabinoids01:24

CNS Stimulants: Cocaine, Amphetamines and Cannabinoids

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CNS stimulants, such as cocaine, amphetamines, and cannabinoids, have varying structures and mechanisms of action that lead to different therapeutic effects and side effects. Cocaine, with its molecular formula C17H21NO4, is a tropane alkaloid and a tertiary amino compound. It has two chemical forms: the hydrochloride salt and the "freebase." The former is in powder form, while the latter involves removing the hydrochloride salt to create a form that can be smoked. Cocaine exerts its...
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Stimulants01:29

Stimulants

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Stimulants are substances that enhance neural activity and elevate dopamine levels in the brain, leading to their highly addictive nature. These drugs include cocaine, amphetamines, MDMA, caffeine, and nicotine, each with distinct mechanisms of action and varied health implications.
Cocaine can be administered via snorting, injection, or smoking. It primarily functions by blocking the reuptake of dopamine, resulting in a euphoric high characterized by an intense sensation of happiness and...
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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
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Teratogen update: Amphetamines.

Joan D Garey1, Shari I Lusskin1,2,3, Anthony R Scialli1

  • 1Reproductive Toxicology Center, A Non-Profit Foundation, Washington, District of Columbia, USA.

Birth Defects Research
|August 6, 2020
PubMed
Summary
This summary is machine-generated.

Amphetamines, used for ADHD and narcolepsy, show limited evidence of causing birth defects in humans. Prenatal amphetamine abuse, however, is linked to neurobehavioral issues in offspring.

Keywords:
amphetaminesbirth defectsmethamphetamineneurobehaviorpregnancy

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Area of Science:

  • Pharmacology
  • Developmental Toxicology
  • Neuroscience

Background:

  • Amphetamines are psychostimulant medications prescribed for conditions like ADHD and narcolepsy.
  • These substances are also associated with recreational abuse.
  • Concerns exist regarding potential adverse developmental effects, including structural malformations.

Purpose of the Study:

  • To review the evidence on amphetamine exposure during pregnancy and its effects on offspring development.
  • To differentiate between therapeutic use and abuse of amphetamines concerning developmental outcomes.

Main Methods:

  • Literature review of experimental animal studies and human controlled studies.
  • Examination of associations between therapeutic amphetamine use and ADHD medication with birth defects.
  • Assessment of studies on prenatal amphetamine and methamphetamine abuse and neurobehavioral outcomes.

Main Results:

  • Animal studies suggest malformations at high doses causing maternal toxicity, not typically seen in therapeutic human use.
  • Controlled human studies do not strongly indicate amphetamines cause structural malformations, though some studies link ADHD medication/methamphetamine abuse to gastroschisis.
  • Limited data exists on neurobehavioral effects of therapeutic prenatal amphetamine exposure; abuse is linked to abnormalities, but confounding factors complicate interpretation.

Conclusions:

  • Therapeutic amphetamine use for ADHD and other conditions is not clearly associated with structural malformations in offspring.
  • Adverse neurobehavioral outcomes in offspring are more strongly linked to prenatal amphetamine/methamphetamine abuse, potentially due to confounding factors.
  • Findings from amphetamine abuse studies may not be directly applicable to prescribed therapeutic amphetamine use during pregnancy.