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    Evidence Based Nursing (Eyes and Ears)

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    Jamie Riesgo
    Among pregnant mothers who take opiates like methadone, this study found their infants are at risk of various visual problems. The study examined 20 infants exposed to methadone in the womb, finding 95% had reduced vision acuity, 70% had nystagmus, and 60% had abnormal electrophysiology tests. Those who were treated for neonatal abstinence syndrome after birth were more likely to develop nystagmus. The authors conclude infants exposed to drug misuse in the womb, especially those severe enough to require treatment, are at risk for visual impairments and abnormalities that clinicians should be aware of.

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    Evidence Based Nursing (Eyes and Ears)

    Uploaded by

    Jamie Riesgo
    20 views4 pages
    Among pregnant mothers who take opiates like methadone, this study found their infants are at risk of various visual problems. The study examined 20 infants exposed to methadone in the womb, finding 95% had reduced vision acuity, 70% had nystagmus, and 60% had abnormal electrophysiology tests. Those who were treated for neonatal abstinence syndrome after birth were more likely to develop nystagmus. The authors conclude infants exposed to drug misuse in the womb, especially those severe enough to require treatment, are at risk for visual impairments and abnormalities that clinicians should be aware of.

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    Among pregnant mothers who take opiates like methadone, this study found their infants are at risk of various visual problems. The study examined 20 infants exposed to methadone in the womb, finding 95% had reduced vision acuity, 70% had nystagmus, and 60% had abnormal electrophysiology tests. Those who were treated for neonatal abstinence syndrome after birth were more likely to develop nystagmus. The authors conclude infants exposed to drug misuse in the womb, especially those severe enough to require treatment, are at risk for visual impairments and abnormalities that clinicians should be aware of.

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    Download as docx, pdf, or txt
    20 views4 pages

    Evidence Based Nursing (Eyes and Ears)

    Uploaded by

    Jamie Riesgo
    Among pregnant mothers who take opiates like methadone, this study found their infants are at risk of various visual problems. The study examined 20 infants exposed to methadone in the womb, finding 95% had reduced vision acuity, 70% had nystagmus, and 60% had abnormal electrophysiology tests. Those who were treated for neonatal abstinence syndrome after birth were more likely to develop nystagmus. The authors conclude infants exposed to drug misuse in the womb, especially those severe enough to require treatment, are at risk for visual impairments and abnormalities that clinicians should be aware of.

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    EVIDENCE ± BASED NURSING

    (EYES AND EARS)

    SUBMITTED BY:
    PUTONG, APRIL VERED
    RENION, LOVELY
    RIESGO JAMIE
    SAMOY, JESSIELYN
    VELASCO, MA LIEZL

    BSN 219 Group 076


    I. Clinical Question

    Among pregnant mothers, do exposure to opiates (including substitute methadone)


    and/or benzodiazepines affect the visual outcome of their infants?

    II. Citations

    Authors:

     R Hamilton1,
     L McGlone2,
     J R MacKinnon3,
     H C Russell3,
     M S Bradnam1,
     H Mactier

    Source:
     Nursing Standard (NURS STAND), 2010 Jun 9-15; 24(40): 17 (1 ref)
     Br J Ophthalmol bjo.2009.169284Published Online First: 21 April 2010

    EBSCO: Methadone exposure in utero puts children's eyesight in jeopardy.

    BMJ JOURNALS: Ophthalmic, clinical and visual electrophysiological findings in


    children born to mothers prescribed substitute methadone in pregnancy

    III. Study Characteristics

    Methadone is a narcotic pain reliever, similar to morphine. It also reduces withdrawal


    symptoms in people addicted to heroin or other narcotic drugs without causing the
    "high" associated with the drug addiction.

    Methadone is used as a pain reliever and as part of drug addiction detoxification and
    maintenance programs.

    There are growing concerns regarding visual outcome of infants exposed to opiates
    (including substitute methadone) and/or benzodiazepines in utero. We describe the
    combined ophthalmology and visual electrophysiology findings in 20 infants and
    children who had been exposed to substitute methadone and other drugs of misuse in
    utero.
    IV. Methodology

    This was a descriptive case series of 20 patients, all of whom had been referred
    to a pediatric visual electrophysiology service because of concerns regarding visual
    function, and all of whom had been exposed to methadone in utero.

    All children underwent a full ophthalmic and orthotics examination as well as


    visual electrophysiology testing deemed appropriate on an individual basis.

    A review was undertaken of pediatric case notes and of maternal antenatal urine
    toxicology.

    V. Results of the Study

    Ophthalmic abnormalities included reduced acuity (95%), nystagmus (70%), delayed


    visual maturation (50%), strabismus (30%), refractive errors (30%), and cerebral visual
    impairment (25%). Visual electrophysiology was abnormal in 60%.

    A quarter of the children had associated neurodevelopmental abnormalities. The


    majority of children with nystagmus (79%) had been treated for neonatal abstinence
    syndrome (NAS).

    VI. Author’s Conclusions

    "Infants born to drug-misusing mothers prescribed methadone in pregnancy are at risk


    of a range of visual problems, the underlying causes of which are not clear. Those
    infants with NAS severe enough to receive pharmaceutical treatment may be at
    particular risk of developing nystagmus.

    The inclusion of visual electrophysiology in comprehensive visual assessment of


    children exposed to substance misuse in utero may help clarify the underlying causes
    by differentiating abnormalities of retinal and cortical origin," the authors write.

    VII. Applicability

    This study is applicable to all pregnant mothers who take opiates as a means to relieve
    pain during pregnancy
    VIII. Reviewer’s Conclusion

    This study will be helpful to all the pregnant mothers especially those who are taking
    pain medications / opiates to control what they take to protect the offspring.

    This study also show results of what is the harmful effects of the opiates to the infant
    when taken during pregnancy

    The results are also credible.

    IX EVALUATION

     Safety:
    There were risks involved in the study since some infants to be exposed to methadone.

     Competence of the Care Provider


    The provider was able to get reasonable results within their time frame

     Acceptability
    The study is acceptable because it showed reasonable results and will be helpful in the
    future researches about opioids namely methadone

     Effectiveness
    It showed effectiveness because those were included in the trial that that had less
    exposure in methadone showed less visual impaired infants

     Appropriateness

    The research is appropriate for pregnancy mothers to less intake of pain relievers for
    the safety of their offspring.

     Efficiency

    The study is not that efficient because a drug had to be used and should be taken by
    mothers.

     Accessibility

    The study is accessible to pregnant mothers, to be able to be aware of what medication


    they should take for the protection of their offspring

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