morphine and Central-Nervous-System-Diseases

This review discusses all pyridine alkaloids with CNS activity, their therapeutic potential, and the interesting array of sources whence they originate.

Topics: Alkaloids; Amphibians; Animals; Bacteria; Central Nervous System Diseases; Fungi; Nicotine; Plants; Pyridines; Receptors, Nicotinic

Recent reports indicate that cocaine metabolites have biologic activity and could be toxic. To explore this possibility, two studies were initiated. The first study aimed to define the distribution of cocaine species by quantifying levels of cocaine and its metabolites norcocaine, benzoylecgonine, and benzoylnorecgonine in newborn cord blood and meconium. The second study sought to determine whether they produced a clinical effect. Compared to cord blood, meconium had a greater number of metabolites and a higher concentration of cocaine metabolites, including the previously undetectable norcocaine and benzoylnorecgonine derivatives. Benzoylecgonine was the most common species found in both sources and was usually lower in concentration in blood. An inverse relation existed between meconium benzoylecgonine levels and the serum catabolic enzyme pseudocholinesterase, implying genetic variability in cocaine metabolism. To determine whether cocaine and/or its metabolites could be linked to a distinct clinical state, a second study focusing on newborn behavior was performed with an independent large cohort of cocaine-exposed infants. Neonates with increased signs of "neuroexcitation" had benzoylecgonine and no cocaine in urine, whereas lethargic neonates had detectable urinary cocaine. These findings support the hypothesis that cocaine metabolites, especially benzoylecgonine, may play a role in altering newborn behavior and produce a clinical syndrome distinct from that related to the parent compound.

Topics: Butyrylcholinesterase; Central Nervous System Diseases; Cocaine; Female; Fetal Blood; Fever; Humans; Infant, Newborn; Maternal-Fetal Exchange; Meconium; Neonatal Abstinence Syndrome; Pregnancy; Prospective Studies; Respiratory Distress Syndrome, Newborn

Topics: Acid-Base Equilibrium; Acidosis; Asphyxia Neonatorum; Blood Circulation; Blood Glucose; Body Temperature Regulation; Calcium; Central Nervous System Diseases; Humans; Hyaline Membrane Disease; Hypoxia; Infant, Newborn; Meconium; Oxygen Consumption; Pneumonia, Aspiration

Analyses were undertaken to determine the causes of cerebral palsy in a prospective study of 43,437 full-term children. Presumed causes were found for about 71% of the 34 quadriplegic and 40% of the 116 nonquadriplegic patients with cerebral palsy. Risk estimates based on predictive models, adjusted for multiple factors, suggest that 53% of the quadriplegic patients with cerebral palsy could be attributed to congenital disorders, 14% to birth asphyxia, and 8% to other identified disorders. Thirty-five percent of the nonquadriplegic patients with cerebral palsy could be attributed to congenital disorders and 6% to other disorders. In the victims of cerebral palsy, characteristic consequences of birth asphyxia were more often the result of nonasphyxial disorders. These included meconium in the amniotic fluid, low 10-minute Apgar scores, neonatal apnea spells, seizures, persisting neurologic abnormalities, and slow head growth after birth.

Topics: Aged; Amniotic Fluid; Apgar Score; Asphyxia Neonatorum; Central Nervous System Diseases; Cerebral Palsy; Child; Confidence Intervals; Congenital Abnormalities; Humans; Infant; Infant, Newborn; Meconium; Prospective Studies; Risk Factors

Topics: Central Nervous System Diseases; Child Development; Congenital Abnormalities; Emaciation; Female; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Prospective Studies; Respiratory Tract Infections; Sleep Wake Disorders; Social Behavior; Syndrome; Thumb