Complications and Hospital Admissions among Pregnant Women with Substance Abuse

In recent times, there has been an increase in drug abuse in not only the general population, but in women of reproductive age. Our objectives were to identify, classify, and describe the spectrum of complications, the average number of admissions, and length of hospital stay that occur among pregnant women with substance abuse. The aim was to obtain better understanding of complication prevalence to improve management in this ever-growing population. A retrospective chart review was conducted of pregnant women ages 18-45 with a history of substance abuse from 2013-2018 in the tri-state area of West Virginia, Ohio, and Kentucky. We collected the following data: demographics, medical history, specific substances abused, inpatient admission dates and diagnoses, and delivery information. A total of 411 patients met the inclusion criteria, with a total of 525 pregnancies. Out of 525 pregnancies, 71.6 % used buprenorphine (i.e., Subutex), 43.4% used opiates, excluding heroin, and 35% of patients used heroin. Out of the 525 pregnancies, there were 714 inpatient antepartum admissions. Of these, 376 were admissions due to withdrawal symptoms (52.7%). A total of 263 pregnancies had at least one admission for withdrawal, drug abuse, overdose, or buprenorphine/methadone conversion (50%). The average length of hospital stay for withdrawal admissions was 3.4 days (SD). There were 62 admissions for infectious causes, 24 of these being due to pyelonephritis (38.7%). The findings highlight multiple areas for future studies as well as areas for quality improvement in the management of this population

Hit-optimization using target-directed dynamic combinatorial chemistry: development of inhibitors of the anti-infective target 1-deoxy-d-xylulose-5-phosphate synthase.

Target-directed dynamic combinatorial chemistry (tdDCC) enables identification, as well as optimization of ligands for un(der)explored targets such as the anti-infective target 1-deoxy-d-xylulose-5-phosphate synthase (DXPS). We report the use of tdDCC to first identify and subsequently optimize binders/inhibitors of the anti-infective target DXPS. The initial hits were also optimized for their antibacterial activity against E. coli and M. tuberculosis during subsequent tdDCC runs. Using tdDCC, we were able to generate acylhydrazone-based inhibitors of DXPS. The tailored tdDCC runs also provided insights into the structure-activity relationship of this novel class of DXPS inhibitors. The competition tdDCC runs provided important information about the mode of inhibition of acylhydrazone-based inhibitors. This approach holds the potential to expedite the drug-discovery process and should be applicable to a range of biological targets

Hit-optimization using target-directed dynamic combinatorial chemistry : development of inhibitors of the anti-infective target 1-deoxy-d-xylulose-5-phosphate synthase

Target-directed dynamic combinatorial chemistry (tdDCC) enables identification, as well as optimization of ligands for un(der)explored targets such as the anti-infective target 1-deoxy-D-xylulose-5-phosphate synthase (DXPS). We report the use of tdDCC to first identify and subsequently optimize binders/inhibitors of the anti-infective target DXPS. The initial hits were also optimized for their antibacterial activity against E. coli and M. tuberculosis during subsequent tdDCC runs. Using tdDCC, we were able to generate acylhydrazone-based inhibitors of DXPS. The tailored tdDCC runs also provided insights into the structure–activity relationship of this novel class of DXPS inhibitors. The competition tdDCC runs provided important information about the mode of inhibition of acylhydrazone-based inhibitors. This approach holds the potential to expedite the drug-discovery process and should be applicable to a range of biological targets