First Aid - Teratogens Flashcards
ACE inhibitors
Renal damage
Alkylating agents
Absence of digits, multiple anomalies
Aminoglycosides
Ototoxicity
– A mean guy hit the baby in the ear.
Antiepileptic drugs
Neural tube defects, cardiac defects, cleft palate, skeletal abnormalities (eg, phalanx/nail hypoplasia, facial dysmorphism)
–High-dose folate supplementation recommended. Most commonly valproate, carbamazepine, phenytoin, phenobarbital.
Diethylstilbestrol
Vaginal clear cell adenocarcinoma, congenital Mullerian anomalies
Folate antagonists
Neural tube defects
- Includes trimethoprim, methotrexate, antiepileptic drugs.
Isotretinoin
Multiple severe birth defects
–Contraception mandatory, IsoTERATinoin.
Lithium
Ebstein anomaly (apical displacement of tricuspid valve)
Methimazole
Aplasia cutis congenita
Tetracyclines
Discolored teeth, inhibited bone growth
–“Teethracyclines.”
Thalidomide
Limb defects (phocomelia, micromelia-"flipper" limbs) --Limb defects with "tha-limb-domide."
Warfarin
Bone deformities, fetal hemorrhage, abortion, ophthalmologic abnormalities
–Do not wage warfare on the baby; keep it heppy with heparin (does not cross placenta).
Alcohol
Common cause of birth defects and intellectual disability; fetal alcohol syndrome
Cocaine
Low birth weight; preterm birth, IUGR, placental abruption
–Cocaine -> vasoconstriction
Smoking (nicotine, CO)
Low birth weight (leading cause in developed countries), preterm labor, placental problems, IUGR, SIDS
– Nicotine -> vasoconstriction.
CO -> impaired O2 delivery
Iodine (lack or excess)
Congenital goiter or hypothyroidism (cretinism)
Maternal diabetes
Caudal regression syndrome (anal atresia to sirenomelia), congenital heart defects, neural tube defects, macrosomia
Methylmercury
Neurotoxicity
– Highest in swordfish, shark, tilefish, king mackerel
Vitamin A excess
Extremely high risk for spontaneous abortions and birth defects (cleft palate, cardiac)
X-rays
Microcephaly, intellectual disability
–Minimized by lead shielding.
