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PCL201 > Lec 19: Drug Induced Birth Defects > Flashcards

Lec 19: Drug Induced Birth Defects Flashcards

1
Q

what are the possible outcomes of pregnancy

A

healthy, healthy but with short term effects, spontaneous abortion, major birth defects, minor anomalies

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2
Q

what is a teratogen

A

agent or factor causing congenital malformations or abnormal mental dev in fetus or after birth

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3
Q

what is teratogenesis

A

initiation of bird defects

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4
Q

what is chemical tertogenesis

A

birth defects caused by exposure to chemicals

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5
Q

what is the incidence of teratogenesis

A

due to all causes, 1-3%. due to drugs, less than 2%

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6
Q

why is assessing teratogenesis difficult

A

because of number of prenatal death, cant know whether it was bc of defect

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7
Q

what is a major birth defect

A

affects child survival

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8
Q

what is thalidomide teratogenesis

A

phocomelia: short limbs bc of thalidomide

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9
Q

what is thalidomide

A

made in 53, on market in 57
used as tranquilers and anti vomiting medicine

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10
Q

what happens in thalidomide tertogenecity

A

but: defects include limb reduction, facial hemangioma, smal; ears, eye abnomrlaities, kidney malformations, heart disease

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11
Q

when is thalidomide terotegencity high risk period

A

20-36 days post fert

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12
Q

what is the mechanism of teratogenecity

A

binds to crbn, then destabalizes cd147/mcti which leads to limb malformation

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13
Q

was thalidomide taken off market after tertogenecity

A

no,

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14
Q

relationship between thalidomide and inflammation

A

actually had other uses (imflammation reduction in leprosy)

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15
Q

why is it challenging to identify human terotogens?

A
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16
Q

what happens during embyotic phase?

A

day 0 to 56 where tissues and organs develop

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17
Q

what happens during fetal phase?

A

56 until birth: rapid growth of tissues and organs

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18
Q

what is the all or nothing period? what happens?

A

first two weeks post conception where, if too many cells are killed, the embryo cant survive.

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19
Q

when is organogenesis? significance?

A

3-8 weeks post conception, where it is more sensitive to chemicals

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20
Q

why is the first trimester so important?

A

thats when development is really getting initiated

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21
Q

what are the consequences of teratogenesis

A

death, mutations (DES), structural anomalies (thalidomide), functional anomalies (alochol)

22
Q

what factors influence drug transfer to fetus

A

placenta
drug properties

23
Q

what characteristics of the placenta influence placental drug transfer?

A

blood flow
drug transport
drug met

24
Q

what properties of the drug influence placantal drug transfer? how?

A

weight
lipid solubility
protein binding
ionization

25
Q

how do drugs cross the maternal placental fetal unit?

A
  1. admin to mom. some goes in receprtor, moms brain, moms tissues, moms liver.
  2. free drug passes through placenta and goes to fetal parts , some comes back through umbilical artery
26
Q

what are the direct effects of drugs on the fetus?

A

receptor mediated tox
reactive intermediate mediated tox
ie: proteratogens -> electrophiles -> target dna proteins and lipids

27
Q

what are the indirect effect of drugs on the fetus?

A

poor nutrition
disease states
altereted blood supply

28
Q

human teratogen examples?

A

anticancer agents
anticoags

29
Q

why are anticancer drugs dangerous during preg?

A

ie: cyclophose causes cns malformations

30
Q

why are anticoags dangerous during preg? specific examples?

A

ie: growth retardation and chondrodysplasia (abnormal cartilage growth), hypoplastic nasal bridge, cns malformations, heart defects

31
Q

what is fetal warfarin syndrome?

A

hypoplastic nose, flat face, low nasal bridge

32
Q

wjhy are antseizure agents during preg dangerous?

A

can cause dismorphic geatures
ie: phenytoin: craniofacial dysmorphology, growth retardation, cns defecits,

33
Q

what is fetal hydantoin syndrome?

A

fetal dismorphia bc of phenytoin use

34
Q

what is a cleft lip or palate? when does it occur?

A

elft lip: lip and nostril formed together

cleft palate: tissue on roof of mouth doesnt join properly

occurs in fetal hydantoin syndrom

35
Q

what can phenytoin during preg lead to?

A

fetal hydantoin syndrom

36
Q

what can carmazepine and valproic acid during preg lead to?

A

neural tube defects

37
Q

what is late neurula? caused by which drug?

A

when the neural tube fails to close.
carbamazepine, valproic acid

38
Q

what can late neurula lead so?

A

different defects
anencephaly, craniorachischisis, oepn spina bifida, iniencephaly, encaphalocele, closed spina bifida

39
Q

what is the relationship between folic acid and neural tube defects?

A

can treat them

40
Q

what is diethylstilbestrol?

A

DES
estrogen that causes vaginal/cervical cancer (clear cell adenocarcinoma), genital defects,
effects not seen until puberty

41
Q

retinoids during preg can lead to

A

istretinoin can lead to cns, craniofacial, cvs, malformations

42
Q

what is retinoic acid embryopathy?

A

congenital condition caused by fetal exposure to retinoids

43
Q

what is fetal alcoholic spectrum disorder?

A

condition when fetus is exposed to alcohol
growth retardation, microcephaly, mental retardation, neura defecits, facial dysmorphology

44
Q

chracteristics of fasd>

A

flat midface, smooth filtrum, thin lip, low nasal bridge, epicanthic folds, ear abnormalities, micrognathia

45
Q

brain changes of fasd babies?

A

smaller, malformed

46
Q

maternal smoking dangers/

A

less in women that stop smoking earlier, but low birth weight, abortion

47
Q

sedatives affect on neonates

A

may cause sedation in neonate

48
Q

when would neonatal withdrawl syndrome occur (NAS)

A

when mom exposed baby to drug, and now supply is cut off

49
Q

what is NAS

A

neonatal abstinance syndrome, happens within hours or days of delivery
irritability, high pitched cry, tremor, rapid breathing, increased muscle tone, seizures

50
Q

drugs contributing to NAS

A

PCL201 (19 decks)

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