Repro Flashcards by Hannah Shull

ACEI effect on fetus?

renal damage

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Alkylating agents effect on fetus?

absence of digits, mult anomalies

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Aminoglycosides effect on fetus?

CN VIII tox (a mean guy hit the baby in the ear)

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Carbamazepine effect on fetus?

neural tube defects, craniofacial defects, fingernail hypoplasia, develop delay, IUGR

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DES effect on fetus?

vaginal clear cell adenoca, congenital Mullerian anomalies

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Folate antag’s effect on fetus?

neutral tube defects

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Li effect on fetus?

Ebstein’s anomaly (atrialized RV, meaning huge RA and small RV, 50% have WPW synd)

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Phenytoin effect on fetus?

fetal hydantoin synd (microcephaly, dysmorphic craniofacial features, hypoplastic nails and distal phalanges, heart defects, IUGR, retard), neuroblastoma, bl’ing from VitK defic

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Tetracyclines effect on fetus?

discolored teeth

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Thalidomide effect on fetus?

limb defects (flipper limbs)

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Valproate effect on fetus?

inhib of mat folate ab’n -> neural tube defects, autism

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Warfarin effect on fetus?

bone deformities, fetal hemorrhage, abortion, eye abnl’ities, nasal hypoplasia, agenesis corpus callosum (GIVE HEPARIN!!!)

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Cocaine effect on fetus?

abnl fetal development, fetal addiction, placental abruption (sm head, low birth wt, renal agenesis, CHD)

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Smoking (nicotine, CO) effect on fetus?

preterm labor, placental problems, IUGR, ADHD

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Lack/excess of iodide effect on fetus?

congenital goiter or hypothyroidism (cretinism)

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Mat DM effect on fetus?

caudal regression synd (anal atresia to sirenomelia), heart and neural tube defects

VitA excess effect on fetus?

high spont abortion rate and birth defects (cleft palate, heard abnl’ities)

XRs effect on fetus?

microcephaly, retard

Leuprolide

- mech, clin use, toxicity

GnRH analog, agonist in pulsatile fashion, or antag in cont fashion (down reg’s R in pit)
pulsative for infertility, cont for prostate ca (w/ flutamide), uterine fibroids and precocious puberty
antiandrogen, N/V
“LEUprolide can be used in LIEU of GnRH”

Testosterone, methyltestosterone

- mech, clin use, tox

androgen R agonist
trt hypogonadism and promote 2* sex charac’s, stim anabolism to promote recovery after burn/injury
masculinization in F, reduces intratestic T in M bc inhib’s LH release (neg fdbk) -> gonadal atropy, premature close of epiphyseal plates, incr’d LDL and decr’d HDL

Finasteride =

- mech, clin use

antiandrogen

5a-reductase inhib (no DHT)
BPH, promotes hair growth

Flutamide =

- mech, clin use

antiandrogen

nonsteroidal competitive inhib of androgens at T R
prostate ca

Ketoconazole =

- mech, clin use, SEs

antiandrogen

inhib’s steroid syn by inhib’ing 17,20-desmolase
PCOS to prevent hirsutism
gynecomastia and amenorrhea

Sprinolactone =

- mech, clin use, SEs

antiandrogen

inhib’s steroid binding
PCOS to prevent hirsutism
gynecomastia and amenorrhea

Estrogens = - mech, clin use, tox - C/I's?

ethinyl estradiol, mestranol - bind E Rs - hypogonadism/ov failure, menstrual abnl'ities, HRT in postmenp F; use in M w/ androgen-dep prostate ca - incr'd risk of endometrial ca, bl'ing in postmenop F, incr'd risk of thrombi - ER(+) br ca, hx of DVTs

Clomiphene | - mech, clin use, SEs

SERM; partial agonist at E Rs in hypo -> no nl fdbk so incr'd LH/FSH from pit -> ovulation - infertility, PCOS - hot flashes, ov enlargement, mult preg's at 1 time, visual disturbances

Tamoxifen | - mech, clin use

SERM but antag on br tissue | - trt and prevent recurrence of ER-pos br ca

Raloxifene | - mech, clin use

SERM, agonist on bone to reduce resorption | - osteoporosis

HRT (hormone replacement tx) - used for in F? - tox?

- relief/prevention of menop sx and osteoporosis | - unopposed E tx -> incr'd risk of endometrial ca, so add on proges; possible incr'd CV risk

Anastrozole/exemestane =

aromatase inhib's used in postmenop. F w/ br ca

Progestins | - mech, clin use

Bind proges Rs, reduce growth and incr vascularization of endometrium - in OCPs, in trtmt of endometrial ca nad abnl uterine bl'ing

Mifepristone (RU-486) | - mech, clin use, tox

competitive inhib of progestins at proges R - abortion, give w/ misoprostol (PGE1) - heavy bl'ing, GI effects (N/V/anorexia), ab pain

OCP - mech - progestins cause? - C/I'd in who?

E and progestins inhib LH/FSH -> no E surge -> no LH surge and no ovulation - thicken cervical mucus, inhib endometrial prolif (less nice for implantation) - Smokers >35yo, hx of thromboembolism and stroke, hx ER(+) tumor

Terbutaline | - mech, used to

b2-agonist that relaxes the uterus | - reduces premature uterine contrac's

Tamsulosin | - mech, used in, selective for

a1-antag that inhib's SmM contrac - used in BPH - a1(A,D) R on prostate and vasc a1(B) Rs

Sildenafil | - mech, clin use, tox

inhib PDE5 -> incr'd cGMP and SmM relax in corpus cavernosum -> incr'd bl flow and erection - ED - HA, flushing, dyspepsia, impaired blue-gr color vision; BAD hypotension if taken w/ nitrates

Danazol | - mech, clin use, tox

synthetic androgen, partial agonist at androgen Rs - endometriosis and hereditary angioedema - wt gain, edema, acne, hirsutism, masculinization, decr'd HDL, hepatotox

EtOH affect on fetus:

mental retardation, sm head, VSD, ASD, ADD, thin upper lip, flat btwn nose/upper lip, sm eye openings