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Pharmacology > Teratogenesis > Flashcards

Teratogenesis Flashcards

1
Q

Which is the most famous teratogen?

A

Thalidomide

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2
Q

When is the critical period of using thalidomide?

A

34th and 50 day after last menstrual period

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3
Q

Children exposed to Thalidomide during the first trimester develop what?

A

Phocomelia (limb defects)

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4
Q

When in pregnancy is the ovum resistant to teratogenic agents

A

During 2 week period between conception and implantation

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5
Q

During development when does organogenesis occur?

A

Days 18-60

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6
Q

What is defined as the fetal phase?

A

From end of embryonic state to term

Characterized by growth of already developed organs

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7
Q

What are examples of CNS functions that are disrupted with Teratogenesis

A

cause intrauterine growth retardation, or cause dysfunction of a particular organ (e.g., renal failure)

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8
Q

MOA of Teratogenesis?

A

Antineoplastic agents often produce teratogenicity through cytotoxicity (depressed mitosis and promotion of cell death) of critical cell masses. Attempts at repair may lead to uncoordinated growth and exacerbation of the original malformation

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9
Q

What are other MOA of Teratogenesis

A

Directly affects DNA

Affects angiogenesis during developement

Inhibits enzymes needed for organ development

Deplete nutrient and vitamins

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10
Q

FDA Pregnancy Categories

What is Category A defined as?

A

Adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters)

  • Folic acid
  • levothyroxine
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11
Q

Category B and meds

A

Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women

  • Amoxicillin
  • Insulin R and N
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12
Q

Which grade pregnancy is absolutely contradindicated for treatments

A

Category X

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13
Q

Category C

A

Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks

  • Sertraline, fluoxetine
  • albuterol
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14
Q

Which teratogens have preconception risk factors and considered dangerous for pregnancy

A

Antiepileptic drugs
Carbamazepine
Phenytoin
Valproate

Isotertinoins

Oral anticoagulants (warfarin)

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15
Q

Slide 14 Potential adverse effects and Prevention

A

slide 14

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16
Q

slide 14

A

slide 14

17
Q

slide 14

A

slide 14

18
Q

What adverse effect can Carbamezapine have on babies

A

Neural tube defects

19
Q

How can Valproate effect baby developement

A

Neural tube defects
Small mouth
Narrow forehead
Flat philtrum

20
Q

Phenytoin and how it effects baby developement

A

Flat, broad nose

Shortened fingers

21
Q

Isoretinoids and how it effects baby development

A 
external ear defects/absence, 
congenital heart 
defects, 
hydrocephalus, 
mental retardation, 
clefts.
22
Q

How does Warfarin effect baby development?

A

Produces fetal warfarin syndrome

  • nasal hypoplasia
  • calcific stippling of epiphyses
  • short stubby fingers
23
Q

What affects can alcohol have on fetal developement

A

IUGR and postnatal growth retardation

Microcephaly
Mental retardation
Facial abnormalities.

24
Q

FAS is likely to develop with ingestion of how many drinks per week

A

2-14 weeks

25
Q

How do ACE-I and ARBs affect fetal development

A

Congenital renal failure

Skull abnormalities,

Oligohydramnios (from impaired renal formation and function)

26
Q

When are ACE-I and ARBS not considered teratogenic?

A

First trimester

27
Q

MOA of Methotrexate?

A

Folic acid antagonist

It inhibits dihydrofolate reductase

28
Q

What are teratogenic effects when taking Methotexate

A

Microcephaly

Short limbs

IUGR

Hypoplastic skull with wide fontanels and craniosynostosis

29
Q

What teratogenic affect does Diethylstilbesterol (DES) have

A

Clear cell vaginal adenocarcinoma

Premature labor (as teenager or adult) in female offspring

Hypospadias in male offspring

30
Q

What teratogenic affect does radiation have?

A

Microephaly and mental retardation

If intense enough can cause cancer

31
Q

How can Tetracycline affect children?

A

Discoloration of teeth from deposition of antibiotic in calcifying teeth

Pharmacology (12 decks)

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