Teratogenic drugs

Question 1

altered pregnancy physiology effects on pharmacokinetics

Answer 1

Absorption - Nausea and vomiting ,Delayed gastric emptying
Distribution- Increased plasma volume
Increased total body water/extracellular fluid increases the volume of distribution, associated reduction in maternal plasma protein concentration
Metabolism- Altered CYP450 activity
Elimination - Increased renal blood flow and GFR rate,Increased renal clearance, Shorter half-lives of renal cleared drugs

Question 2

Transfer of drugs from mum to baby

Answer 2

• Almost all drugs can pass freely through the placenta

* Exceptions are those with a molecular weight of >1kDa, examples include insulin and heparin.

Question 3

Common Teratogenic Drugs effects - ACEi

Answer 3

Renal abnormalities, patent ductus arteriosus (PDA), oligohydramnios
Can cause 2nd/3rd trimester termination of pregnancy

Question 4

Common Teratogenic Drugs effects - beta blocker

Answer 4

UGR, neonatal hypoglycaemia and bradycardia

Question 5

Common Teratogenic Drugs effects - Lithium

Answer 5

Cardiac defects (Ebsteins anomaly which is a congenital heart defect in which the septal and posterior leaflets of the tricuspid valve are displaced towards the apex of the right ventricle of the heart.)

Question 6

Common Teratogenic Drugs effects -Methotrexate

Answer 6

Medical termination, craniofacial defects, ear/kidney/lung defects, cardiac abnormalities

both partners must stop methotrexate for 6 months before conceiving.

Question 7

Common Teratogenic Drugs effects -NSAIDS

Answer 7

Premature closure of ductus arteriosus, oligohydramnios, PPHN persistent pulmonary hypertension of the newborn

Question 8

Common Teratogenic Drugs effects - phenytoin

Answer 8

Craniofacial abnormalities, growth/mental deficiency

Question 9

Common teratogenic drug effects - Thiazide diuretics

Answer 9

Electrolyte abnormalities, growth retardation

Question 10

Common terratogenic drug effects - Warfarin

Answer 10

Fetal warfarin syndrome (Resulting abnormalities include low birth weight, slower growth, mental retardation, malformed bones, cartilage and joints, deafness and small head size.) maybe more found in women with heart valve issues, older generation compared to now
CNS defects/eye abnormalities
Fetal/neonatal/placental hemorrhage