Teratogens Flashcards
ACE inhibitors
renal failure, oligohydramnios, hypocalvaria
alkylating agents
multiple anomalies (e.g., ear/facial abnormalities, absence of digits)
aminoglycosides
ototoxicity
antiepileptic drugs
neural tube defects, cardiac defects, cleft palate, skeletal abnormalities (phalanx/nail hypoplasia, facial dysmorphism)
most commonly due to valproate, carbamazepine, phenytoin, phenobarbital
diethylstilbestrol
vaginal clear cell adenocarcinoma, congenital Mullerian anomalies
fluoroquinolones
cartilage damage
folate antagonists
neural tube defects
most commonly due to trimethoprim, methotrexate
isotretinoin
craniofacial (microtia, dysmorphism), CNS, cardiac, thymic defects
contraception mandatory
lithium
Ebstein anomaly
methimazole
aplasia cutis congenita (congenital absence of skin, typically on scalp)
tetracyclines
discolored teeth, inhibited bone growth
thalidomide
limb defects (phocomelia: flipper-like limbs)
warfarin
bone and cartilage deformities (stippled epiphyses, nasal and limb hypoplasia), optic nerve atrophy, cerebral hemorrhage
alcohol
fetal alcohol syndrome
cocaine
preterm birth, low birth weight, fetal growth restriction (FGR)
cocaine => vasoconstriction
tobacco smoking
preterm birth, low birth weight, FGR, sudden infant death syndrome, ADHD
nicotine => vasoconstriction; CO => impaired O2 delivery
iodine lack or excess
congenital hypothyroidism
maternal diabetes
caudal regression syndrome, cardiac defects (transposition of the great arteries, VSD), neural tube defects, macrosomia, neonatal hypoglycemia (islet cell hyperplasia), polycythemia, respiratory distress syndrome
maternal PKU
fetal growth restriction, microcephaly, intellectual disability, congenital heart defects
methylmercury
neurotoxicity
increased concentration in top-predator fish (shark, swordfish, king mackerel, tilefish)
x-rays
microcephaly, intellectual disability
