TERATOGENS Flashcards
EXPLAIN WHAT TERATOGEN TIMING IS
FIRST TWO WEEKS
- ALL OR NONE PERIOD
- SPONTANEOUS ABORTION OR NO EFFECT
WEEKS 2 - 8
- ORGANOGENESIS
- STRUCTURAL DEFECTS
AFTER WEEK 8
- DECREASED GROWTH
- CENTRAL NERVOUS SYSTEM DYSFUNCTION
- USUALLY NO BIRTH DEFECTS
MENTION THE CATEGORIES OF DRUGS
CATEGORY A - NO RISK TO FETUS IN HUMAN STUDIES
CATEGORY B - NO RISK TO FETUS IN OTHER STUDIES
CATEGORY C - RISK CANNOT BE RULED OUT
CATEGORY D - POSITIVE EVIDENCE OF RISK
CATEGORY X - CONTRAINDICATED IN PREGNANCY
WHAT CATEGORY IS ACE INHIBITORS AND ARBs
PREGNANCY CLASS D
1ST TRIMESTER> NUMEROUS CONGENITAL MALFORMATIONS
2ND - 3RD TRIMESTER > OLIGOHYDRAMNIOS
- DECREASED FETAL KIDNEY FUNCTION
- FETAL RENAL FAILURE
- CAN LEAD TO POTTERS SYNDROME
- PULMONARY HYPOPLASIA, LIMB / SKELETAL DEFORMITIES
WHAT KIND OF SEIZURE DRUGS ARE TERATOGENS?
VALPROIC ACID - NEURAL TUBE DEFECTS - MAJOR
PHENYTOIN
PHENOBARBITAL
CARBAMAZEPINE
MANY ANTI SEIZURE DRUGS ASSOCIATED WITH MINOR FOLIC ACID > NEURAL TUBE DEFECTS SO YOU SHOULD GIVE HIGH DOSE FOLIC ACIS SUPPLEMENTATION
EXPLAIN WHAT FETAL HYDANTOIN SYNDROME IS
ASSOCIATED WITH PHENYTOIN USE IN PREGNANCY
-GROWTH DEFICIENCY
- ABNORMAL FACIAL FEATURES
-BROAD, SHORT NOSE
-WIDE-SPACED EYES
-MALFORMED EARS
-MICROCEPHALY
-CLASICALLY CLEFT LIP AND CLEFT PALATE
CHEMOTHERAPY
RARELY WOMEN DEVELOP MALIGNANCY WHILE PREGNANT > HODKING LYMPHOMA
IDEALLY CHEMOTHERAPY DEFERRED > AFTER BIRTH , 2ND / 3RD TRIMESTER.
FETAL MALFORMATIONS 15 % WITH THERAPY IN 1ST TRIMESTER.
WHAT KIND OF CHEMOTHERAPY ARE TERATOGENS
ALKYLATING AGENTS AND ANTIMETABOLITES
- ADVERSE EFFECTS ON FETUS > SPONTANEOUS ABORTION , MISSING DIGITS, MANY OTHER FETAL ABNORMALITIES.
ISOTRETINOIN
DERIVATIVE OF VITAMIN A
USED TO TREAT ACNE
PREGNANCY CLASS X
SPONTANEOUS ABORTIONS
BIRTH CONTROL MANDATORY
VITAMIN A EXCESS
TERATOGENIC IN FIRST TRIMESTER
SPONTANEOUS ABORTIONS
MICROCEPHALY
CARDIAC ANOMALIES
OCCURS AT DOSES SEVERAL TIMES RDA
METHOTREXATE
INHIBITS FOLATE METABOLISM
USED AS ANTI-INFLAMATORY
PREGNANCY CLASS X - USED TO INDUCE ABORTION IN ECTOPIC PREGNANCY
MAY CAUSE NEURAL TUBE DEFECTS.
WARFARIN
ANTICOAGULANT
PREGNANCY CLASS D
FETAL HEMORRHAGE
SPONTANEOUS ABORTION
OPTIC ATROPHY
WARFARIN EMBRYOPATHY > BONE AND CARTILAGE ABNORMALITIES, STIPPLED EPIPHYSES, NASAL HYPOPLASIA, LIMB HYPOPLASIA
METHIMAZOLE
TREATMENT FOR HYPERTHYROIDISM
PREGNANCY CLASS D
MAY CAUSE FETAL AND NEONATAL HYPOTHYROIDISM
APLASIA CUTIS
LITHIUM
USED IN PSYCHIATRIC DISORDERS
PREGNANCY CLASS D
TERATOGENIC EFFECTS PRIMARILY INVOLVE HEART
EBSTEIN ANOMALY MOST COMMON
AMINOGLYCOSIDES
PERMANENT DEAFNESS IN FETUS
TETRACYCLINE
ACCUMULATE IN FETAL TEETH AND LONG BONES
MAY PERMANENTLY DISCOLOR FETAL TEETH
FLUOROQUINOLONES
FETAL CARTILAGE DAMAGE
TRIMETHOPRIM
MAY DISRUPT FOLATE METABOLISM IN FETUS > NEURAL TUBE DEFECTS
SULFONAMIDES
DISPLACE BILIRUBIN FROM ALBUMIN
CAN CAUSE KERNICTERYUS
THALIDOMIDE
PREGNANCY CLASS X
LIMB DEFORMITIES> AMELIA - ABSENCE OF LIMB
MICROMELIA - SHORT LIMB
PHOCOMELIA - ABNORMAL LIMB
DIETHYLSTILLBESTROL
NONSTEROIDAL ESTROGEN
USED TO PREVENT MISCARRIAGE, PREMATURE BIRTH
REMOVED FROM US MARKET
FEMALE BIRTH / REPRODUCTIVE TRACT ABNORMALITIES
HYPOPLASIC UTERUS
CERVICAL HYPOPLASI
VAGINAL ADENOSIS
VAGINAL CLEAR CELL ADENOCARCINOMA
HIGH RATE OF INFERTILITY
ALCOHOL
MAY CAUSE FETAL ALCOHOL SYNDROME (FAS)
-FACIAL FEATURES
-CONGENITAL HEART DEFECTS
-SKELETAL ANOMALIES
-INTELLECTUAL DISABILITY
MENTION THE FACIAL FAILURES IN FETAL ALCOHOL SYNDROME DISEASE
SMOOTH PHILTRUM
SHORT PALPEBRAL FISSURES
THIN VERMILLION BORDER
MENTION THE HEART DEFECTS IN FETAL ALCOHOL SYNDROME DISEASE
ATRIAL SEPTAL DEFECT
VENTRICULAR SEPTAL DEFET
TETRALOGY OF FALLOT
