Teratogens Flashcards
ACE/ARB
Increase risk of oligohydramnios and fetal kidney damage, decreased skull ossification
Tetracyclines (Doxycycline)
Interfere w/ fetal bone and tooth development
Gray/yellow discoloration of teeth
Fluoroquinolones (Ciprofloxacin)
Associated w/ bone/cartilage deformaties and arthropathy
Sulfonamides (TMP-SMX)
Class C
First trimester - interferes with folic acid metabolism
Third trimester - increases risk of kernicterus (possibly)
Retinoids (isotretinoin)
CNS abnl, cardiovascular abnl, facial abnl, spontaneous abortion
Lithium
Congenital heart disease, esp Ebstein’s anomaly
NSAIDs
Increase risk of miscarriage
May promote premature closure of fetal ductus arteriosus
Mycophenolate
(Immunosuppressant)
Ear/face congenital malformations
Increases risk of first trimester miscarriages
Thalidomide
(Immunosuppressant) Flipper limbs (phocomelia)
Warfarin
Spontaneous abortion, IUgR, CNS abnl, facial abnl, MR, Dandy-Walker malformation (use heparin or LMWH)
Efavirenz
NNRTI (teratogenic)
Finasteride
Blocks testosterone -> DHEA
Femininization / genitalia abnl in male fetus
Aminoglycosides (gentamicin, etc)
CN VIII damage (deafness)
Skeletal abnormalities, renal defects
Anti-seizure medications in general
NTD, facial abnormalities (clefting)
Carbamazepine
Facial abnl, NTD
Fingernail hypoplasia
Chemotherapeutics (all classes)
Intrauterine fetal demise (30%)
Severe IUGR, multiple anatomic abnl, MR, spontaneous abortion, secondary neoplasms
Diazepam
Cleft palate
Diethylstilbestrol (DES)
Anatomic genital tract abnl +
Vaginal and cervical adenocarcinoma later in life
Heparin
Mild prematurity, IUFD (much safer than warfarin)
OCPs
Spontaneous abortion, ectopic pregnancy (overall fairly safe)
Phenobarbital
Neonatal withdrawal
Phenytoin
Facial abnl (cleft)
Valproic acid
NTD (1%), facial abnl (cleft)
Cocaine
Abruptio placentae
Arrythmia, MI, stroke in mother
Ethanol
FAS (MR, IUGR, facial abnl, fetal demise)
Opioids
Narcotic withdrawal
Tobacco
IUGR, prematurity
Radiation
> 10 rads risk of fetal malformation, small increased risk of childhood leukemias