Teratogens Flashcards
o ACE inhibitors (lisinopril, captopril, enalapril, ramipril)
– impaired renal development/function
o ARBs (losartan, cadesartan, valsartan)
– impaired renal development/function
• Specific receptor/enzyme mediated events
o NSAIDs
– stop COX enzymes, may cause maturing closure of fetal heart in utero?
o SSRIs
– congenital malformations, pulmonary-arterial hypertension but not entirely shown
• Worry about post-partum harm that may come to baby if mom is depressed
o Alkylating agents (cyclophosphamide/isfosphamide, carmustine/loustine, busulfan)
– absence of digits and multiple birth defects
o Aminoglycosides (gentamicin, neomycin, amikacin, tobramycin, streptomycin)
– CN VIII toxicity causing deafness
o Carbamazepine (anti-psychotic/seizure)
– facial dysmorphia, developmental delay, NTDs, phalanx/fingernail hypoplasia
o Lithium (bipolar disorder)
– atrialization of right ventricle (ebstein anomaly)
o Methimazole (hyperthyroidism)
– aplasia cutis congenita
o Phenytoin (anti-seizure)
– fetal hydantoin syndrome (cleft palate, cardiac defects, phalanx/fingernail hypoplasia)
o Tetracyclines (tetracycline, doxycycline, minocycline)
– brown discolored teeth
o Warfarin
– bone deformities, fetal hemorrhage, abortion, ophthalmologic abnormalities
Drugs that Pass Through Breastmilk
o Sedative/dependence forming drugs: chloral hydrate, diazepam, heroin
o Thyroid suppressing agents: radiolabeled iodine, propytiouracil (PTU)
o Growth/neurological development impairment: lithium, methadone
o Chloramphenicol: antimicrobial that causes “Grey Baby syndrome” and bone marrow suppression
o SSRIs: worry of growth/neurological development impairment
Paternal Teratogenicity Agents
- If dad does something to damage his sperm’s DNA, technically that’s a teratogen!
- Often workplace/chemical exposures, anti-virals, anti-cancer, retinoids, and MABs implicated
