Teratogens Flashcards
ACE inhibitors
Renal damage
Alkylating agents
Absence of digits, multiple anomlies
Aminoglycoside
Ototoxicity
Antiepileptic drugs (valproate, carbamazepine, phenytoin, phenobarbital)
- neural tube defects (valproate, carbamazepine)
- cleft palate (phenytoin)
- skeletal abnormalities
Diethylstilbestrol
- Vaginal clear cell adenocarcinoma
- Mullerian anomalies
Folate antagonists (trimethoprim, methotrexate, antiepileptic drugs)
NT defects
Isotretinoin
- multiple severe defects
Lithium
Ebstein anomaly (apical displacement of tricuspid valve)
Methimazole
aplasia cutis congenita
Tetracyclines
Discolored teeth, inhibited bone growth
Talidomide
Limb defects (phocomelia, micromelia- “flipper limbs”)
Warfarin
Bone deformities, fetal hemorrhage, abortion, opthal abnormalities
Alcohol
Fetal alcohol syndrome: leading cause of intel disability in the US
- microcephaly
- facial abnml (smooth philtrum, thin upper lip, small palpebral fissures)
- and heart-lung fistulas, heart defects, limb dislocation
Note: failure of cell migration
Cocaine
- low birth wt (IUGR)
- preterm
- placental abruption
Smoking (nicotine, CO)
- low birth wt (leading case in developed countries)
- preterm labor
- placental problems
- IUGR
- SIDS
Note: nicotine and cocaine cause vasoconstriction and CO causes less O2 delivery
Iodine (lack or excess)
- congenital goiter or hypothyroidism
Maternal DM
- caudal regression syndrome (anal atresia to sirenomelia)
- congenital heart defects
- NT defects
- macrosomia
Methylmercury (from fish, sharks, etc)
Neurotoxicity
Vit A excess
- extremely high risk for spontaneous abortion and birth defects (cleft palate, cardiac)
Note: think isotretinoin
X-rays
- microcephaly
- intel disability
Heart- EtOH
- VSD/ASD/PDA
- tet
Heart- rubella
- PDA
- septal defect
- pulm art stenosis
Heart- Down
- AV septal defect (endocardial cushion) - VSD/ASD
Heart- DM mom
Transposition
