Teratogens Flashcards
Thalidomide effects
Amelia, meromelia, phocomelia
deafness blindness cleft palate congenital heart disease malformations of inner/outer ear intellectual disability autism UG/GI defects
Thalidomide random facts
used for nausea/sedative
Led to Kefauver-Harris Drug Amendments Act in 1962
Increased length of process for drug approval
DES daughters
increased risk of vaginal clear cell adenocarcinoma
2x increase in vaginal/cervical intraepithelial neoplasm
structural defects in cervix/uterus/Fallopian tubes
Infertility
poor pregnancy outcomes
decreased endometrial thickness
reduced uterine perfusion
DES sons
increased risk of epididymal cysts microphallus undescended testicle testicular hypoplasia decreased sperm count
DES use
estrogen used to prevent SAB and PTL
widely supported though no benefits demonstrated
Vitamin A effects
cleft lip
cleft palate
hydrocephalus
cardiac deformities
Vitamin A teratogenic dose
> 10,000 units of Vitamin-A daily
Isotretinoin effects
increased risk of SAB
20-30% of neonates have abnormality
abnormalities can involve any organ system
ACE inhibitors effects if used in 2nd/3rd trimesters
growth retardation
renal dysfunction
fetal demise
oligohydramnios
ACE inhibitors effects if used in 1st trimester
risks unclear
CV and CNS abnormalities
SSRI effects
increased CV defects
may increase risk of SAB
inhibit serotonin signaling in heart development
late exposure–>increased transient newborn respiratory distress
Anticonvulsants effects
cleft palate cleft lip atrial septal defects spina bifida developmental delay limb abnormalities
NSAIDs 1st trimester use
increased risk of cardiac ventricular and septal defects
NSAIDs 3rd trimester use
pulmonary HTN in newborn
Warfarin effects if used in 1st trimester
skeletal abnormalities
nasal hypoplasia
long bone development abnormalities
limb hypoplasia
Benzodiazepines effects
neonatal withdrawal
hypotonia
cyanosis
floppy infant syndrome
Alcohol effects in infants
Irritability
jitteriness
sleep disruption
Alcohol effects on facial features
small head epicanthal folds small eye openings low nasal bridge short nose flat midface thin upper lip smooth philtrum underdeveloped jaw
Alcohol features on child
railroad track ears ptosis decreased elbow pronation/supination incomplete extension of digits defects in palmar crease
Alcohol deformities
growth retardation (pre and postnatally)
34% of FAS pts at or below 10th percentile for height/weight
atrial/ventricular septal defects
multiple skeletal abnormalities
renal dysplasia/aplasia
hearing loss
ocular and vision abnormalities
Fetal alcohol syndrome
abnormal brain structure
reduction of brain volume in multiple structures
decreased impulse control and judgement
abnormal transfer of info b/w hemispheres
deficiencies in memory/learning/motor coordination
inability to work toward goal
abnormal time perception
diminished IQ
ADHD
inappropriate behavior/lack of social cues/skills
Tobacco effects
vasospasm structural changes in placenta affecting gas exchange carboxyhemoglobin SIDS LBW PTB preterm death may increase chromosome instability
Tobacco clinical effects
cleft lip/palate gastroschisis anal atresia limb reduction cardiac defects digital defects renal aplasia/dysplasia
increased risk of infertility, placenta previa, PPROM, placental abruption
Marijuana effects
minimal
may have some difficulty w/problem solving skills, learning, memory deficits
Cocaine effects on mother
MI arrhythmias aortic rupture CVA seizure bowel ischemia sudden death
Cocaine effects on fetus
SAB fetal demise placental abruption premature birth IUGR
Cocaine effects on newborn
neurobehavioral issues w/in 48-72 hrs of life tremors high pitched cry irritability excess suck hyperalertness apnea tachypnea
long term behavioral issues w/aggression/attention span
Opioids effects on neonate
high pitched cry poor feeding irritability altered sleep patterns abnormal reflexes hypertonicity tremors feeding difficulty GI distress seizures small for GA respiratory complications autonomic dysfunction
Opioids effects
increased risk of fetal growth restriction abruptio placentae fetal death PTL meconium risk
Other teratogens
depo-provera anti-thyroid meds lithium androgens some hypoglycemics estrogens/progestins aspirin bactrim
