Teratogens Flashcards
Thalidomide: intended use
- anti-emetic
- sleep aid
Thalidomide: teratogenic effect (3)
-limb defects **(phocomelia)
- external ear defects
- visceral organ abnormalities (ex. agenesis of organs)
Thalidomide: mechanism of teratogenesis
inhibits angiogenesis during limb bud formation (1st trimester)
What organ system is affected usually during the fetal phase?
CNS function
Name the mechanisms of teratogenesis
- Cytotoxicity
- DNA interaction
- Angiogenesis (ex. thalidomide)
- Enzyme inhibition (ex. warfarin)
- Nutrient and Vitamin Deficiency (ex. folate antagonists)
FDA: category A
studies have not shown risk in 1st trimester
Ex. Folic Acid, Levothyroxine
FDA: category B
Animal reproduction studies haven’t shown risk.
Ex. Amoxicillin, Insulin R and N
FDA: category C
Animal studies have shown adverse effect
Ex. Sertraline, Fluoxetine, Albuterol
FDA: category D
positive evidence of human fetal risk
FDA: category X
positive evidence for risk to human fetus
Antiepileptic drugs (Ex. Carbamazepine, Phenytoin, Valproate) adverse outcome
-craniofacial, cardiac, and limb defects
How do you prevent adverse effect with antiepileptic drugs?
- use lowest dose possible to maintain control
2. Folic acid 4mg daily
Isoretinoins (Ex. Accutane): adverse pregancy effects
- Miscarriage
- CNS, craniofacial, and cardiac defects
How do you protect against the ADE of Isotretinoins?
use effective pregnancy
Oral anticoagulants: Pregnancy ADEs
fetal warfarin syndrome
