Teratology And Drugs In Pregnancy Flashcards
Increased free drugs d/t decreased plasma albumin concentration
Diazepam, phenytoin, valproate, warfarin
Effect of prolonged gut transit time on absorption
Increased absorption
Drugs with increased elimination d/t increased renal blood flow in 3rd trisem
Ampicillin Gentamicin Digoxin:heart failure Phenytoin Carbamazepine Valproic acid Lithium
Enzymatic changes
Increased CYP 3a4, 2d6, 2c9:NSAIDs, calcium. Channel blockers Decreased cyp1a2(theophylline), 2c19(phenobarbital)
Placenta metabolizes
Pentobarbital.
Create toxic metabolites: ethanol
Causes adenocarcinoma of cervix and vagina if taken <18 wks AOG
Diethylstilbestrol
Only US FDA approved indicationw for thalidomide
Erythema nodosum leprosum
Mutiple sclerosis
AIDS
Percentage of pregnancies with babies having an anatomic abnormality
2-3%
To be considered teratogenic
Results in a set of malformations
Exert effects at a particular stage of devlpt
Dose dependent incidence
Tobacco causes
SGA
IUGR
Diabetes mellitus causes
Large for gestational age babies
Macrosomia-> difficult delivery-> fractured clavicle
Babies with rubella
Cataract
Microcephaly
PDA
Congenital minamata disease manif and cause
D/t methymercury
MR, malformed head and teeth
Max limit for ionizing radiation
150 mSv
CT scans:10-50 mSv
Xray: 0.1
Drugs that disrupt folic acid absorption/metab
Carbamazepine Lamotrigine Phenobarb Hydantoin Valproic acid
Pregnancy induced HTN
Hydralazine
Causes fetal goiter
Iodine/iodine containing compounds
AE of systemic steroids esp during 1st trisem
Cleft lip/palate
anti epileptic drugs are FDA category ?
FDA D
Phenytoin causes what syndrome
Fetal hydantoin syndrome: broad nasal bridge, hypertelorism(abn inc in interorbital distance), epicanthal folds, blepharoptosis(drooping upper eyelid), strabismus, low-set deformed ears
AE of sex hormones during pregnancy
Microtia
AE of misoprostol
Associated with mobius syndrome(facial paralysis, inability to move eyes fr side to side, of normal imtelligence)
