Baby on Board - NOT really focus drugs

Question 1

What adverse effect does thalidomide have on fetuses?

Answer 1

20% of fetuses exposed within 34-50 days menstrual age acquire malformations and limb-reduction defects. (Phocomelia and dysmorphogenesis)

Question 2

What other drugs can create teratogen effects similar to those seen with thalidomide?

Answer 2

warfarin, phenytoin and misoprostol

Question 3

What are the warfarin exposure risks for a fetus between 6-9 weeks?

Answer 3

embryopathy. Nasal and midface hypolasea and stippled vertebral and femoral epiphyses.
Inhibits posttranslational carboxylation of coagulation proteins

Question 4

What are the warfarin exposure risks for a fetus in 2nd and 3rd trimesters?

Answer 4

hemorrhage and disharmonic growth/deformation from scarring of several organs

Question 5

In the ABCDX teratogen categorization, which class is the most risky?

Answer 5

Not clear cut. Categories C,D, and X are not just based on risk, but instead risk vs. benefit. The risks may be similar for a C and X drug, but the benefit for Class C makes it worth it. A category X drug isn’t deemed to have high enough benefit to validate the risk.

Question 6

How is protein binding of drugs different in the neonate compared to the mother?

Answer 6

in general, protein binding of drugs is reduced in neonate and concentration of free drug is increased.