Teratogenicity Flashcards

(30 cards)

1
Q

tetracyclines

A

yellow-brown discoloration of deciduous teeth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

sulfonamides

A

avoid near delivery due to risk of hyperbilirubinemia through the displacement of bilirubin from protein-binding sites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

nitrofurantoin

A

rare theoretic risk of hemolytic anemia in women with a G6-PD deficiency
for infants younger than age 1 month and those with a known G6PD deficiency, nitrofurantoin is contraindicated because of potential hemolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

quinolones

A

associated with irreversible arthropathies and cartilage erosion in animal studies
no teratogenic effects in animal studies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

metronidazole

A

not teratogenic to fetuses exposed in the first trimester

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

warfarin

A

highly teratogenic due to ability to easily cross placental barrier
if exposed between weeks 6 and 9 - fetus at risk for developing a warfarin embryopathy - nasal and midface hypoplasia with stippled vertebral and femoral epiphyses
later exposure is associated with hemorrhage-related fetal abnormalities, such as hydrocephalus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

heparin and LMWH

A

anticoagulant of choice for pregnancy because the large, polar molecules do not cross the placenta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

phenytoin

A

may produce abnormal facies, cleft lip or palate, microcephaly, growth deficiency, and hypoplastic nails and distal phalanges in as many as 10% of exposed offspring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

valproic acid and carbamazapine

A

exposure during embryogenesis is associated with risk of spina bifida and neural tube defects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

SSRIs

A

paroxetine - increased risk of ventral and atrial septal cardiac defects
all SSRIs - exposure late in pregnancy associated with a neonatal behavioral syndrome (increased muscle tone, irritability, jitteriness, and respiratory distress)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

ACE inhibitors

A

associated with numerous fetal anomalies, including growth restriction, limb contractures, and abnormalities in cavarum development

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

diuretics

A

thiazides - when given near delivery, fetus may experience thrombocytopenia with associated bleeding and electrolyte disturbances
all - may interfere with breast milk production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

ß-blockers

A

reported association with fetal growth restriction and neonatal hypoglycemia
neonates may experience transient mild hypotension with symptomatic ß-blockade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

calcium channel blockers

A

generally considered safe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

methyldopa and hydralazine

A

generally considered safe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

alkylating agents

A

cyclophosphamide - associated with missing or hypoplastic digits of the hands and feet when the fetus is exposed in the first trimester; second-trimester exposure is not associated with defects

17
Q

methotrexate

A

alters normal folic acid metabolism
high doses can lead to growth restriction, severe limb abnormalities, posteriorly rotated ears, micrognathia, and hypoplastic supraorbital ridges

18
Q

androgens

A

exposure to exogenous androgens between 7 and 12wks can cause full masculinization, with later exposure causing partial masculinization

19
Q

testosterone and anabolic steroids

A

can result in varying degrees of virilization, including labioscrotal fusion and phallic enlargement, depending on the timing and extent of exposure

20
Q

danazol

A

dose-related patterns of clitiromegaly, urogenital sinus malformation, and labioscrotal fusion

21
Q

aspirin and acetaminophen

A

aspirin - theoretical risk of premature closure of ductus arteriosus
acetaminophen - not associated with an increased risk of defect

22
Q

NSAIDs

A

in general, not teratogenic and can be used short term in the third trimester, with reversible fetal effects
indamethacin - used as a tocolytic agent; constriction of the fetal ductus arteriosus and neonatal pulmonary hypertension have been associated with use of indomethacin near delivery

23
Q

pseudoephedrine

A

retrospective study found an increased risk of gastroschisis
should be avoided in first trimester

24
Q

benzodiazepines

A

teratogenicity not clearly defined

exposed neonates should be monitored for transient withdrawal symptoms

25
lithium
associated with an increase in cardiovascular malformations, although evidence for a significant increases as been challenged limiting exposure until after 8wks gestation to allow the cardiac structures to complete organogenesis is reasonable
26
vitamin A
extremely high doses of vitamin A are associated with congenital anomalies, but categorization is limited by the small number of confirmed cases
27
isotretinoin
potent teratogen | associated with significant fetal loss and malformations with first-trimester use
28
tretinoin
topical retinoid gel information about teratogenicity is lacking women should avoid during pregnancy
29
alcohol congenital syndrome
growth restriction facial abnormalities, including shortened palpebral fissures, low-set ears, midfacial hypoplasia, smooth philtrum, and thin upper lip CNS dysfunction, including microcephaly, mental retardation, and behavioral disorders such as attention deficit disorder
30
smoking
IUGR low birth weight fetal mortality