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Flashcards in Teratogens Deck (26):
1

def. teratogen

an agent that may have a negative effect on the baby

2

5 possible teratogen effects

1. preg. loss
2. congenital malformations
3. neurobehavioral
4. IUGR
5. long term carcinogen

3

2 classes of malformation

1. major - require intervention
2. minor - traits with no serious or cosmetic consequence

4

** what is baseline risk of malformation

1-3%

5

2 major risk for malformation

1. unknown
2. genetic
drugs are 1%

6

what is all or none period

time after fert and before implantation (12 days after ovulation)
- either kills or is fine

7

when is are most structures developed by and 2 exception

done by end of T1 except brain and eye

8

when does placenta play a role

5 weeks
- won;t let some drugs through

9

4 mechs. of teratology

1. control of cell division
2. apop
3. gene expression
4. cell metabolism

10

6 mech of toxicity

1. hyperthermia
2. hypoxia
3. acid base
4. reduced uterine flow
5. elevated cortisol
6. def. of zinc

11

4 maternal conditions that are teratologic

1. diabetes - hyperglycemia - cardiac, neural tube, macrosomia
2. hypothyroidism - decrease IQ
3. chronic renal failure - oligohydro
4. conditions with antibodies -SLE, graves

12

5 major maternal infections

Toxoplasmosis
Other (syph, varicella)
Rubella
Cytomegalovirus
Herpes simplex

13

6 bad drugs

1. accutane - miscarriage and malformations
2. thalidomide - flippers (phocomegaly)
3. warfarin 6-9 weeks
4. anticonvulsants
5. ACEi
6. lithium

14

when is warfarin risk

6-9 weeks - facial defects

15

4 anticonvulsants and their risks

1. carbamazepin - 1% risk of NTD
2. lamotragine - no effects
3. valproic acid - 2% risk of NTD, others possible
4. phenytoin (dilantin) - craniofacial, impaired growth - 10%

16

when is ACEi effect and what

back in T2-3
- oligouria, low BP - polyhydramnios

17

what is effect of lithium

ebsteins abnormality

18

5 classes of FDA

A - no risk human studies
B - no risk in human studies, but yes in animals
C- animals studies bad - no human studies
D- poor quality studies
x- contraindicated

19

2 probs with FDA

1. not always updated
2. need RCTs which preg women are excluded from

20

how to anticoagulate a preg. woman

heparin - large and can't pass

21

what to use for asthma

1. bronchdilator - safe
2. inhaled steroids - safe
3. systemic steroid - some probs

22

what is radiation principle

ALARA - need 5-15rads to cause prob- all are way below 5

23

2 env. exposures

1. organic solvents
2. mercury - avoid big fish and 1 can tuna/week

24

traid of FAS

1. growth retard
2. dysmorphic features
3. decreased IQ and behav issues

25

3 prevention strategies

1. folic acid before preg - high dose if high risk
2. multivitamin throughout
3. US at 18 weeks

26

what is breastfeeding reccomendation

generally safe - keep to 10% of maternal dose

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