Teratogens Flashcards Preview

Pharmacology II > Teratogens > Flashcards

Flashcards in Teratogens Deck (29):
1

Thalidomide: intended use

-anti-emetic
-sleep aid

2

Thalidomide: teratogenic effect (3)

-limb defects **(phocomelia)

-external ear defects
-visceral organ abnormalities (ex. agenesis of organs)

3

Thalidomide: mechanism of teratogenesis

inhibits angiogenesis during limb bud formation (1st trimester)

4

What organ system is affected usually during the fetal phase?

CNS function

5

Name the mechanisms of teratogenesis

1. Cytotoxicity
2. DNA interaction
3. Angiogenesis (ex. thalidomide)
4. Enzyme inhibition (ex. warfarin)
5. Nutrient and Vitamin Deficiency (ex. folate antagonists)

6

FDA: category A

studies have not shown risk in 1st trimester

Ex. Folic Acid, Levothyroxine

7

FDA: category B

Animal reproduction studies haven't shown risk.

Ex. Amoxicillin, Insulin R and N

8

FDA: category C

Animal studies have shown adverse effect

Ex. Sertraline, Fluoxetine, Albuterol

9

FDA: category D

positive evidence of human fetal risk

10

FDA: category X

positive evidence for risk to human fetus

11

Antiepileptic drugs (Ex. Carbamazepine, Phenytoin, Valproate) adverse outcome

-craniofacial, cardiac, and limb defects

12

How do you prevent adverse effect with antiepileptic drugs?

1. use lowest dose possible to maintain control
2. Folic acid 4mg daily

13

Isoretinoins (Ex. Accutane): adverse pregancy effects

-Miscarriage
-CNS, craniofacial, and cardiac defects

14

How do you protect against the ADE of Isotretinoins?

use effective pregnancy

15

Oral anticoagulants: Pregnancy ADEs

fetal warfarin syndrome

16

Carbamazepine: Pregnancy ADE

neural tube defect

17

Phenytoin: baby birth defects

-flat broad nose bridge
-Far apart eyes
-Crossed eyes (strabismus)
-Ptosis
-Underdeveloped fingers and toes*

18

Valproate: Pregnancy ADE

neural tube defects (from 1st trimester exposure)
-small mouth**
-narrow forehead
-flat philtrum

19

Isotretinoin (Retinoids): ADE of pregnancy

-External ear defects/absence
-congenital heart defects
-hydrocephalus*

20

Warfarin: Pregnancy ADEs of 1st trimester

First trimester (6-9 weeks)

-nasal hypoplasia
-calcific stippling of epiphyses
-short stubby fingers

21

Warfarin: Pregnancy ADEs after 1st trimester

-CNS defects
-Bone defects (ex. dwarfism, scoliosis, skull defects)

22

Alcohol: Pregnancy ADEs

-microcephaly
-mental retardation
-facial abnormalities

**one drink a day doesn't change risk

23

ACE/ARBs: ADEs of pregnancy

-congenital renal failure
-skull abnormalities

(concern in all trimesters)

24

Methotrexate: ADEs of pregnancy

Folic acid antagonist
-Microcephaly
-short limbs
-hypoplastic skull with wide fontanels

(typically requires doses higher than 10mg/week

25

Smoking: ADEs in pregnacy

-preterm birth
-low birth weight
-spontaneous abortion
-increased perinatal mortality

26

Diethylstilbestrol (DES): ADE in pregnancy

1. clear cell vaginal adenocarcinoma
2. Premature labor
3. Hypospadias in male

27

Radiation: ADE in pregnancy

microcephaly

28

Tetracycline: ADE in pregnancy

-discolored yellow-brown teeth

29

Cocaine: ADE in pregnancy

-increased risk of spontaneous abortion
-abruptio placentae