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Teratogens

Terms in this set (30)

Thalidomide
Category X Drug
An antinauseant drug that was prescribed for pregnant women (no longer used) for "morning sickness." This drug can cause limb reduction (e.g. meromelia, amelia), ear and nasal abnormalities, cardiac defects, lung defects, pyloric or duodenal stenosis, and gastrointestinal atresia.
Aminopterin and Methotrexate
Category X Drug
Folic acid antagonists used in cancer chemotherapy. These drugs can cause small stature, abnormal cranial ossification, ocular hypertelorism, low-set ears, cleft palate, and myelomeningocele.
Busulfan (Myleran), Chlorambucil (Leukeran), Cyclophosphamide (Cytoxan)
Category X Drug
Alkylating agents used in cancer chemotherapy. These drugs cause cleft palate, eye defects, hydronephrosis, renal agenesis, absences of toes and growth retardation.
Phenytoin (Dilantin)
Category X drug
Antiepileptic drug. In 30% of cases, this drug causes fetal hydantoin syndrome, which results in growth retardation, mental retardation, microcephaly, craniofacial defects, and nail and digit hypoplasia. In the majority of cases, this drug causes cleft lip, cleft palate, and congenital heart defects.
Triazolam (Halcion) and Estazolam (Prosom)
Category X Drug
Hypnotic drugs. These drugs cause cleft lip and cleft palate, especially if used in the first trimester of pregnancy.
Warfarin (Coumadin)
Category X Drug
Anticoagulant drug that acts by inhibiting vitamin K-dependent coagulation factors. This drug can cause stippled epiphyses, mental retardation, microcephaly, seizures, fetal hemorrhage, and optic atrophy in the fetus.
Isotretinoin (Accutane)
Category X Drug
Retinoic acid derivative used in the treatment of severe acne. This drug can cause CNS abnormalities, external ear abnormalities, eye abnormalities, facial dysmorphia, and cleft palate (i.e., vitamin A embryopathy)
Diethylstilbesterol (DES)
Category X Drug
A synthetic estrogen that was used to prevent spontaneous abortion in women. This dug can cause cervical hood, T-shaped uterus, hypoplastic uterus, ovulatory disorders, infertility, premature labor, and cervical incompetence in women who were exposed to DES in utero. These women are also subject to increased risk of adenocarcinoma of the vagina later in life.
Ethisterone, Norethisterone, and Megesterol (Megace)
Category X Drug
Synthetic progesterone derivatives. These drugs can cause masculinization of genitalia in female embryos, hypospadias in males, and cardiovascular anomalies
Ovcon, Levlen, and Norinyl
Category X Drug
Oral contraceptives that contain a combination of estrogen and progesterone derivatives. These drugs can cause an increase of fetal abnormalities, particularly in VACTERL syndrome, consisting of vertebral, anal, cardiac, tracheo-esophageal, renal, and limb malformations.
Nicotine
Category X Drug
Organic compound delivered to the fetus through cigarette smoking by pregnant women (cigarette smoke also contains hydrogen cyanide and carbon monoxide). This drug can cause intrauterine growth retardation, premature delivery, low birth weight, and fetal hypoxia due to reduced uterine blood flow and diminished capacity of the blood to transport oxygen to fetal tissue.
Alcohol
Category X Drug
Organic compound delivered to the fetus through recreational or addictive drinking by pregnant women. This drug can cause fetal alcohol syndrome, which results in mental retardation, microcephaly, holoprosencephaly, limb deformities, craniofacial abnormalities (i.e., hypertelorism, long philtrum, and short palpebral fissures), and cardiovascular defects (i.e., VSD). Fetal alcohol syndrome is the leading cause of mental retardation.
Tetracycline (Achromycin) and Doxycycline (Vibramycin)
Category D Drug
Antibiotics in the tetracycline family. These drugs can cause permanently stained teeth and hypoplasia of enamel.
Streptomycin, Amikacin, and Tobramycin (Nebcin)
Category D Drug
Antibiotics in the aminoglycoside family. These drugs can cause CN VIII toxicity with permanent bilateral deafness and loss of vestibular function.
Valproic Acid (Depakene)
Category D Drug
Antiepileptic drug. This drug can cause neural defects, cleft lip, and renal defects.
Diazepam (Valium), Chlordiazepoxide (Librium), Alprazolam (Xanax), and Lorazepam (Ativan)
Category D Drug
Anticonvulsants or antianxiety drugs. These drugs can cause cleft lip and cleft palate, especially if used in the first trimester of pregnancy.
Lithium
Category D Drug
Used to treat manic-depressive disorder. This drug can cause fetal cardiac defects (i.e., Ebstein's anomaly and malformations of the great vessels)
Chlorothiazide (Diuril)
Category D Drug
Diuretic and hypertensive drug. This drug can cause fetal jaundice and thrombocytopenia.
Lisinopril
ACE inhibitor. Anti-hypertensive that can cause abnormal kidney function and anatomy.
Organic Mercury
Consumption of organic mercury during pregnancy results in fetal neurological damage, including seizures, psychomotor retardation, cerebral palsy, blindness, and deafness.
Lead
Consumption of lead during pregnancy results in abortion due to embryotoxicity, growth retardation, increased perinatal mortality, and developmental delay.
Polychlorinated Biphenyls (PCBS)
Consumption of PCBs during pregnancy results in intrauterine growth retardation, dark-brown skin pigmentation, exophthalmos, gingival hyperplasia, skull calcification, mental retardation, and neurobehavioral abnormalities.
Potassium Iodide (PI)
Found in over the counter cough medicine and radiograph cocktails for organ visualization and is involved in thyroid enlargement (goiter) and mental retardation (cretinism).
Lysergic Acid (LSD)
Has not been shown to be teratogenic
Marijuana
Has not been shown to be teratogenic
Caffeine
Has not been shown to be teratogenic
Cocaine
Results in an increased risk of various congenital abnormalities, stillbirths, low birth weight, and placental abruption.
Heroin
Has not been shown to be teratogenic. It is drugs that are often taken with heroin that produce congenital anomalies. The principle adverse effect is severe neonatal withdrawal, causing death in 3%-5%. Methadone (used to replace heroin) is not teratogenic, but is also associated with severe neonatal withdrawal.
Acute High Dose Radiation (>250 RADS)
Results in microcephaly, mental retardation, growth retardation, and leukemia. After exposure to greater than 25 rads, classic fetal defects will be observed, so that termination of the pregnancy should be offered as an option.
Diagnostic Radiation
Even if several radiographic studies are performed, rarely does the dose add up to significant exposure to produce fetal defects. Radioactive iodine cocktails for organ visualization should be avoided after week 10 of gestation because fetal thyroid development can be impaired.
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