Pharm Spring Ob-Gyn-3 - Teratogenic Drugs
Pharm Spring Ob-Gyn-3 - Teratogenic Drugs
Pharm Spring Ob-Gyn-3 - Teratogenic Drugs
Pharmacology III:
Drug and Teratogenicity
2017 Tanchun Wang. Reproduction for non-profit educational use by TouroCOM students
permitted, all other rights reserved. Distribution and/or duplication for
1 any other purposes
Learning Objectives
3
Teratogen and Drug Teratogenicity
Teratogen: an agent that when administered
to the pregnant mother causes structural or
functional abnormalities in the fetus or in the
child after birth, which may not be apparent
until later life.
10
Antimicrobials
Antibacterials: Antifungals:
Aminoglycosides Griseofulvin
Chloramphenicol
Tetracycline
Antivirual:
Clarithromycin
Ribavirin
Fluoroquinolones
Sulfonamides
Nitrofurantoin
11
Antimicrobials
Aminoglycosides (D): Ototoxicity (eg,
damage to fetal labyrinth), resulting in
deafness.
13
Antimicrobials (continue)
A
A: Ototoxicity
B: Gray baby syndrome C
C: Inhibition of bone growth B
D: Embryotoxicity
E: Cartilage damage
F: Kernicterus
D: Clarithromycin
14
Practice Question 1 A 5-year-old boy is brought to the
Department of Pediatric Dentistry by his mom with a
complaint of discoloration of his teeth since childhood.
On examination, you notice a generalized grayish to
yellow brown discoloration in the teeth. Stains are not
scrapable by dental explorer. The stains fluoresce when
observed under ultraviolet (UV) light. His mother had
used an antibiotic drug during her first trimester of
pregnancy. which of the following statements describes
the mechanism of this drug?
A. Inhibits the formation of initial translation complex
B. Blocks the attachment of aminoacyl tRNA to
acceptor site
C. Inhibits the enzyme peptidyl transferase and block
the formation of peptide bonds
D. Inhibits DNA gyrase and interfere DNA synthesis
E. Block dihydropteroate synthetase and inhibit folate
synthesis 15
Practice Question 1 A 5-year-old boy is brought to the
Department of Pediatric Dentistry by his mom with a
complaint of discoloration of his teeth since childhood.
On examination, you notice a generalized grayish to
yellow brown discoloration in the teeth. Stains are not
scrapable by dental explorer. The stains fluoresce when
observed under ultraviolet (UV) light. His mother had
used an antibiotic drug during her first trimester of
pregnancy. which of the following statements describes
the mechanism of this drug?
A. Inhibits the formation of initial translation complex
B. Blocks the attachment of aminoacyl tRNA to
acceptor site
C. Inhibits the enzyme peptidyl transferase and block
the formation of peptide bonds
D. Inhibits DNA gyrase and interfere DNA synthesis
E. Block dihydropteroate synthetase and inhibit folate
synthesis 16
Objective 3
17
CNS Drugs
Anticonvulsants:
Carbamazepine,
Phenytoin
Valproic acid
Alcohol
18
CNS Drugs: Anticonvulsants
Carbamazepine, Phenytoin(D):
Fetal hydantoin/dilantin syndrome: Craniofacial
defects: microcephaly, cleft lip/palate. Facial features
such as short, flat nose, eyes that are farther apart,
dropped eyelids etc. Risk of neural tube defects,
Congenital heart defects
19
Ebsteins anomaly
CNS Drugs (continue)
Lithium (D): Ebsteins anomaly. Risk of
major cardiac congenital malformations.
Nephrogenic diabetes insipidus in the
neonate When given in 3rd trimester.
20
Objective 4
21
Immuno & Dermatologic drugs
Aspirin (D, full dose): Prolong labor and increase
maternal/neonatal hemorrhage. Increased perinatal
mortality, intrauterine growth retardation, and
premature closing of fetal ductus arteriosus.
Other NSAIDs (D, 3rd trimester): Similar to
aspirin.
Prostaglandin analogues (abortifacient):
Misoprostol, Dinoprostone Carboprostand
Levothyroxine/Propylthiouracil (PTU)
preferred during pregnancy 24
Other Drugs/Substances
A. Warfarin
B. Lithium
C. Valproic acid
D. Lisinopril
E. 131I
F. Alcohol 26
Practice Question 2: A 31-year-old female with a
past medical history of hypertension,
hyperthyroidism, bipolar disorder, and
hypercoagulability disorders undergoes a normal
vaginal delivery. Soon after birth, the infant is
found with AV reentrant tachycardia, severe
tricuspid regurgitation, dyspnea, heart failure, and
cyanosis. Which of the following medications the
patient is likely exposed during pregnancy?
A. Warfarin
B. Lithium
C. Valproic acid
D. Lisinopril
E. 131I
F. Alcohol 27
Review of Objectives