Monday, April 27, 2009

LIST OF DRUGS ADVERSE EFFECTS ON FETUS

LIST OF DRUGS WITH SIGNIFICANT ADVERSE EFFECTS ON THE FETUS.
[TERATOGENIC AND FETOTOXIC DRUGS]









The lists adverse drugs consist of: Name of drugs; Trimester adverse [T1 is first trimester, T2 is second, T3 is third, T-all is all trimester] respectively; Effect [E];and Indications [I].





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ACE [Angiotensin-converting enzyme]inhibitor; T-all especially second and third; E: Renal damage; I: Essential hypertension.
Aminopterin; T1; E: Multiple gross anomalies .
Amphetamines: T-all; E: Suspected abnormal developmental patterns, decreased school performance I: Narcolepsy.
Androgens; T2, T3; E: Masculinization of female fetus; I: Osteoporosis, aging.
Anti depressants, tricyclic; T3; E: Neonatal withdrawal symptoms have been reported in a few cases with clomipramine, desipramine, and imipramine; I: Antihistamine,antidepressant.
Barbiturate; T-all; E: Chronic use can lead to neonatal dependence; I: Sedation, anti-convulsants.
Busulfan; T-all; E: Various congenital malformations, low birth weight; I: Chronic myelogenous leukemia.
Carbamazepine; T1; E: Neural tube defects; I: Partial and tonic-clonic seizures, mania
Chlorpropamide; T-all; E: Prolonged symptomatic neonatal hypoglycemia; I: Diabetes mellitus.
Clomipramine; T3; E: Neonatal lethargy, hypotonia, cyanosis, hypothermia; I: Antidepressants.
Cyclophosphamide; T1; E: Various congenital malformation; I: Rheumatoid arthritis.
Cytarabine; T1, T2; E: Various congenital malformation; I: Acute myelogenous leukemia.
Diazepam; T-all; E: Chronic use may lead to neonatal dependence; I: Sedations, spasmolytics.
Diethylstilbestrol; T-all; E: Vaginal adenosis, clear cell vaginal adeno-carcinoma; I: Postcoital contraceptives.
Etretinate; T-all; E: High risk of multiple congenital malformation; I: Vitamin A analogs.
Iodide; T-all; E: Congenital goiter, hypothyroidism; I: Antithyroid agents.
Isotretinoin; T-all: E: Extremely high risk of CNS [central nervous system], face ear, and other malformations; I: Severe cystic acne.
Lithium; T1; E: Ebstein’s anomaly or cardiac anomaly; I: Anti manic-depressive.
Methotrexate: T1: E: Multiple congenital malformations; I: Rheumatoid artrhitis.
Methylthiouracil: T-all: E: Hypothyroidism; I: Cancer chemotherapy.
Metronidazole; T1: May be mutagenic [from animal studies; there is no evidence for mutagenic or teratogenic effects in humans]; I: Amebiasis, trichomoniasis.
Misoprostol; T1; E: Mobius sequence, cramping abdominal pain, and stimulate uterine contraction may induce abortion; I: Peptic ulcer.
Penicillamine: T1; E: Cutis laxa [loose skin], other congenital malformations; I: Severe rheumatoid arthritis.
Phencyclidine: T-all; E: Abnormal neurologic examination, poor suck reflex and feeding; I: General anasthetics.
Phenytoin; T-all; E: Fetal hydantoin syndrome, congenital malformations, spina bifida [spinal column malformation]; I: Partial and generalized tonic-clonic seizures.
Propylthiouracil; T-all; E: Congenital goiter; I: Thyrotoxicosis.
Sterptomycin; T-all; E: Eighth nerve toxicity, deafness; I: Tuberculosis.
Tamoxifen; T-all; E: Increased risk of spontaneous abortion or fetal damage; I: Breast cancer, chemo-prevention breast cancer.
Tetracycline; T-all; E: Discoloration and defects of teeth and altered bone growth; I: Broadspectrum bacteriostatic and antibiotics.
Thalidomide; T1: E: Phocomelia [shortened or absent long bones of the limbs] and many internal malformations ; I: Multiple myeloma, lupus erythematosus.
Trimethadione; T-all; E: Multiple congenital anomalies; I: Anti seizure, sedation.
Valproic acid; T-all; E: Neural tube defects, cardiac and limb malformations; I: Against absence [prevention] seizures, migraine.
Warfarin; T1; E: hypoplastic nasal bridge, chondrodysplasia; T2, E: CNS malformations; T3, E: Risk of bleeding. Discontinue use one month before delivery; I: Anticoagulants.

Source: Bertram G. Katzung, MD, PhD. Basic and Clinical Pharmacology, McGraw-Hill,California, 2007, p 975-76.

Note: The writer adds Indication [I] to the list of the source for "warning" the physicians and the patients ; for treatment of patients as indicated the above list of drugs are contra-indicated for pregnant women, particularly in trimester concern. Please be careful.

Good luck,have a nice treatments of diseases have been indicated!!!

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