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Pharmacology Obstetric Pharmacology & Teratology Intermediate
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Teratogenic Drugs High-Yield List

T
E
R
A
T
O
The highest-yield universally tested medications that cause severe fetal structural malformations when taken during pregnancy.

These lipophilic drugs cross the hemochorial placenta and disrupt embryogenesis, particularly during the critical organogenesis window (gestational weeks 3 through 8).

Systematic Breakdown

T

Thalidomide & Tetracyclines

Thalidomide causes severe phocomelia (seal limbs); Tetracyclines (Doxycycline) cause permanent tooth discoloration and impaired bone growth.

E

Epilepsy Drugs (Valproate, Phenytoin, Carbamazepine)

Valproate causes neural tube defects (spina bifida); Phenytoin causes fetal hydantoin syndrome (cleft lip/palate, hypoplastic nails, microcephaly).

R

Retinoids (Isotretinoin)

Extremely high teratogenic risk: craniofacial, thymic, cardiac, and CNS malformations (requires strict iPLEDGE pregnancy testing).

A

ACE Inhibitors & ARBs

Renal dysgenesis, oligohydramnios leading to pulmonary hypoplasia, and cranial bone hypocalcification in 2nd/3rd trimester.

T

Thyroid Drugs (Methimazole)

Methimazole causes aplasia cutis congenita and choanal atresia (PTU preferred in 1st trimester).

O

Oral Anticoagulants (Warfarin)

Chondrodysplasia punctata, nasal bone hypoplasia, optic nerve atrophy, and CNS hemorrhage.

High-Yield Clinical Pearls & Exam Tips
  • Folate supplementation (0.4 - 4 mg daily) prior to conception significantly mitigates neural tube defect risk from antiepileptic drugs.
  • PTU is used in the 1st trimester of pregnancy (lower teratogenicity); Methimazole is switched in for 2nd and 3rd trimesters (avoids PTU hepatotoxicity).
Related Pharmaceuticals
Isotretinoin Valproic Acid Lisinopril Warfarin Methimazole
Related Clinical Conditions
Spina Bifida Fetal Hydantoin Syndrome Phocomelia
Authoritative Sources: Briggs Drugs in Pregnancy and Lactation 12e · FDA Pregnancy Risk Categories

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