Drug-related teratogenicity

Human Drug-Related Teratogenicity Risks Data Base... 

T. Pexieder, Five years experience with the human drug-related teratogenicity risks data base operation, Teratology, 33(3) (1986) 52C. 

The teratogenic effects of lithium have been reviewed in several articles (466,467,488) two reviews of drug-related congenital malformation briefly mentioned lithium and cardiovascular teratogenesis (480,489). The authors concluded that while the risk of cardiovascular malformation is lower than once believed, it is nevertheless increased. 

Women receive the same benefits from antihypertensive therapy as men. However, ACE inhibitors and ARBs are contraindicated in women who intend to become pregnant because they are teratogenic. Thiazide diuretics may be especially beneficial in postmenopausal women with osteoporosis because they cause retention of calcium and have been shown to positively affect bone mineral density. Women tend to have higher rates of drug-related adverse effects than men. 

Several related analogues of the benzimidazoles are also anthelmintics including the imidazopyridine (5), tioxidazole (6), and the prodrugs, thiophanate (7) and febantel (8). However, although the benzimidazoles and related anthelmintics have proved a rich source of drugs, there is now evidence of widespread resistance to them, particularly in sheep parasites. Moreover, some benzimidazole carbamates are suspect in respect of teratogenicity and mutagenicity. 

In 1988, the U.S. Food and Drag Administration estimated that Accutane, used as an antiacne medication, may have been reponsible for approximately 1000 birth defects in children bom to women taking the drug during the period of 1982 to 1986. The chemical name for Accutane is isoretinoin, and it is chemically related to retinoic acid, vitamin A, which likewise is teratogenic at excessive levels. Exposure of the fetus to Accutane over a period of only several days can result in birth defects such as severe facial malformations, heart defects, thymus defects, and mental retardation.13... 

Adverse effects These are primarily related to CNS and Gl disturbances. They include impaired concentration, dizziness, ataxia, diplopia, somnolence, nervousness, and confusion, as well as nausea and weight loss. Renal stones have been reported in 1.5 percent of patients. Topiramate is teratogenic in animals, and should be avoided during pregnancy. Inducers of drug metabolism such as phenytoin and carbamazepine decrease topiramate serum concentrations by approximately 50 percent. Topiramate decreases ethinyl estradiol concentrations of oral contraceptive preparations, and individuals should supplement the amount of ethinyl estradiol. 

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