Teratogens summary

In summary, preliminary results from two animal models (rabbit and mouse) indicate that poly(N-palmitoylhydroxyproline ester) elicits a very mild, local tissue response that compares favorably with the responses observed for established biomaterials such as medical grade stainless steel or poly(lactic acid)/poly(glycolic acid) implants. At this point, additional assays need to be performed to evaluate possible allergic responses, as well as systemic toxic effects, carcinogenic, teratogenic, or mutagenic activity, and adaptive responses. 

As noted above, OC failure may lead to accidental pregnancy and exposure of the developing fetus to potentially teratogenic properties of CBZ ( 383). Therefore, OC levels should be closely monitored and patients should notify their physician of spotting, an indicator of OC failure. Prothrombin time and the International Normalized Ratio (INR) should be monitored when patients are on warfarin and CBZ concomitantly. Patients stabilized on an antipsychotic may decompensate when CBZ is added. This may necessitate an increase in the antipsychotic dose and is one indication for TDM of antipsychotic drug levels ( 384). Conversely, when CBZ is discontinued, the dose of these other agents may need to be lowered to avoid toxicity. In summary ... 

Figure 4.1 Summary of structural requirements for high teratogenic potency of carboxylic acids, a) Information obtained or derived from (50-58]. b) Esters of carboxylic...

Mutagenicity, Carcinogenicity, and Teratogenicity of Industrial Pollutants (ref. 15) contains summaries of teratogenicity information about industrial pollutants. Discussions of these pollutants are divided into four groups heavy metals, insecticides, monomers, and halogenated hydrocarbon solvents. 

TERIS is designed to assist in counseling pregnant women about possible developmental risks other forms of reproductive toxicity are not considered. In addition to brief critical reviews and references to the peer-reviewed literature, each TERIS summary contains an assessment of the risk of teratogenic effects in children of women with typical exposures during pregnancy. An evaluation of the quality of data available to determine the risk is also provided. 

TERIS is useful clinically. It provides succinct, authoritative summaries and interpretations of information available on the teratogenicity of a large number of drugs and a few important occupational agents. No information is included on other forms of reproductive toxicity. The system is designed for use by health professionals who are familiar with the general principles of risk assessment and is intended to assist in the counseling of individual patients. 

Summary statements are provided under the heading of reproductive toxicity, embryotoxicity, and teratogenicity. Data from individual studies usually are not presented. 

A standard text listing the teratogenic potential of hundreds of substances provides indexes, summaries of literature, and references to source materials. 

If extracts, fractions, or pure compounds are spilled, they must immediately be cleaned up. If not, others may be unknowingly be exposed to the compound. Even one small drop of a compound such as myclamide A, a substance that is extremely irritating and causes immediate blistering of the skin upon exposure, can be extremely unpleasant if touched. The long-term effects of exposure, such as tumor promotion, and teratogenicity, are not known for most of these compounds, and so exposure should be avoided. In summary, handle all marine specimens and extracts with caution. Use proper protective wear and minimize exposure to the materials. This is true of both the raw organism and extracts or fractions derived thereof. 

A slight but significant increase in maternal and fetal toxieity occurred in Sprague-Dawley rats and Swiss Webster mice exposed to 300 ppm tetrachloroethylene by inhalation on days 6-15 of gestation (Schwetz et al. 1975). Maternal or fetal toxicity or teratogenicity was not, however, reported for rats e q)Osed on days 1-19 or rabbits on days 1-24 of gestation by inhalation to 500 ppm tetrachloroethylene (Hardin et al. 1981). Limitations of this study include use of only one dose level, the use of summary and nonquantitative data, and conduct of portions of the study at two separate laboratory facilities. 

Seidenberg JM, Becker RA. 1987. A summary of the results of 55 chemicals screened for developmental toxicity in mice. Teratogen Carcinogen Mutagen 7 17-28. 

TABLE 1, Summary of Data Obtained with Available Mutagenicity Tests, and Data on Teratogenicity and Carcinogenicity ... 

In summary, there is no definitive evidence of thallium-induced teratogenic or genotoxic effects in humans with either acute high-dose or chronic low-dose exposure. Transplacental thallium intoxication, however, can occur following acute maternal ingestion of the toxin. Occupational or environmental exposure, with rare exception, does not result in clinical toxicity [22],... 

Before considering the effects of retinoids on isolated cellular systems, either in organ culture or cell culture, we briefly note some of the marked effects that retinoid deficiency or excess has on the developing embryo. For many years, retinoids have been known to be potent teratogens and an extensive summary of their teratogenic effects can be found in review articles (Kalter and Warkany, 1961 Kochhar, 1967, 1968 Shenefelt, 1972 Spom eta/., 1981) and in Chapter 13. Apart from the clinical importance of these phenomena, they may also provide valuable clues relating to the mechanism of action. 

Teratogenicity In a meta-analysis of the safety of quinolones in the first trimester of pregnancy five studies were included, representing 984 quinolone exposures, 318 of which were exposures to fluoroquinolones [34 ]. The summary odds ratio was 1.05 (95% Cl = 0.9,1.22) for major malformations, 2.6 (0.36, 19) for stillbirth, 1.15 (0.69, 1.91) for preterm birth, and 0.73 (0.57, 2.2) for low birth weight. The authors concluded that fears of teratogenicity from quinolones are not justified. 

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