Teratogens therapeutically used

Embryotoxicity/teratogenicity is the major drawback in the therapeutic use of retinoids. The exposure of the fetus during the first trimester with oral retinoids is known to produce characteristic malformations.93 There have also been case reports about malformations associated with retinoid embryopathy after the mother had used tretinoin topically during the first trimester of pregnancy 94-96... 

Exposure to retinoic acid, methylnitrosourea, and clomiphene during the early embryonic period, prior to the induction of the neural plate (before day 18 in the human), results in an increased incidence of neural tube defects and other malformations in experimental animal models (Bennett Finnell, 1998). In addition, exposure of rodents to teratogens such as retinoic acid, arsenic, and valproic acid during the period of neurulation results in neural tube defects such as spina bifida and encephaloceles (Adams Lammer, 1993 Bennett Finnell, 1998). Of these, therapeutic use of... 

In 1983, Merrell Dow Pharmaceuticals, Inc. voluntarily removed Bendectin from the market because of the many product liability suits pending. However, subsequent in-depth analysis of epidemiological and scientific data indicated that the therapeutic use of Bendectin had no measurable teratogenic effects. Nevertheless, despite the overwhelming scientific evidence, a number of jury decisions were rendered against the company (providing an argument for tort reform). 

There has been concern from animal experiments that lindane may be mutagenic, carcinogenic, and teratogenic in therapeutic use, however, such hazards are highly unlikely (1,2). 

Quinine crosses the placenta and can be found in relatively high concentrations in cord blood it is also excreted in the breast milk. Data about possible teratogenicity related to the therapeutic use of malaria are scanty (SEDA-14, 239). Hypoplasia of the optic nerve and deafness have been reliably described in children born after failure to induce abortion with the drug. 

In addition to phocomelias, other teratogenic effects include eye and ear abnormalities, esophageal and duodenal atresias, and defects in internal organs such as the heart and kidneys. Congenital defects of the kidneys and nervous system may persist throughout life. Very large doses taken with ethanol have been associated with transient hypotension. Bradycardia has been rarely reported with therapeutic use. Acute toxicity appears infrequent. 

Klopman G, Ptchelintsev D. Antifungal triazole alcohols a comparative analysis of structure-activity, structure-teratogenicity and structure-therapeutic index relationships using the multiple computer-automated structure evaluation (Multi-... 

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