teratogenic factors


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anil    on Mar 15, 2012 Says :

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1 :
2 : 7 wks pc
3 : A teratogen is an agent that can produce a permanent alteration of structure or function in an organism exposed during embyronic or fetal life.
4 : There is no such thing as a teratogenic agent.
5 : Many agents can produce a teratogenic effect under some circumstances.
6 : Nature of the agent Factors That Influence Teratogenicity Dose Route Frequency of exposure Duration of exposure
7 : Gestational timing Factors That Influence Teratogenicity Concurrent exposures Concurrent illness Genetic susceptibility Mother Fetus
8 : Principal Mechanisms of Teratogenesis Cell growth or proliferation Cell death Cell migration Cell and tissue interactions Disruptions
9 : Mutagenesis Principal mechanisms Gene mutation Chromosomal abnormalies Before or after conception Males and females both affected
10 : Multifactorial 42% Unknown 37% Chromosomal 3% Monogenic 8% Teratogens 10% Baird et al. AJHG 42:677, 1988 Birth Defects in Childhood
11 : Teratogens Birth Defects in Childhood
12 : Birth Defects Caused By Teratogenic Exposures Are Preventable.
13 : Prevention of Birth Defects Caused by Teratogenic Exposures is an Important Public Health Problem.
14 : Prevention of known teratogenic exposures Public Health Concerns Alcohol Infectious diseases Isotretinoin, thalidomide
15 : Occupational exposures Public Health Concerns Environmental exposures Drugs of abuse Medications
16 : Over-the-counter medicines Medications Herbals and dietary supplements Prescription drugs
17 : Frequently used by pregnant women Medications Biologically active Taken systemically Taken in high doses Information about teratogenicity very limited
18 : Teratogenic Risk of 468 Drugs Approved 1980-2000 Lo & Friedman, 2002
19 : Teratogenic Risk of 468 Drugs Approved 1980-2000 Lo & Friedman, 2002 11 (2.4%) of treatments pose a “small”, “moderate” or “high” teratogenic risk On average, 6.0 ± 4.1 years after FDA approval required to recognize risk in humans
20 : Teratogenic Risk of 468 Drugs Approved 1980-2000 Lo & Friedman, 2002 30 (6.4%) of treatments unlikely to pose a risk in human pregnancy On average, 9.1 ± 4.5 years after FDA approval required to show safety in humans
21 : Animal teratology studies are valuable
22 : Animal teratology studies are valuable but false positives and false negatives do occur.
23 : Chlorpheniramine Animal Teratology Studies: False Positives Hydroxyzine Propoxyphene
24 : Captopril, enalapril Animal Teratology Studies: False Negatives Carbimazole, methimazole Misoprostol
25 : Pregnant women may not receive treatments that benefit their own health or that of the fetus Lack of Knowledge Is a Problem Exposures that really do pose a risk remain unrecognized
26 : Women may be advised or choose to terminate pregnancy to avoid risk Lack of Knowledge Is a Problem Labeling tends to provoke anxiety, often unnecessarily
27 : Characterizing teratogenic risks of important exposures Public Health Priorities Prevention of exposures that are known to be teratogenic Recognition of pregnancies at high risk
28 :

 

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