7 Well known Teratogens and their Birth Defects follow.
Phenytoin: Mech: unknown. SE: Neural tube defects, orofacial clefts, microcephaly, nail, digit hypoplasia (In adults, gingival hyperplasia d/t increased PDGF after 3-4 mo of tx).
Lithium: Mech: displaces Sodium. SE: Ebstein anomaly=atrialization of the R ventricle, nephrogenic DI, hypothyroidism
Valproate: Mech: blocks voltage sodium channels in cortex. SE: Neural tube defects
Isotretinoin: Mech: Compet. Inhib of Testosterone enzyme. Vit A stimulates skin, nail growth. SE: Microcephaly, Thymic Hypoplasia, small ears, hydrocephalus
Methotrexate: Mech: Inhibits Dihydrofolate reductase, prevents folate cofactor to dUMP to dTMP reaction. Results in messed up DNA transcription. SE: Limb, craniofacial abnormalities, neural tube defects, abortion
ACE Inhibs and ARBs: Mech: blocks renal efferent dilation by decreasing Ang. II/blocking its receptors. SE: Renal dysgenesis, oligohydramnios
Warfarin: Mech: prevents regen of Vit. K (affects Prot C anticoag first, so bridge w Heparin). SE: Nasal hypoplasia, stippled epiphysis
Non-teratogen but Dangerous:
Aspirin: Mech: COX inhib, will cause baby and mother to bleed.
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