Lots of drugs are a no-no in pregnancy. Here’s my way of remembering the teratogenic ones.
Pam is a very worried pregnant lady. She is sat at a cafe with her depressed parrot that suddenly has 3 seizures. She’s having miso soup because she’s on a low carb diet and he’s eating carrots.
- pam – diazepam (anxiolytics)
- paroxetine – antidepressants
- seizures – carbamazepine, valproate, phenytoin
- misoprostol
- carbimazole
- carrots – retinoids
A man called Danny, who is a well-known meth addict with a lisp approaches on a bicycle, holding a pack of cards. He says;
“Lithen clothely, I am going to perform a magic trick”
Pam, remembering Danny’s last trick, puts tha’ lid on her soup and says, “It better not be a lame pencil trick again, that was just a fluke”
- Androgen – danazol
- methotrexate
- cyclophosphamide
- ace of spades – ace inhibitors
- lithium
- thalidomide
- lame pencil – pencil-lame – penicillamine
- fluconazole
He suddenly starts bleeding from one of his injection sites, starts glowing, and then screams “DIE ETHYL!” before collapsing on the ground and lying completely static.
- warfarin
- radioactive contrast
- diethylstilbestrol
- statins
Disclaimer: not all of them are listed here, and the evidence may change in the future! This paper:
describes how not all of them are absolutely contraindicated, but most of them are avoided if possible. Sometimes discontinuing the drug, such as psychotropics, is likely to lead to a worse outcome than continuing.
Category X drugs in pregnancy:
Known Teratogenic drugs:
- ACE inhibitors
- captopril
- enalapril
- lisinopril
- Antidepressants
- paroxetine
- Antiepileptics
- carbamazepine
- phenytoin
- valproate
- Anxiolytics
- diazepam
- Alkylating agents
- cyclophosphamide
- Androgens
- danazol
- Antimetabolites
- methotrexate
- Carbimazole
- Coumarins
- warfarin
- Oestrogens
- diethylstilbestrol
- Fluconazole
- Lithium
- Misoprostol
- Oral contraceptives
- Penicillamine
- Retinoids
- isotretinoin
- Radioactive iodine
- Thalidomide
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