Chemical & Drug Injuries
Chemical & drug injuries
***All chemicals & drugs are capable of causing injury or
death.***
accidental exposure
self-ad...
Adverse drug reactions (ADRs)
 any response to a drug that is noxious & unintended,
occurring at doses used in humans for...
Therapeutic agents
ANALGESICS
 Aspirin
 Aspirin + Phenacetin
 NSAIDS (non-steroidal anti-inflammatory drugs):
Ibuprofe...
Therapeutic agents: aspirin
Therapeutic dose: 0.5-1.0 gm./day
Lethal dose: 2-4 gm./day in children
10-30 gm./day in adul...
Therapeutic agents: analgesics
Aspirin + Phenacetin
 Toxicity: nephropathy : renal papillary necrosis
NSAIDS:
 known s...
Therapeutic agents: anti-neoplastics
Anti-metabolites
 Bone marrow suppression
 GI mucosal injury
 Hair follicle injur...
Therapeutic agents:
antimicrobials/antibiotics
Hypersensitivity
 rashes, urticaria, exfoliative dermatoses
 anaphylaxis...
Adverse drug reactions
 BLOOD (DYSCRACIAS)
 Granulocytopenia
 Aplastic anemia
 Pancytopenia
 Hemolytic anemia
 throm...
Adverse drug reactions
 CARDIAC
 Arrhythmias
 Cardiomyopathy
 HEPATIC
 Fatty change
 Cholestasis
 Hepatocellular
da...
Adverse drug reactions
RENAL
 Glomerulonephritis
 Tubulointerstitial
nephritis
 Acute tubular nephritis
SYSTEMIC
 An...
Fatal drug reactions
Tricyclic anti-depressants
 Alprazolam
 Ipramine, Desipramine
 Nortriptyline
Acetaminophen
Halo...
Thank you !
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Chem&druginjuries

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Chem&druginjuries

  1. 1. Chemical & Drug Injuries
  2. 2. Chemical & drug injuries ***All chemicals & drugs are capable of causing injury or death.*** accidental exposure self-administration accidental overdose non-medical use of street drugs unanticipated result of self-administered or prescribed use of standard medicines. exaggeration of an intended pharmacologic effect or an accompanying side effect
  3. 3. Adverse drug reactions (ADRs)  any response to a drug that is noxious & unintended, occurring at doses used in humans for prophylaxis, diagnosis, or therapy, excluding failure to accomplish the intended purpose; [mechanisms: direct toxicity to cells; immunologic/idiosyncratic reactions; or due to ↓immunologic / hormonal host defenses] Predictable ADRs: known side-effects; dose-related, severity depends on route of administration Unpredictable ADRs: unanticipated, usually immunologic, idiosyncratic; dose & route of administration do not affect the severity
  4. 4. Therapeutic agents ANALGESICS  Aspirin  Aspirin + Phenacetin  NSAIDS (non-steroidal anti-inflammatory drugs): Ibuprofen, Diclofenac,  Acetaminophen/Paracetamol ANTIMICROBIALS ANTI-NEOPLASTIC AGENTS  Anti-metabolites  Immunosuppressives
  5. 5. Therapeutic agents: aspirin Therapeutic dose: 0.5-1.0 gm./day Lethal dose: 2-4 gm./day in children 10-30 gm./day in adults Acute toxicity: initial alkalosis--- fluid & electrolyte imbalance--- metabolic acidosis--- death Chronic toxicity: (3 gm/day): dizziness, nausea, vomiting, diarrhea, drowsiness, hallucinations, convulsions, coma Known effects: analgesic; anti-platelet aggregation; gastric irritant--- acute erosive gastritis Unpredictable ADRs: hypersensitivity: rashes, urticaria, exfoliative dermatoses
  6. 6. Therapeutic agents: analgesics Aspirin + Phenacetin  Toxicity: nephropathy : renal papillary necrosis NSAIDS:  known side effect: gastric irritation;  UADR: hypersensitivity Acetaminophen:  therapeutic dose: 0.5 gm q 4 hrs.(up to 3gm/day)  toxic dose: 15-25 gm;  toxicity: nausea, vomiting, diarrhea; shock; hepatic injury  pathology: hepatic necrosis; renal/myocardial damage
  7. 7. Therapeutic agents: anti-neoplastics Anti-metabolites  Bone marrow suppression  GI mucosal injury  Hair follicle injury  Immunosuppression  Nonlethal mutations  Initiation of some form of Cancer Immunosuppressives  ↑ susceptibility to infections, esp. opportunistic  ↑ risk of malignant lymphoma
  8. 8. Therapeutic agents: antimicrobials/antibiotics Hypersensitivity  rashes, urticaria, exfoliative dermatoses  anaphylaxis Emergence of microbial resistance  “super-infections” Eradication of normal flora  vitamin K deficiency--- bleeding diathesis
  9. 9. Adverse drug reactions  BLOOD (DYSCRACIAS)  Granulocytopenia  Aplastic anemia  Pancytopenia  Hemolytic anemia  thrombocytopenia  CNS  Tinnitus, dizziness  Acute dystonic reactions  Parkinson’s syndrome  CUTANEOUS  Urticaria  Petechia  Exfoliative dermatitis  BLOOD DYSCRACIAS  Anti-neoplastics  Immunosuppressants  Chloramphenicol  Quinidine  Methyldopa  CNS  Salicylates  Phenothiazine antipsychotics  Sedatives  CUTANEOUS  Sulfonamides  Hydantoin  Anti-neoplastics
  10. 10. Adverse drug reactions  CARDIAC  Arrhythmias  Cardiomyopathy  HEPATIC  Fatty change  Cholestasis  Hepatocellular damage  PULMONARY  Acute Pneumonitis  Interstitial fibrosis  Asthma  CARDIAC  Theophylline  Hydantoin  Doxorubicin, Daunorubicin  HEPATIC  Tetracycline  Chlorpromazine, Estrogens  Halothane, Acetaminophen, INH  PULMONARY  Salicylates  Nitrofurantoin  Busulfan, Bleomycin
  11. 11. Adverse drug reactions RENAL  Glomerulonephritis  Tubulointerstitial nephritis  Acute tubular nephritis SYSTEMIC  Anaphylaxis  Lupus erythematosus syndrome RENAL  Penicillamine  Phenacetin  Salicylates  Aminoglycosides, Cyclosporine, Amphotericin B SYSTEMIC  Penicillin, Aspirin  Hydralazine, Procainamide
  12. 12. Fatal drug reactions Tricyclic anti-depressants  Alprazolam  Ipramine, Desipramine  Nortriptyline Acetaminophen Halothane Aspirin CNS depression Hepatic necrosis Hepatic necrosis Metabolic acidosis; Fluid & Electrolyte imbalance
  13. 13. Thank you !

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