Adverse drug reactions (ADRs) are untoward effects of drugs that are given in conventional therapeutic settings. These reactions are extremely common in the practice of medicine and are believed to affect 7% to 8% of patients admitted to a hospital. About 10% of such reactions prove fatal .

1. Ministry of High Education
Almajmaa University
College of Medicine

3. Adverse drug reactions
Adverse drug reactions (ADRs) are
untoward effects of drugs that are given
in conventional therapeutic settings.
These reactions are extremely common
in the practice of medicine and are
believed to affect 7% to 8% of patients
admitted to a hospital. About 10% of
such reactions prove fatal .

4. Adverse reaction to minocycline, a
long-acting tetracycline derivative

5. Exogenous Estrogens and Oral
Contraceptives
Estrogen therapy, once used primarily for
distressing menopausal symptoms , with
added progestins, to prevent or slow the
progression of osteoporosis
endogenous hyperestrinism increases the risk
of developing ovarian carcinoma and,
probably, breast carcinoma

6. Risks of estrogen
• increases the risk of endometrial carcinoma
• increases the risk of thromboembolism,
including deep vein thrombosis, pulmonary
embolism, and stroke .
• Estrogens and progestins increase blood
levels of high-density lipoprotein and
decrease levels of low-density lipoprotein.

7. Risks of Oral Contraceptives
•
•
•
•
Breast carcinoma
Cervical cancer
Thromboembolism
Cardiovascular disease

8. Aspirin (Acetylsalicylic Acid)
Aspirin overdose may result from accidental
ingestion in young children or suicide attempts in
adults
The major untoward consequences are , metabolic
respiratory alkalosis develops, followed by a
metabolic acidosis that often proves fatal
 Fatal doses may be as little as 2 to 4 gm in children
and 10 to 30 gm in adults

9. Chronic aspirin toxicity (salicylism)
develop in persons who take 3 gm or more
daily.
Chronic salicylism is manifested by headache,
dizziness, ringing in the ears (tinnitus),
difficulty in hearing, mental confusion,
drowsiness, nausea, vomiting, and diarrhea
The CNS changes may progress to convulsions
and coma

10. Injury by Nontherapeutic Toxic Agents
(Drug Abuse)
Drug abuse generally
involves the use of mindaltering substances
Drug addiction and
overdose are serious
public health problems
Considered here are
cocaine, heroin, and
marijuana

11. Cocaine
 In 2008, the National Survey on
Drug Use and Health estimated that
there were 1.9 million users of
cocaine in the United States.
 Cocaine Extracted from the leaves
of the coca plant, cocaine usually is
prepared as a water-soluble powder
.
 Cocaine can be snorted, smoked
after mixing with tobacco, ingested,
or injected subcutaneously or
intravenously.

12. The effects of cocaine
Cardiovascular effects : tachycardia,
hypertension, and peripheral vasoconstriction.
Cocaine also induces myocardial ischemia
CNS effects. The most common CNS findings are
hyperpyrexia
Effects on the fetus. In pregnant women,
cocaine may cause decreasehypoxiad blood flow
to the placenta, resulting in fetal and
spontaneous abortion

14. Heroin
• Heroin derived from the
poppy plant and is closely
related to morphine. Its
effects are even more harmful
than those of cocaine.
• estimated that almost 4
million people in the United
States have used heroin.
• Effects are varied and include
euphoria, hallucinations,
somnolence, and sedation.

15. The effects of Heroin
• Sudden death. Sudden death, usually related to overdose
• Pulmonary disease. Pulmonary complications include
edema, septic embolism, lung abscess.
• Infections. Infectious complications are common. The sites
most commonly affected are the skin and subcutaneous
tissue, heart valves, liver, and lungs Most cases are caused
by Staphylococcus aureus Viral hepatitis virus (HIV) infection
because sharing of dirty needles .
• Skin lesions abscesses, cellulitis, and ulcerations due to
subcutaneous injections. Scarring at injection sites
• Renal problems.

16. Marijuana
Marijuana, or “pot,” is the
most widely used illegal drug .
is made from the leaves of the
Cannabis sativa plant, which
contain the psychoactive
substance Δ9tetrahydrocannabinol (THC)

17. The effects of Marijuana
• The lungs are
affected by chronic
marijuana smoking
• laryngitis,
pharyngitis
bronchitis
• cough, hoarseness,
and asthma

18. summary
Drug injury may be caused by therapeutic drugs
(adverse drug reactions) or non-therapeutic agents
(drug abuse).
long-acting tetracyclines and other antibiotics , and
aspirin are the drugs most frequently involved.
The common drugs of abuse include Cocaine ,
Heroin , Marijuana .

19. Questions ?

20. Resources
• basic robbins pathology
• Medicine books web site.

21. Thank you
Don by : Mohammed Abdullah Hazazi
2nd year medical student
Supervisor : DR. khwaja amer
Assistant Professor of Physiology