I.

OVERVIEW

What is PHARMACOLOGY?

I. OVERVIEW
Pharmacology is the study of drugs (chemicals)
that alter functions of living organisms.
Drug therapy, also called pharmacotherapy, is the
use of drugs to prevent, diagnose, or treat signs,
symptoms, and disease processes.
Drugs given for therapeutic purposes are usually
called medications.

PHARMACOTHERAPEUTICS
is the branch of pharmacology that uses
drugs to treat, prevent and diagnose.

PHARMACODYNAMICS
Study of biochemical and physiological
effects of drugs; study of drugs
mechanism of action.

PHARMACOKINETICS
Study of the absorption, distribution, and
biotransformation (metabolism) and
excretion of drugs.

PHARMACOGNOSY
Study of drugs derived from herbal and
other natural sources.

TOXICOLOGY
Study of poisons and poisoning.

SOURCES OF DRUGS

Plants
Animals
Minerals
Synthetic chemical

DRUG CLASSIFICATIONS
Drugs are classified according to their
effects on particular body systems,
their therapeutic uses.

A. PRESCRIPTION DRUGS
Are those that have on their labels the
prescription legend.
May be prescribed by the physicians,
dentists, veterinarians, or other legally
authorized health practitioner as part of
their specific practice.

B. NON-PRESCRIPTION DRUGS
The drugs that may be legally acquired
by the client without the prescription
order.
Also known as over the counter drugs
(OTC)

C. INVESTIGATIONAL DRUGS
A new drug which a manufacturer wishes
to market.
Must fulfill the requirements of FDA.

D. ORPHAN DRUG
Are drugs that have been discovered but
are not financially viable and therefore
have not been adopted by any drug
company.

E. ELLICIT DRUG
a.k.a. street drugs are those which are
used and/or distributed illegally.

Legal Regulation of Drugs

A. FDA Pregnancy Categories
B. Controlled Substances

A. FDA Pregnancy
Categories

Category A
Adequate studies in pregnant women
have NOT demonstrated a risk in the
fetus in the first trimester of pregnancy
and there is no evidence of risk in later
trimester.

Category B
Animal studies have NOT demonstrated a
risk for the fetus but there are No adequate
studies in pregnant women, or animal
studies have shown an adverse effect, but
adequate studies in pregnant women have not
demonstrated a risk to the fetus during the
first trimester, and there is no evidence of risk
on later trimester.

Category C
Animal studies have shown an adverse
effect on the fetus but there are no adequate
studies in humans, the benefits from the use
of the drug in pregnant women may be
acceptable despite the potential risks, or there
are no animal reproduction studies and no
adequate studies in humans.

Category D
There is evidence of human fetal risk,
but the potential benefits from the use of
the drug in pregnant women may be
acceptable despite of its potential risks.

B. Controlled
Substances

Schedule I
Drugs that are not approved for medical
use and have high abuse potentials:
heroin, lysergic acid diethylamide
(LSD), peyote, mescaline,
tetrahydrocannabinol, marijuana.

Schedule II
Drugs that are used medically and have high
abuse potentials: opioid analgesics (eg,
codeine, hydromorphone, methadone,
meperidine, morphine, oxycodone,
oxymorphone), central nervous system (CNS)
stimulants (eg, cocaine, methamphetamine,
methylphenidate), and barbiturate sedativehypnotics (amobarbital, pentobarbital,
secobarbital).

Schedule III
Drugs with less potential for abuse than those
in Schedules I and II, but abuse may lead to
psychological or physical dependence: androgens and anabolic steroids, some CNS
stimulants (eg, benzphetamine), and
mixtures containing small amounts of
controlled substances (eg, codeine,
barbiturates not listed in other schedules).

Schedule IV
Drugs with some potential for abuse:
benzodiazepines (eg, diazepam,
lorazepam, temazepam), other sedativehypnotics (eg, phenobarbital, chloral hydrate),
and some prescription appetite suppressants
(eg, mazindol, phentermine).

Schedule V
Products containing moderate amounts of
controlled substances. They may be
dispensed by the pharmacist without a
physicians prescription but with some
restrictions regarding amount, record keeping,
and other safeguards. Included are
antidiarrheal drugs, such as diphenoxylate
and atropine (Lomotil).

CLASSIFICATIONS

Antipyretic
Analgesics
Antibiotics
Antidepressants
anti-hypertensives
anti-diabetic
Antihistamine
Antitussive
cholinergics

Decongestants
Diuretics
Emetics
Expectorants
Hypnotics
Laxatives
Sedatives
Tranquilizers
Antipsychotic

PHARMACOLOGY\PHARMACOLOGY
SONGS\nurses medication study song.mp4

DRUG NAMES
Individual drugs may have several
different names, but the two most
commonly used are the GENERIC
NAME and the TRADE NAME (also
called the brand or proprietary name).

 The GENERIC NAME (eg, amoxicillin)

is related to the chemical or official name
and is independent of the manufacturer.
Differentiated from Trade Name by initial
lowercase letter; NOT CAPITALIZED

 The TRADE NAME is designated and

patented by the manufacturer.
CAPITALIZED FIRST LETTER
For example, amoxicillin is manufactured
by several pharmaceutical companies,
some of which assign a specific trade
name (eg, Amoxil, Trimox)

 CHEMICAL NAME is the exact molecular

formula of the drug; usually a long, very
difficult name to pronounce and of a little
concern to the health care worker.

 OFFICIAL NAME is the name of the drug

as it appears in the official reference, the
USP/NF; generally the same as the
generic name.

GENERIC NAME

TRADE NAME

ibuprofen

Advil

lorazepam

Ativan

diphenhydramine

Benadryl

captopril

Capoten

GENERIC NAME

TRADE NAME

clonidine

Catapres

celecoxib

Celebrex

metformin

Glucophage

misoprostol

Cytotec

PRESCRIPTION AND
NONPRESCRIPTION DRUGS
Legally, consumers have two routes of access to
therapeutic drugs.
One route is by PRESCRIPTION or order from a
licensed health care provider, such as a
physician, dentist, or nurse practitioner.
The other route is by OVER-THE-COUNTER
(OTC) purchase of drugs that do not require a
prescription.

DRUG APPROVAL PROCESSES

The FDA (Food and Drug
Administration) is responsible for
assuring that new drugs are safe and
effective before approving the drugs
and allowing them to be marketed.

Testing and Clinical Trials

The testing process begins with
animal studies to determine
potential uses and effects.

 In Phase I, a few doses are given to a

few healthy volunteers to determine safe
dosages, routes of administration,
absorption, metabolism, excretion, and
toxicity.

 In Phase II, a few doses are given to a

few subjects with the disease or symptom
for which the drug is being studied, and
responses are compared with those of
healthy subjects.

 In Phase III, the drug is given to a larger

and more representative group of
subjects.

 In phase IV, after a drug is approved for

marketing, it enters a phase of continual
evaluation.

TERMS INDICATING DRUG

ACTION

INDICATIONS
A list of medical conditions or diseases
for which the drug is meant to be used.

ACTIONS
A description of the cellular changes that
occur as a result of the drug.

CONTRAINDICATIONS
A list of conditions for which the drug
should not be given.

SIDE EFFECTS and ADVERSE

REACTIONS
A list of possible unpleasant or
dangerous effects, other than the desired
effects,

INTERACTIONS
A list of other drugs or foods that may
alter the effects of the drug and usually
should not be given during the same
course of therapy.

Basic Concepts and

Processes

 How do systemic drugs reach,

interact with, and leave body cells?
How do people respond to drug
actions?

CELLULAR PHYSIOLOGY
Cells are dynamic, busy, factories
That is, they take in raw materials,
manufacture various products required
to maintain cellular and bodily functions,
and deliver those products to their
appropriate destinations in the body.

DRUG TRANSPORT THROUGH

CELL MEMBRANES
Most drugs are given for effects on body
cells that are distant from the sites of
administration (ie, systemic effects). To
move through the body and reach their
sites of action, metabolism, and excretion
drug molecules must cross numerous cell
membranes.

PHARMACOKINETICS
Pharmacokinetics involves drug
movement through the body (ie,
what the body does to the drug)
to reach sites of action, metabolism,
and excretion.

PHARMACOLOGY\VIDEOS\Pharmacokinetics What the Body Does to a Drug.mp4

1. ABSORPTION
Absorption is the process that
occurs from the time a drug enters
the body to the time it enters the
bloodstream to be circulated.

PHARMACOLOGY\ANIMATION\Pharmacology_ Oral Meds Absorption.mp4

PHARMACOLOGY\ANIMATION\Pharmacology_ IM Absorption.mp4
PHARMACOLOGY\ANIMATION\Pharmacology_ IV Absorption.mp4

PHYSICAL FACTORS INFLUENCING

ABSORPTION
1. BLOOD FLOW to the absorption site:
-blood flow to the intestine is much
greater than the flow to the stomach;
thus absorption from the intestine is
favored over that from the stomach.

2. TOTAL SURFACE AREA available for

absorption:
- because the intestine has a surface
rich in microvilli, it has a surface area about
1,000 times that of the stomach, thus
absorption of the drug across the intestine
is more efficient.

3. CONTACT TIME at the absorption

surface:
- anything that delays the transport of
the drug from the stomach to the intestine
delays the rate of absorption of the drug.

BIOVAILABILITY
Is the fraction of administered drug that
reaches the systemic circulation.
Ex: if 100mg of drug is administered orally
and 70mg of this drug is absorbed
unchanged, the bioavailability is 70 %.

2. DISTRIBUTION
Distribution involves the transport of
drug molecules within the body.
Once a drug is injected or absorbed into
the bloodstream, it is carried by the blood
and tissue fluids to its sites of
pharmacologic action, metabolism, and
excretion

 Distribution depends largely on the

adequacy of blood circulation.
Drugs are distributed rapidly to organs
receiving a large blood supply, such as
the liver, heart, and kidneys.

 Distribution to other internal organs,

muscle, fat, and skin is usually
slower.

PHARMACOLOGY\Pharmacology_ Meds Distribution.mp4

 Protein binding allows part of a drug dose

to be stored and released as needed.
Some drugs also are stored in muscle, fat,
or other body tissues and released gradually
when plasma drug levels fall. These storage
mechanisms maintain lower, more even
blood levels and reduce the risk of toxicity

 Drug distribution into the central

nervous system (CNS) is limited
because the bloodbrain barrier, which is
composed of capillaries with tight walls,
limits movement of drug molecules into
brain tissue

 Drug distribution during pregnancy and

lactation is also unique.
During pregnancy, most drugs cross the
placenta and may affect the fetus.
During lactation, many drugs enter
breast milk and may affect the nursing
infant.

3. METABOLISM
Metabolism is the method by which drugs are
inactivated or bio transformed by the body.
Most often, an active drug is changed into one or
more inactive metabolites, which are then
excreted.
Some active drugs yield metabolites that are also
active and that continue to exert their effects on
body cells until they are metabolized further or
excreted.

 Most drugs are lipid soluble, a characteristic

that aids their movement across cell
membranes.
However, the kidneys, which are the primary
excretory organs, can excrete only watersoluble substances. Therefore, one function
of metabolism is to convert fat-soluble drugs
into water-soluble metabolites.

 When drugs are given orally, they are

absorbed from the GI tract and carried to the
liver through the portal circulation.
Some drugs are extensively metabolized in
the liver, with only part of a drug dose
reaching the systemic circulation for
distribution to sites of action. This is called the
first-pass effect or presystemic metabolism.
PHARMACOLOGY\VIDEOS\First Pass Metabolism - Pharmacology Lect
6.mp4

 The LIVER is the major site of

metabolism, but specific drugs may
undergo biotransformation in other
tissues.

4. EXCRETION
Excretion refers to elimination of a drug
from the body.
Effective excretion requires adequate
functioning of the circulatory system and
of the organs of excretion (kidneys,
bowel, lungs, and skin).

 Most drugs are excreted by the kidneys

and eliminated unchanged or as
metabolites in the urine.
Some drugs or metabolites are excreted in
bile, then eliminated in feces;
others are excreted in bile, reabsorbed
from the small intestine, returned to the
liver (called enterohepatic recirculation),

 The lungs mainly remove volatile

substances, such as anesthetic gases.
The skin has minimal excretory function.

PHARMACOLOGY\ANIMATION\Drug Excretion.mp4

RENAL ELIMINATION OF
DRUG

1. GLOMERULAR FILTRATION
Drugs enter the kidney through renal
arteries, which divide to form a
glomerular capillary plexus.

Serum Drug Levels

A serum drug level is a laboratory
measurement of the amount of a drug in
the blood at a particular time.
It reflects dosage, absorption,
bioavailability, half-life, and the rates of
metabolism and excretion.

 A toxic concentration is an excessive

level at which toxicity occurs.
Toxic concentrations may stem from a
single large dose, repeated small doses,
or slow metabolism that allows the drug
to accumulate in the body.

 For most drugs, serum levels indicate the

onset, peak, and duration of drug
action.

 The drug level continues to climb as

more of the drug is absorbed, until it
reaches its highest concentration and
peak drug action occurs. Then, drug
levels decline as the drug is eliminated
(ie, metabolized and excreted) from the
body.

Serum Half-Life
Serum half-life, also called elimination
half-life, is the time required for the serum
concentration of a drug to decrease by
50%. It is determined primarily by the drugs
rates of metabolism and excretion. A drug
with a short half-life requires more frequent
administration than one with a long half-life.

PHARMACODYNAMICS
Pharmacodynamics involves drug
actions on target cells and the resulting
alterations in cellular biochemical
reactions and functions (ie, what the
drug does to the body).
As previously stated, all drug actions
occur at the cellular level.

VARIABLES THAT AFFECT

DRUG ACTIONS
Expected responses to drugs are largely
based on those occurring when a
particular drug is given to healthy adult
men (18 to 65 years of age) of average
weight (150 lb [70 kg]).

 However, other groups of people (eg,

women, children, older adults, different
ethnic or racial groups, and clients with
diseases or symptoms that the drugs are
designed to treat) receive drugs and
respond differently than healthy adult
men.

Drug-Related Variables
Dosage
dose indicates the amount to be given
at one time and dosage refers to the
frequency, size, and number of doses.

 Dosage is a major determinant of drug actions

and responses, both therapeutic and adverse.
If the amount is too small or administered
infrequently, no pharmacologic action occurs
because the drug does not reach an adequate
concentration at target cells.
If the amount is too large or administered too
often, toxicity (poisoning) may occur.

 MINIMUM DOSE a smallest amount of a

drug that will produce a therapeutic effect.
MAXIMUM DOSE largest amount of a
drug that will produce a desired effect
without producing symptoms of toxicity.

 LOADING DOSE initial high dose used to

quickly elevate the level of the drug in the blood
(often followed by a series of lower doses)
MAINTENANCE DOSE dose required to
keep the drug blood level at a steady state in
order to maintain the desired effect.

 TOXIC DOSE amount of drug that will

produce harmful effects or symptoms of
toxicity.
LETHAL DOSE dose that can cause death.
THERAPEUTIC DOSE- dose that is
customarily given; adjusted according to
variations from the norm.

ROUTE OF ADMINISTRATION
There are two major routes of drug
administration;
ENTERAL
PARENTERAL

ENTERAL
1. ORAL
The most common route of drug
administration
The oral route usually produces
slower drug action than parenteral
routes.

 FIRST PASS metabolism by the intestine

or LIVER limits the efficacy of many
drugs when taken orally.
PHARMACOLOGY\VIDEOS\First Pass Metabolism - Pharmacology
Lect 6.mp4

2. SUBLINGUAL
- placement under the tongue.

3. RECTAL
- both the sublingual and the rectal
have the additional advantage that they
prevent the destruction of the drug by
intestinal enzymes or low pH in the
stomach.

PARENTERAL
1. For rapid drug action and response,
the IV (Intravenous) route is most
effective because the drug is injected
directly into the bloodstream.

2. For some drugs, the IM

(Intramuscular) route also produces
drug action within a few minutes
because muscles have a large blood
supply.

3. SUBCUTANEOUS
It requires absorption and is
somewhat slower than the IV route.

OTHERS
1.
2.
3.
4.
5.
6.

INHALATION
INTRANASAL
INTRATHECAL
VAGINAL
TRANSDERMAL
TOPICAL

 Absorption and action of topical drugs

vary according to the drug formulation,
whether the drug is applied to skin or
mucous membranes, and other factors.

DrugDiet Interactions
Food may alter the absorption of oral drugs. In
many instances, food slows absorption by
slowing gastric emptying time and altering GI
secretions and motility.
When tablets or capsules are taken with or soon
after food, they dissolve more slowly; therefore,
drug molecules are delivered to absorptive sites in
the small intestine more slowly

 Food also may decrease absorption by

combining with a drug to form an
insoluble drugfood complex.

 In other instances, however, certain

drugs or dosage forms are better
absorbed with certain types of meals.

DrugDrug Interactions
The action of a drug may be increased or
decreased by its interaction with another
drug in the body. Most interactions occur
whenever the interacting drugs are present
in the body; some, especially those
affecting the absorption of oral drugs, occur
when the interacting drugs are given at or
near the same time.

Increased Drug Effects

Interactions that can increase the
therapeutic or adverse effects of drugs
are as follows:

Additive effects
Additive effects occur when two drugs
with similar pharmacologic actions are
taken.
Example: ethanol + sedative drug
increased sedation

Synergism or potentiation
Synergism or potentiation occurs when two
drugs with different sites or mechanisms of
action produce greater effects when taken
together than either does when taken alone.
Example: acetaminophen (non-opioid
analgesic) + codeine (opioid analgesic)
increased analgesia

Interference
Interference by one drug with the metabolism
or elimination of a second drug may result in
intensified effects of the second drug.
Example: cimetidine inhibits CYP 1A, 2C, and
3A drug-metabolizing enzymes in the liver and
therefore interferes with the metabolism of
many drugs

 When these drugs are given concurrently

with cimetidine, they are likely to cause
adverse and toxic effects.

Displacement
Displacement of one drug from plasma proteinbinding sites by a second drug increases the effects
of the displaced drug. This increase occurs because
the molecules of the displaced drug, freed from their
bound form, become pharmacologically active.
Example: aspirin (an antiinflammatory/analgesic/antipyretic agent) + warfarin
(an anticoagulant) increased anticoagulant
effect

Decreased Drug Effects

Interactions in which drug effects are
decreased are grouped under the term
antagonism.
Examples of such interactions are as
follows:

 In some situations, a drug that is a specific antidote

is given to antagonize the toxic effects of another
drug.
Example: naloxone (a narcotic antagonist) +
morphine (a narcotic or opioid analgesic) relief
of opioid induced respiratory depression.
Naloxone molecules displace morphine molecules
from their receptor sites on nerve cells in the brain
so that the morphine molecules cannot continue to
exert their depressant effects.

 Decreased intestinal absorption of oral drugs

occurs when drugs combine to produce
nonabsorbable compounds.
Example: aluminum or magnesium hydroxide
(antacids) + oral tetracycline (an antibiotic)
binding of tetracycline to aluminum or
magnesium, causing decreased absorption
and decreased antibiotic effect of tetracycline

 Activation of drug-metabolizing enzymes in the

liver increases the metabolism rate of any
drug metabolized primarily by that group of
enzymes. Several drugs (eg, phenytoin,
rifampin), ethanol, and cigarette smoking are
known enzyme inducers.
Example: phenobarbital (a barbiturate) +
warfarin (an anticoagulant) decreased
effects of warfarin

 Increased excretion occurs when urinary pH

is changed and renal reabsorption is blocked.
Example: sodium bicarbonate +
phenobarbital increased excretion of
phenobarbital. The sodium bicarbonate
alkalinizes the urine, raising the number of
barbiturate ions in the renal filtrate.

Client-Related Variables
Age
The effects of age on drug action are most
pronounced in neonates, infants, and older
adults. In children, drug action depends
largely on age and developmental stage.
During pregnancy, drugs cross the
placenta and may harm the fetus.

 Drug distribution, metabolism, and excretion

differ markedly in neonates, especially
premature infants, because their organ
systems are not fully developed.
Older infants (1 month to 1 year) reach
approximately adult levels of protein binding
and kidney function, but liver function and
the bloodbrain barrier are still immature.

 Children (1 to 12 years) experience a

period of increased activity of drugmetabolizing enzymes so that some drugs
are rapidly metabolized and eliminated.
After approximately 12 years of age,
healthy children handle drugs similarly to
healthy adults.

 In older adults (65 years and older),

physiologic changes may alter all
pharmacokinetic processes. Changes in the
GI tract include decreased gastric acidity,
decreased blood flow, and decreased
motility. Despite these changes, however,
there is little difference in absorption.

 Body Weight
Body weight affects drug action mainly in
relation to dose. The ratio between the
amount of drug given and body weight
influences drug distribution and
concentration at sites of action.

 In general, people heavier than average

need larger doses, provided that their
renal, hepatic, and cardiovascular
functions are adequate. Recommended
doses for many drugs are listed in terms
of grams or milligrams per kilogram of
body weight.

TOLERANCE AND CROSS-TOLERANCE

Drug tolerance occurs when the body
becomes accustomed to a particular drug
over time so that larger doses must be given
to produce the same effects.
Tolerance may be acquired to the
pharmacologic action of many drugs,
especially opioid analgesics, alcohol, and
other CNS depressants.

 Tolerance to pharmacologically related drugs is

called cross-tolerance.
For example, a person who regularly drinks
large amounts of alcohol becomes able to
ingest even larger amounts before becoming
intoxicated this is tolerance to alcohol. If
the person is then given sedative-type drugs or
a general anesthetic, larger-than-usual doses
are required to produce a pharmacologic effect
this is cross-tolerance.

ADVERSE EFFECTS OF DRUGS

the term adverse effects refers to any
undesired responses to drug
administration, as opposed to
therapeutic effects, which are desired
responses.

 Most drugs produce a mixture of

therapeutic and adverse effects; all drugs
can produce adverse effects. Adverse
effects may produce essentially any sign,
symptom, or disease process and may
involve any body system or tissue.

 Some adverse effects occur with usual

therapeutic doses of drugs (often called
side effects); others are more likely to
occur and to be more severe with high
doses.
Common or serious adverse effects
include the following:

Common or serious adverse

effects

CNS effects
CNS effects may result from CNS stimulation
(eg, agitation, confusion, delirium,
disorientation, hallucinations, psychosis,
seizures) or CNS depression (dizziness,
drowsiness, impaired level of
consciousness, sedation, coma, impaired
respiration and circulation).

Gastrointestinal effects
Gastrointestinal effects (anorexia, nausea,
vomiting, constipation, diarrhea) are among the
most common adverse reactions to drugs. Diarrhea
occurs with drugs that cause local irritation or
increase peristalsis.
More serious effects include bleeding or
ulceration (most often with aspirin and nonsteroidal
anti-inflammatory agents) and severe
diarrhea/colitis (most often with antibiotics).

Hematologic effects
Hematologic effects (blood coagulation disorders,
bleeding disorders, bone marrow depression,
anemias, leukopenia, agranulocytosis,
thrombocytopenia) are relatively common and
potentially life threatening. Excessive bleeding is
most often associated with anticoagulants and
thrombolytics; bone marrow depression is usually
associated with antineoplastic drugs.

Hepatotoxicity
Hepatotoxicity (hepatitis, liver dysfunction or
failure, biliary tract inflammation or obstruction) is
potentially life threatening. Because most drugs
are metabolized by the liver, the liver is especially
susceptible to drug induced injury. Drugs that are
hepatotoxic include acetaminophen (Tylenol),
isoniazid (INH), methotrexate (Mexate), phenytoin
(Dilantin), and aspirin and other salicylates.

Nephrotoxicity
Nephrotoxicity (nephritis, renal insufficiency or
failure) occurs with several antimicrobial
agents (eg, gentamicin and other
aminoglycosides), nonsteroidal
antiinflammatory agents (eg, ibuprofen and
related drugs), and others.

Hypersensitivity
Hypersensitivity or allergy may occur with
almost any drug in susceptible clients. It
is largely unpredictable and unrelated to
dose. It occurs in those who have
previously been exposed to the drug or a
similar substance (antigen) and who have
developed antibodies

Drug fever
Drug fever is a fever associated with
administration of a medication. Drugs can
cause fever by several mechanisms,
including allergic reactions, damaging body
tissues, increasing body heat or interfering
with its dissipation, or acting on the
temperature regulating center in the brain.

Drug dependence
Drug dependence may occur with mindaltering drugs, such as opioid analgesics,
sedative-hypnotic agents, antianxiety
agents, and CNS stimulants.

Carcinogenicity
Carcinogenicity is the ability of a
substance to cause cancer. Several
drugs are carcinogens, including some
hormones and anticancer drugs.
Carcinogenicity apparently results from
drug-induced alterations in cellular DNA.

Teratogenicity
Teratogenicity is the ability of a substance
to cause abnormal fetal development
when taken by pregnant women. Drug
groups considered teratogenic include
analgesics, diuretics, antiepileptic drugs,
antihistamines, antibiotics, antiemetics,
and others.

Toxic Effects of Drugs

Drug toxicity (also called poisoning,
overdose, or intoxication) results from
excessive amounts of a drug and may
cause reversible or irreversible damage
to body tissues.

 In some cases, the patient or someone

accompanying the patient may know the
toxic agent (eg, accidental overdose of a
therapeutic drug, use of an illicit drug, a
suicide attempt).