In recent years, a considerable amount of attention has been directed towards iatrogenic poisoning and many cases arise

because the following factors are ignored or forgotten :

I-Personal factors: A-Age. B- Nutritional status.

II- Genetic and racial factors: drug acetylating enzymes Plasma pseudocholine esterase (ChE) Glucose-6 phosphate dehydrogenase (G6PD) Prophyrias Malignant hyperthermia Steroid Acatalasia

III- Immunological factors (Drug allergy) IV- Environmental Factors V- pharmacologic factors (Drug interactions) Interactons on pharmacokinetic bases A-Interactions affecting gut absorption -Gut motility -Ph of gut contents -Alterations in gut flora - Interference with absorptive mechanisms

B-Interactions involving plasma protein binding sites C-Interactions related to drug biotransformation -Enzyme inhibtion interactions D-Altered excretion interactions - Changes of urinary pH -Competition for active tubular secretion

Interaction on pharmcodynamic bases (effect of the drug on the body ) 1- Interaction on the same physiologic system 2- Interactions involving changes in blood volume and/or electrolytes 3- Interactions involving modification of neurotransmitter concentration 4- Interactions at the level of receptors

VI- Miscellaneous factors: a) Inadvertent intra-arterial injections b) Drugs prescribed Via telephone c) Errors of prescribing d) Hazards of life on drugs (Chronic pharmacology) e) Drug therapy carries unavoidable risk

1- Iatrogenic addiction 2-Iatrogenic poisoning due to withdrawal of some drugs 3- Iatrogenic parkinsonism 4-Iastrogenic respiratory diseases 5- Iatrogenic hepatotoxicity 6-Iatrogenic nephrotoxicity 7-Iatrogenic cardiotoxicity 8- Iatrogenic neurotoxicity

9-Iatrogenic skin disease 10-Iatrogenic drug-infertility 11- Iatrogenic intrauterine poisoning 12-Iatrogenic poisoning of the breast fed infants 13-Iatrogenic anaesthetic problems 14-Iatrogenic water intoxication 15- Iatrogenic poisoning from radiotherapy 16- Iatrogenic ocular toxicity

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