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Related Concept Videos

Drug Toxicity: Allergic Reactions01:30

Drug Toxicity: Allergic Reactions

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Drug-related allergies are immune-mediated responses triggered by the administration of pharmacological agents. These hypersensitivity reactions are classified based on the immune mechanisms involved. The four primary types—Type I, II, III, and IV—are mediated by different immunological pathways and exhibit distinct clinical manifestations.Type I Hypersensitivity/ IgE-Mediated Reactions: Immunoglobulin E (IgE) immediately mediates Type I hypersensitivity reactions. Upon initial...
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Drug toxicity: Idiosyncratic Reactions01:16

Drug toxicity: Idiosyncratic Reactions

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Idiosyncratic drug reactions represent abnormal chemical responses that vary significantly among individuals, ranging from extreme sensitivity to low doses to insensitivity to high doses. These reactions often occur due to the drug's covalent binding with serum proteins, forming a foreign hapten that triggers an immunotoxicological response. The variability in drug reactions has a strong pharmacogenetic foundation, with genetic differences crucial in how individuals metabolize drugs. For...
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Allergic Drug Reactions01:27

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Allergic reactions related to drugs are hypersensitivity responses driven by the immune system and bear no connection to the drug's therapeutic action. While drugs in isolation do not trigger an immune response, they can interact with endogenous proteins to form antigens. These antigens stimulate lymphocytes to produce antibodies. IgE-type antibodies attach themselves to mast cells. Upon subsequent exposure to the same stimulus, the antigen-antibody interaction is initiated, unleashing...
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Drug Toxicity: Dose-Dependent Reactions01:24

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Drug toxicities can be stratified into pharmacological, pathological, or genotoxic based on their mechanisms. The incidence and severity of these toxicities generally increase with the drug's concentration in the body and exposure time.Pharmacological toxicity is evident when the therapeutic effects of drugs overshoot into adverse reactions in a predictable, dose-dependent manner. Central nervous system (CNS) depression from barbiturates is a classic example, with effects escalating from...
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Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

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Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
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Hypersensitivity Reactions: Cytolytic Reactions01:01

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Type II hypersensitivity involves IgG and IgM antibodies targeting cell surface antigens, leading to cell destruction. This can occur through complement activation, antibody-dependent cell-mediated cytotoxicity (ADCC), or acting as opsonins for phagocytosis. When excessive, these reactions cause significant tissue damage.Drug-induced hemolytic anemia is a common example, where drugs like penicillin or cephalosporins bind to red blood cells, forming drug-protein complexes. These complexes...
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Drug-induced lupus.

Robert L Rubin1

  • 1University of New Mexico Health Sciences Center, Department of Molecular Genetics and Microbiology , Albuquerque, NM 87131 , USA +1 505 272 4640 ; +1 505 272 9550 ; rlrubin@salud.unm.edu.

Expert Opinion on Drug Safety
|January 3, 2015
PubMed
Summary
This summary is machine-generated.

Drug-induced lupus (DIL) is a reversible condition mimicking systemic lupus erythematosus, triggered by certain medications. Its complex autoimmune mechanisms involve genetic factors and drug metabolites, offering insights into immune tolerance.

Keywords:
autoantibodiesautoimmune diseasedrug metabolismdrug-induced lupusimmune complexesimmune tolerancepathogenesissystemic lupus erythematosus

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Area of Science:

  • Immunology
  • Rheumatology
  • Pharmacology

Background:

  • Drug-induced lupus (DIL) presents with symptoms overlapping systemic lupus erythematosus.
  • DIL is an idiosyncratic reaction to various medications and is reversible upon drug cessation.
  • The underlying cause is linked to the adaptive immune system's susceptibility to auto-reactivity.

Purpose of the Study:

  • To compare clinical and laboratory features of DIL with idiopathic lupus and other drug reactions.
  • To discuss the role of reactive drug metabolites in initiating autoimmunity.
  • To explore proposed mechanisms of DIL pathogenesis within the context of autoimmunity and immune tolerance.

Main Methods:

  • Comparative analysis of clinical and laboratory data for DIL, idiopathic lupus, and other drug reactions.
  • Review of pharmacological properties and reactive drug metabolites.
  • Discussion of pathogenetic mechanisms including complement, human leukocyte allotypes, and drug acetylator phenotype.

Main Results:

  • Certain older drugs posed a high risk for DIL, though risk is unestablished for most lupus-inducing agents.
  • Parent drug compounds' properties are uninformative regarding DIL risk.
  • Reactive drug metabolites are implicated in initiating autoimmunity.

Conclusions:

  • The pathogenesis of DIL is complex and not fully understood.
  • Proposed mechanisms for DIL involve genetic predispositions and drug-specific factors.
  • Understanding DIL contributes to broader knowledge of autoimmunity and immune tolerance.