1. Chemical injuries Adverse drug reactions (ADRs). Definition: Any response to a drug that is noxious and unintended that occur at doses used in humans for prophylaxis,diagnosis and therapy.

2. Examples: Skin : Urticaria. Antineoplastic agents. Macule. Sulfonamides. papules. Heart: Arrhythmias. Theophylline. Cardiomyopathy. Doxorubcin. Kidney: Glomerulonephritis : Penicillamine. Acute tubular necrosis : aminoglycosides. Tubulointerstitial diseases with papillary necrosis : Phenacetin & salicylate.

3. Pulmonary : Asthma : salicylate Pneumonitis : Nitrofurantoin Interstitial fibrosis : Busulfan & Bleomycin GIT : NSAIDs : Gastritis and peptic ulcer Liver : Fatty change : Tetracyclin Diffuse hepatocellular injuries: Halothane Cholestasis : Chlorpromazine.

4. Blood dyscrasias : Granulocytopenia: chemotherapy. Aplastic anemia: Chloramphe. Pancytopenia : immunosupp. Hemolytic anemia: Penicillin ( G6PD) :Antimalarial drugs. Systemic effects : Anaphylaxis : Penicillin. SLE : Hydralazine

5. Estrogen : Postmenopausal osteoporosis complications : * Endometrial carcinoma. * Breast carcinoma. * Cardiovascular diseases. * Venous thrombosis. * Cholestasis..

6. Oral cotraceptive : No relation Endometrial carcinoma. Breast carcinoma. relation with Hepatic adenoma Hypertension Cholestasis

7. Antineoplastic drugs : 1- Bone marrow suppression. 2- Immunosuppression. 3- carcinogenic. Antibiotics : 1- Hypersensitivity reaction. 2- Bacterial resistance. 3- Eradication of normal flora

8. Non Therapeutic Effect alcohol abuse Alcohol-Metabolism and Health Effects Acute alcohol abuse causes drowsiness at blood levels of approximately 200 mg/dL. Stupor and coma develop at higher levels.Alcohol is oxidized to acetaldehyde in the liver by alcohol dehydrogenase, by the cytochrome P-450 system, and by catalase, which is of minor importance. t

9. Acetaldehyde is converted to acetate in mitochondria and utilized in the respiratory chain.Alcohol oxidation by alcohol dehydrogenase depletes NAD, leading to accumulation of fat in the liver and metabolic acidosis.The main effects of chronic alcohol consumption are fatty liver, alcoholic hepatitis, and cirrhosis, which causes portal hypertension and increases the risk of development of hepatocellular carcinoma..

10. Chronic alcohol consumption can cause bleeding from gastritis and gastric ulcers, peripheral neuropathy associated with thiamine deficiency, and alcoholic cardiomyopathy, and increases the risk for acute and chronic pancreatitis.Chronic alcohol consumption is a major risk factor for cancers of the oral cavity, pharynx, larynx, and esophagus. The risk is greatly increased by concurrent smoking or use of smokeless tobacco

11. Toxic Effects Of Heavy Metals Lead Mercury Arsenic Cadmium

12. Lead poisoning Most commonly associated with toxic effects in humans.Children absorb more ingested lead than adults, The main source of exposure for children is lead containing paints. Excess lead causes CNS defects in children &peripheral neuropathy in adults. It competes with calcium in bones & interferes with remodeling of cartilage.It also cause anemia.

13. Mercury The major source is contaminated fish. The developing brain is highly sensitive to methyl mercury which accumulate in the brain & blocks ion channels. High level of mercury may cause cerebral palsy, deafness & blindness

14. Arsenic It is naturally found in soil & water.It is a component of some wood preservatives. Excess arsenic interferes with mitochondrial oxidative phosphorylation & cause toxic effects in GIT, CNS & CVS.