Difference between revisions of "Drug toxicity"
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=General principles= | =General principles= | ||
A drug/toxin reaction should be considered if there is: | |||
# Ingestion | # Ingestion/exposure. | ||
# | # An appropriate temporal relation. | ||
# | # An empirical correlation between the drug/toxin and the pattern. | ||
#* Worsening with re-challenge. | #* Worsening with re-challenge. | ||
#* Improvement with removal of exposure. | #* Improvement with removal of exposure. | ||
Revision as of 03:05, 22 March 2018
Drug toxicity, also drug reaction, in pathology is often a diagnosis of exclusion. Few drugs leave a distinctive histomorphologic pattern.
This article covers a few of the distinctive histomorphologic pattern and links to other articles that deal with specific organ systems.
General principles
A drug/toxin reaction should be considered if there is:
- Ingestion/exposure.
- An appropriate temporal relation.
- An empirical correlation between the drug/toxin and the pattern.
- Worsening with re-challenge.
- Improvement with removal of exposure.
- Pathologic pattern matches with toxin.
- Drug.
Site specific
Liver drug toxicity
Stomach
Small bowel
Specific drugs
Sodium polystyrene sulfonate
- AKA Kayexalate (trade name).
General
- Used to treat hyperkalemia.
Microscopic
Features:[1]
- Purple blobs on H&E stain - look somewhat like calcium phosphate.
- Can cause focal necrosis.
Image
Kayexalate crystals and adenocarcinoma. (WC)
Proton pump inhibitor
Main article: Proton pump inhibitor effect
Nonsteroidal anti-inflammatory drugs
Main article: Nonsteroidal anti-inflammatory drugs
Oral contraceptive pill
Main article: Oral contraceptive pill
Minocycline
Spironolactone
See also
References
- ↑ Abraham SC, Bhagavan BS, Lee LA, Rashid A, Wu TT (May 2001). "Upper gastrointestinal tract injury in patients receiving kayexalate (sodium polystyrene sulfonate) in sorbitol: clinical, endoscopic, and histopathologic findings". Am. J. Surg. Pathol. 25 (5): 637-44. PMID 11342776. http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0147-5185&volume=25&issue=5&spage=637.