Drugs 13

• target organ toxicity 


  adverse toxic effects of a substance on a specific tissue or organ
• why specific organs are vulnerable to toxic effects of a substance

  metabolism, perfusion, enzymatic profile, receptor expression, parenchyma
• metabolism - target organ toxicity


  increased conc of metabolising enzymes more susceptible to toxicity
• perfusion - target organ toxicity


  highly perused organs exposed to higher toxic load
• parenchyma - target organ toxicity

  specialised cells in an organ may be damaged by drug which decreases organ function
• individual risk factors for target organ toxicity

  genetics, sex, lifestyle, concurrent medications, previous disease
• example of organ susceptibility due to receptor expression

  trastuzumab toxicity to HER2+ cells
• organ toxicity risk trastuzumab 


  HER-2 receptors over expressed in breast cancer cells but also is HER-2 signalling in the cardiac tissue
• example of target organ toxicity due to parenchyma

  digoxin cardiotoxicity
• 2 cardiotoxins 


  doxorubicin and cocaine
• 2 hepatotoxins 


  rifampificn and azathioprine
• cardio toxicity symptoms


  cardiomyopathy and arrhythmia, damage to the CM
• hepatotoxicity symptoms


  increased triglycerides, decreased bile flow and cytotoxic damage