Biochemical mechanisms of drug toxicity

Abstract Drugs are an essential tool for the treatment of many diseases; however, drugs can also cause many different types of adverse effects. Many adverse reactions are simply an extension of their therapeutic effects and are relatively easy to predict. The focus of this chapter will be on idiosyncratic adverse drug reactions, carcinogenic effects of drugs, and teratogenic effects of drugs. Drugs can be converted to multiple metabolites, and these metabolites can be responsible for many of the adverse effects associated with the use of medication. In particular, chemically reactive metabolites can cause both direct toxicity such as carcinogenic and teratogenic effects, and they can also result in adverse immune responses. A better mechanistic understanding of adverse drug reactions would lead to safer use of current drugs and make it easier to screen drug candidates for their potential to cause adverse reactions.