In recent years, a considerable amount of attention has been directed towards iatrogenic poisoning and many cases arise because the following factors are ignored or forgotten :

I-Personal factors: A-Age. B- Nutritional status.

II- Genetic and racial factors: drug acetylating enzymes Plasma pseudocholine esterase (ChE) Glucose-6 phosphate dehydrogenase

(G6PD) Prophyrias Malignant hyperthermia Steroid Acatalasia

III- Immunological factors (Drug allergy) IV- Environmental FactorsV- pharmacologic factors (Drug

interactions) Interactons on pharmacokinetic basesA-Interactions affecting gut absorption-Gut motility-Ph of gut contents

-Alterations in gut flora - Interference with absorptive mechanisms

B-Interactions involving plasma protein binding sites

C-Interactions related to drug biotransformation -Enzyme inhibtion interactions

D-Altered excretion interactions- Changes of urinary pH -Competition for active tubular secretion

Interaction on pharmcodynamic bases (effect of the drug on the body )

1- Interaction on the same physiologic system

2- Interactions involving changes in blood volume and/or electrolytes

3- Interactions involving modification of neurotransmitter concentration

4- Interactions at the level of receptors

VI- Miscellaneous factors:a) Inadvertent intra-arterial injectionsb) Drugs prescribed Via telephone c) Errors of prescribingd) Hazards of life on drugs (Chronic

pharmacology)e) Drug therapy carries unavoidable risk

1- Iatrogenic addiction 2-Iatrogenic poisoning due to withdrawal of

some drugs 3- Iatrogenic parkinsonism 4-Iastrogenic respiratory diseases 5- Iatrogenic hepatotoxicity 6-Iatrogenic nephrotoxicity 7-Iatrogenic cardiotoxicity 8- Iatrogenic neurotoxicity

9-Iatrogenic skin disease 10-Iatrogenic drug-infertility 11- Iatrogenic intrauterine poisoning 12-Iatrogenic poisoning of the breast fed

infants13-Iatrogenic anaesthetic problems14-Iatrogenic water intoxication15- Iatrogenic poisoning from radiotherapy16- Iatrogenic ocular toxicity

Manufacturer’s liability Physician’ liability