Hypersensitivity

It refers to the undesirable reactions produced by the normal immune system that can damage, cause discomfort or sometimes be fatal to an individual. These reactions are produced in the presence of certain antigens and are considered to be abnormal. There are 4 different types of hypersensitivity depending on the altaration in the immune system, they are: 1. 2. 3. 4. Type I: Immediate Hypersensitivity Type II: Cytotoxic Hypersensitivity Type III: Immune Complex Hypersensitivity Type IV: Delayed Hypersensitivity

Example Many different examples of hypersensitivity have been recognized in animals and humans. These are often referred to collectively as allergies, and clinically may take such forms as asthma, hives, hay fever, anaphylactic reactions to certain foods or insect venoms, some forms of eczema and kidney diseases, and skin reactions to poison ivy antigens and many other substances.

Tachyphylaxis
It is a rapid decrease in the response to a drug after repeated doses over a short period of time. Hence increasing the dosage of the drug will not increase the desired pharamcological response. The drug causing tachyphylaxis acts indirectly by causing release of the stored neurotransmitter from the nerve terminal. After a few doses the neurotransmitter stores are depleted and no more reponse is obtained. Example Repeated doses of ephedrine may display tachyphylaxis, since it is an indirectly acting sympathomimetic amine which will deplete noradrenaline from the nerve terminal. Thus repeated doses result in less noradrenaline being released than the initial dose.

Idiosyncrasy
It is a non-immunological hypersensitivity to a substance, without a connection to pharmacological toxicity. It explores the fact that every individual reacts in an unusually different way to a given substance, and this difference is based on the condition that the individual suffers from. This reaction usually occurs in a small group of individuals. Example Antipsychotic drugs such as chlorpromazine and clozapine cause infrequent reactions such as rhabdomyolysis or breakdown of striated muscle and liver toxicity which can be seen by by an increase in serum -glutamyl transferase (GGT) activity.

Allergy
Allergy is a disorder of the immune system often also referred to as atopy. Allergic reactions occur to normally harmless environmental substances known as allergens; these reactions are acquired, predictable, and rapid Example Many allergens such as dust or pollen are airborne particles. In these cases, symptoms arise in areas in contact with air, such as eyes, nose and lungs. For instance, allergic rhinitis, also known as hay fever, causes irritation of the nose, sneezing, and itching and redness of the eyes. Inhaled allergens can also lead to asthmatic symptoms, caused by narrowing of the airways (bronchoconstriction) and increased production of mucus in the lungs, shortness of breath (dyspnea), coughing and wheezing.

Tolerance
Tolerance is defined either as getting less and less response to the drug at the usual dosage, or as having to administer more and more of the drug to get the same effect. Example Long-term benzodiazepine usage, in general, leads to some form of tolerance and/or drug dependence with the appearance of a benzodiazepine withdrawal syndrome when the benzodiazepines are stopped or the dose is reduced. Long term use of benzodiazepines can cause a range of health problems in a proportion of people. The long term effects of benzodiazepines include impaired concentration and memory, sleep problems, depression, anxiety and panic attacks as well as agoraphobia

Hyper-reactivity
The quality of being hyperreactive. Example Bronchial Hyperreactivity: a condition where the individual is 100- to 1000-fold more sensitive to histamine than a normal individual.

Supersensitivity
Abnormally increased sensitivity Example

Denervation Supersensitivity: denervation supersensitivity occurs in autonomic effector tissues after administration of drugs that deplete transmitter stores and prevent activation of the postsynaptic receptors for a sufficient period of time. For example, administration of large doses of reserpine, a norepinephrine depleter, can cause increased sensitivity of the smooth muscle and cardiac muscle effector cells served by the depleted sympathetic fibers

Addiction
Strong physiological and psychological dependence on a drug or other psychoactive substance. Example Heroin addiction.

Dependence
A state in which there is a compulsive or chronic need. Physical Substance dependence in which there is evidence of tolerance, withdrawal or both. Example Nicotine dependence in smokers. Psychical Substance dependence in which the drug is used to obtain relief from tension or emotional discomfort, rather than being associated with tolerance or withdrawal. Example Alcoholism

References
Katzung B. Basic Pharmacology. Lange. Dorlands 31st Illustrated Medical Dictionary. Elsevier. Ament PW, Roth JD, and Fox CJ (1994) Famotidine-induced mixed hepatocellular jaundice. Ann Pharmacotherapy 28: 4042.