Drug-Induced Diseases - Types, Diagnosis, Treatment & Prevention (2022)

Drug-Induced Diseases - Types, Diagnosis, Treatment & Prevention (1)

Written byDr. Simi Paknikar,MD
Medically Reviewed by
The Medindia Medical Review Team on Nov 28, 2017

Introduction

The term ‘drug-induced diseases’ sounds like a paradox. Drugs or medications are taken to treat diseases. The last thing one would expect is that the medication used to relieve discomfort would actually do harm! ‘Drug-induced diseases’ refer to those adverse effects of drugs that are serious enough for the patient to consult a doctor or get hospitalized. The effects may persist even after the treatment with the drug has been discontinued.

Adverse drug reactions are a reality. Then why do we use drugs? Drugs are approved for use only if their potential benefits far outweigh the risks involved. Also, not all people react similarly to a drug. It is possible that a particular drug, while completely benefiting some people may cause a potentially life-threatening adverse effect on some others!

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Every drug undergoes extensive testing before it is introduced into the market. This includes testing in animals, and only once the safety and efficacy of the drug are established, it is tested in humans. Once approved, it is introduced into the market. Unfortunately, several adverse effects appear when the drug is introduced into the larger population. Many drugs have had label changes, introduction of black box warnings on their labels, or had to be withdrawn due to this reason. These adverse effects come to the notice of authorities either through spontaneous reporting by physicians, or various studies conducted.

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What are the Types of Drug-Induced Diseases?

Diseases caused by drugs can be either predictable or unpredictable. Predictable effects are an extension of the normal pharmacological effects of the drug. For example, blood thinners (anticoagulant and antiplatelet drugs) that are used to prevent clotting of blood can cause bleeding as a side effect. Several anti-diabetes medications like insulin and sulfonylureas can cause low blood glucose levels.

On the other hand, unpredictable effects are completely unrelated to the therapeutic effect of the drug. For example, amiodarone, a drug used to treat abnormal heart rhythms, can cause lung damage.

Depending on their severity, drug-induced diseases may be classified as mild, moderate, severe, or lethal if they cause death.

Drug-induced diseases can affect various organ systems of the body. Several drugs have been banned because of their ability to cause serious diseases. The list of drugs that cause diseases can go on for several pages; here are some examples listed below according to the organ system affected:

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Cardiovascular system:

  • Rofecoxib, a COX-2 inhibitor painkiller, was introduced with the hope that it would avoid the adverse effects of nonsteroidal anti-inflammatory drugs (NSAIDs) like stomach ulcers. Unfortunately, its use was associated with cardiovascular events like heart attack and stroke and the drug had to be withdrawn from the market.
  • Several drugs used for the treatment of obesity met a similar fate. Fenfluramine and dexfenfluramine affected the heart valves, while sibutramine, was associated with cardiovascular events and stroke, and therefore had to be removed from the market.
  • Several drugs have been associated with congestive heart failure. These include the anti-diabetes drug rosiglitazone, which should be avoided in patients who already suffer from heart failure. Drugs that slow down the heart like calcium channel blockers and beta blockers, and corticosteroids that cause retention of salt and water can also cause heart failure.
  • Astemizole, terfenadine and cisapride can affect the electrical activity of the heart causing prolongation of the QT interval and resulting in a condition called torsades de pointes. The chances of this side effect are particularly high when one of these drugs is administered with drugs that prevent its breakdown like erythromycin and ketoconazole.

Drug-Induced Diseases - Types, Diagnosis, Treatment & Prevention (2)

Skin:

The skin is the most obvious part of the body, and therefore any reaction is very easy to notice. Drug-induced skin reactions may be acute or chronic.

  • The acute reactions may vary from a simple rash and itching to a serious condition like angioedema and Stevens-Johnson’s syndrome / toxic epidermal necrolysis. Drugs that often cause acute skin reactions include penicillin, sulfonamides, allopurinol (anti-gout medication) and those that treat seizures and mental illnesses like anticonvulsants and antipsychotics.
  • A special type of skin reaction caused by drugs is called fixed drug eruption. Here, the skin lesion appears only on a particular part. Fixed-drug reactions are noted with tetracycline, barbiturates and sulfonamides.
  • The blood-thinner warfarin can rarely cause necrosis of the skin.
  • Sulfonamides, chloroquine and tetracycline can produce a photosensitivity reaction, which is a skin reaction that develops when the patient taking these drugs is exposed to sunlight. Therefore, patients on these medications are asked to avoid sunlight while being treated.
  • Hydralazine and procainamide cause a chronic immunological reaction called SLE-like syndrome that also affects the musculoskeletal system, kidneys and the brain.

Brain and Nerves:

  • The anti-tuberculosis drug isoniazid or INH interferes with the utilization of vitamin B6 and causes neurological symptoms ranging from peripheral neuritis, mental disturbances and rarely seizures.
  • Theophylline, an anti-asthma medication, if not maintained within normal levels in the blood, can cause neurological symptoms like restlessness and tremors, which may also progress to seizures along with abnormal heart rhythms and shock.
  • Some of the older antipsychotic drugs like fluphenazine and haloperidol can cause movement disorders like acute dystonia (abnormal muscle spasms) in the facial muscles, akathisia (a compulsion to move), Parkinsonism, malignant neuroleptic syndrome (which results in stiffness and tremor), and tardive dyskinesia which occurs later during therapy.
  • Pregabalin, barbiturates and benzodiazepines can cause excessive sleepiness. Patients taking such drugs should avoid driving or using dangerous machinery while on the medication to prevent accidents.

Drug-Induced Diseases - Types, Diagnosis, Treatment & Prevention (3)

Lung:

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  • Drugs used for the treatment of cancer, methotrexate and bleomycin cause scarring of the lungs called pulmonary fibrosis or interstitial pneumonitis. The patient suffers from breathlessness and non-productive cough, which can worsen if the dosage is not lowered. Amiodarone is a non-anticancer drug that also damages the lung.
  • Aspirin and nonselective beta blockers like propranolol can cause an asthma-like condition, making it difficult for the patient to breathe. These should be avoided in patients with pre-existing asthma. In addition, any drug can cause a severe allergic reaction that mimics an asthmatic attack.

Digestive tract:

  • Nonsteroidal painkillers and corticosteroids are well known to cause stomach ulcers, especially when taken on an empty stomach. Bisphosphonates used in the treatment of osteoporosis can cause esophageal ulcers and are advised to be taken in an upright position.
  • Diarrhea can be caused by nearly every oral drug. Iron salts and loperamide can cause constipation.
  • The liver is the site for detoxification. Some drugs, however, affect the liver causing serious problems. High dose of acetaminophen, an otherwise safe drug in normal doses, causes liver toxicity (hepatotoxicity). Several first-line anti-tuberculosis drugs that include INH, rifampicin and pyrazinamide cause liver damage, and reduce the options for the treatment of tuberculosis in these patients. Amiodarone, methotrexate, and valproic acid are some of the other hepatotoxic drugs. These drugs should be avoided in alcoholics and other patients who already suffer from liver disease. Troglitazone, an anti-diabetes medication was withdrawn due to its liver-damaging effect.

Drug-Induced Diseases - Types, Diagnosis, Treatment & Prevention (4)

Genital and Urinary tract:

  • Drugs can affect different parts of the kidney causing a number of kidney disorders. These include glomerulonephritis which may be caused by drugs like penicillin, NSAIDs, gold, lithium and hydralazine, acute tubular necrosis caused by drugs like aminoglycosides and amphotericin B, and acute interstitial nephritis caused by penicillin, NSAIDs and rifampicin. Cyclosporine and tacrolimus can cause chronic kidney failure. Damage to the kidneys may reduce the excretion of several drugs through the urine; hence these drugs may need to be avoided or may require dosage adjustment.
  • Erectile dysfunction is a side effect of drugs like thiazide diuretics and antidepressants.

Blood:

  • Drugs can produce anemia by reducing the production of red blood cells by the bone marrow (e.g. chloramphenicol, sulfonamides and carbamazepine), or destroying the formed red blood cells by a process called hemolysis (e.g. primaquine, penicillin and sulfonamides). Hemolysis is particularly a problem in patients with the deficiency of an enzyme called glucose-6-phosphatase.
  • Some drugs reduce white blood cell counts and increase the chances of suffering from infections. These include methimazole, phenylbutazone and clozapine.
  • Heparin has been associated with thrombocytopenia, a condition that lowers the platelet counts in the blood and increases the chances of bleeding.

Drug-Induced Diseases - Types, Diagnosis, Treatment & Prevention (5)

Bone:

  • Long-term use of glucocorticoids can weaken bones causing osteoporosis and increasing the risk of fractures.
  • The anti-tubercular drugs ethambutol and pyrazinamide can increase the blood uric acid, causing a gout-like disease.

Hormonal conditions:

  • Glucocorticoids raise blood glucose levels and cause a diabetes-like condition. Therefore, a history of drug intake is important in any individual who tests positive for high blood glucose.
  • Amiodarone and lithium can cause thyroid problems.

Cancer:

  • Hormone replacement therapies can cause breast cancer.
  • Diethylstilbestrol caused vaginal adenocarcinoma in daughters of women who took the drug during pregnancy.

How are Drug-Induced Diseases Diagnosed?

Drug-induced diseases are primarily diagnosed based on the history of drug intake obtained from the patient or the family. The symptoms should appear at a reasonable time frame after taking the medication. By default, physicians should enquire about drug intake to any patient coming to the clinic with a problem so as not to miss out on a drug-induced disease. If the drug is re-administered the symptoms may reappear. This is referred to as re-challenge. Re-challenge confirms a drug-induced disease, but is usually not done due to ethical reasons.

How are Drug-Induced Diseases Treated?

The first step in the treatment of drug-induced diseases is to report the adverse effect to the physician who may stop the intake of the medication or at times, reduce the dose gradually, and replace with an appropriate alternative. Many times, this simple step can relieve the patient of the symptoms. Those who do not recover require additional treatments depending on the adverse event.

(Video) Drug induced diseases: Introduction & its mechanism, Important topic l पूरी जानकारी notes के साथ

How do you Prevent Drug-Induced Diseases?

Steps that could help to prevent a drug-induced disease include the following:

  • Always inform your doctor if you suffer from any illness or take any other medication including a nutritional supplement before you are prescribed a medication.
  • Inform your doctor if you have suffered from any previous allergic reaction to a drug or any other substances like food ingredients.
  • Take the medication only as prescribed by the doctor. Stick to the dose, duration of treatment as well as other instructions like taking it after meals.

Published on Nov 25, 2017
Last Updated on Nov 28, 2017

References:

Citations

Latest Publications and Research on Drug-Induced Diseases

  • Osteopontin - A potential biomarker of advanced liver disease. - Published by PubMed
  • The Effects of Inhibin B in the Chemotherapy Drug-Induced Premature Ovarian Insufficiency Mice and hPMSCs Treatment. - Published by PubMed
  • Dipeptidyl peptidase-4 inhibitor-associated bullous pemphigoid, likely triggered by scabies, in a hemodialysis patient with human leukocyte antigen-DQB1*03:01. - Published by PubMed
  • Brugada syndrome: A comprehensive review of pathophysiological mechanisms and risk stratification strategies. - Published by PubMed
  • Cytochrome P450 endoplasmic reticulum-associated degradation (ERAD): therapeutic and pathophysiological implications. - Published by PubMed

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Frequently Asked Questions >>

(Video) Diagnosis & Treatment | Drug Induced Liver Disorders

FAQs

How is drug-induced disease diagnosed? ›

Drug-induced diseases are primarily diagnosed based on the history of drug intake obtained from the patient or the family. The symptoms should appear at a reasonable time frame after taking the medication.

What are drug-induced diseases? ›

A drug-induced disease is defined as the unintended effect of a drug that results in mortality or morbidity with symptoms sufficient to prompt a patient to seek medical attention and/or to require hospitalization and may persist even after the offending drug has been withdrawn25.

Which drug is used for diagnosis of disease? ›

Radiopaque agents are drugs used to help diagnose certain medical problems. They contain iodine, which absorbs x-rays. Depending on how they are given, radiopaque agents build up in a particular area of the body. The resulting high level of iodine allows the x-rays to make a "picture" of the area.

Why diagnosis is important in treatment of diseases? ›

Diagnosis can improve the effectiveness of treatments and avoid long-term complications for the infected patient. Undiagnosed patients can unknowingly transmit the disease to others. Early diagnosis can help to prevent or stop an outbreak.

What is drug-induced diabetes? ›

Drug-induced diabetes is defined as diabetes resulting from the use of medication. Key medication classes to monitor due to risk of drug-induced diabetes are listed in TABLE 1, as well as specific agents, mechanisms of causing diabetes, incidence, and short-term reversibility.

What is drug information services? ›

Drug information service is a dedicated and specialized service provided by pharmacists to enhance knowledge of medicines use, promote rational prescribing among prescribers, and reduce medication errors.

What drugs cause drug-induced hepatitis? ›

Aspirin and over-the-counter pain and fever medicines (NSAIDs or nonsteroidal anti-inflammatory medicines) Anabolic steroids, man-made medicines that are like the male sex hormone testosterone. Some medicines used to treat bacterial infections (antibiotics) Birth control pills (oral contraceptives)

Can medicine cause diseases? ›

No healthcare provider wants a prescribed drug to cause another disease. But, such is the case with drug-induced diseases (DIDs), which refer to unintended effects of a drug that could result in complications or death, with symptoms sufficient to elicit medical attention or hospitalization.

What is drug-induced schizophrenia? ›

Drug-induced schizophrenia is schizophrenia that emerges due to exposure to a substance. You may notice symptoms begin with drug-induced psychosis, but these two conditions aren't the same. Drug-induced schizophrenia is a lifelong condition with symptoms that can persist before and after substance exposure.

What is the use of drugs to treat a disease? ›

Medicines act in a variety of ways. Some can cure an illness by killing or halting the spread of invading germs, such as bacteria and viruses. Others are used to treat cancer by killing cells as they divide or preventing them from multiplying.

How many diseases are there? ›

“We generally say: Several thousand diseases affect humans of which only about 500 have any U.S. Food and Drug Administration-approved treatment,” said Cindy McConnell, a spokeswoman at NIH's National Center for Advancing Translational Sciences (NCATS).

What are the types of diagnosis? ›

Diagnostic tests
  • Biopsy. A biopsy helps a doctor diagnose a medical condition. ...
  • Colonoscopy. ...
  • CT scan. ...
  • CT scans and radiation exposure in children and young people. ...
  • Electrocardiogram (ECG) ...
  • Electroencephalogram (EEG) ...
  • Gastroscopy. ...
  • Eye tests.

What is diagnosis example? ›

Examples of diagnosis in a Sentence

She is an expert in the diagnosis and treatment of eye diseases. The diagnosis was a mild concussion. His doctor made an initial diagnosis of pneumonia. The committee published its diagnosis of the problems affecting urban schools.

What is disease diagnosis? ›

Listen to pronunciation. (DY-ug-NOH-sis) The process of identifying a disease, condition, or injury from its signs and symptoms. A health history, physical exam, and tests, such as blood tests, imaging tests, and biopsies, may be used to help make a diagnosis.

What is Type 4 diabetes? ›

Type 4 diabetes is the proposed term for diabetes caused by insulin resistance in older people who don't have overweight or obesity. A 2015 study with mice suggested this type of diabetes might be widely underdiagnosed. This is because it occurs in people who aren't overweight or obese, but are older in age.

What is drug-induced hypertension? ›

Drug-induced hypertension is high blood pressure caused by a chemical substance or medicine. Hypertension is a disorder characterized by chronically high blood pressure. It must be monitored, treated and controlled by medicines, lifestyle changes, or a combination of both.

Is drug-induced diabetes type 2? ›

A number of drugs have been linked with an increased risk development of type 2 diabetes.

What is considered a drug? ›

(drug) Any substance (other than food) that is used to prevent, diagnose, treat, or relieve symptoms of a disease or abnormal condition. Drugs can also affect how the brain and the rest of the body work and cause changes in mood, awareness, thoughts, feelings, or behavior.

Why is drug information important? ›

The primary goal of a drug information service is to improve patient care by providing objective and unbiased information for drug-related questions.

How do drugs affect the liver? ›

For example, drugs may damage the liver by directly damaging liver cells (hepatocellular), by blocking the flow of bile out of the liver (cholestatic), or by doing both.

What are the three types of hepatitis? ›

Heavy alcohol use, toxins, some medications, and certain medical conditions can cause hepatitis. However, hepatitis is often caused by a virus. In the United States, the most common types of viral hepatitis are hepatitis A, hepatitis B, and hepatitis C.

What drugs can cause liver damage? ›

Other drugs that can lead to liver injury include:
  • Amiodarone.
  • Anabolic steroids.
  • Birth control pills.
  • Chlorpromazine.
  • Erythromycin.
  • Halothane (a type of anesthesia)
  • Methyldopa.
  • Isoniazid.
27 Oct 2020

What are side effects of drugs? ›

Side effects, also known as adverse reactions, are unwanted undesirable effects that are possibly related to a drug. Side effects can vary from minor problems like a runny nose to life-threatening events, such as a heart attack or liver damage.

Why do drugs have side effects? ›

Side effects occur because the body is a very complex.

It is difficult to make a drug that targets one part of the body but that doesn't affect other parts. Developing drugs is also complicated because no two people are exactly the same.

How do you diagnose schizophrenia? ›

At least one of the symptoms must be delusions, hallucinations, or disorganized speech. In determining a diagnosis, the doctor may order additional tests, including an MRI scan or blood test.

What are the 7 types of drugs? ›

DREs classify drugs in one of seven categories: central nervous system (CNS) depressants, CNS stimulants, hallucinogens, dissociative anesthetics, narcotic analgesics, inhalants, and cannabis.

What are the 10 common diseases? ›

Common Illnesses
  • Allergies.
  • Colds and Flu.
  • Conjunctivitis ("pink eye“)
  • Diarrhea.
  • Headaches.
  • Mononucleosis.
  • Stomach Aches.

What are the 8 types of drugs? ›

The drug categories are:
  • Stimulants.
  • Inhalants.
  • Cannabinoids.
  • Depressants.
  • Opioids.
  • Steroids.
  • Hallucinogens.
  • Prescription drugs.
24 Jul 2019

What causes disease? ›

Infectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful. But under certain conditions, some organisms may cause disease.

What are called disease? ›

disease, any harmful deviation from the normal structural or functional state of an organism, generally associated with certain signs and symptoms and differing in nature from physical injury. A diseased organism commonly exhibits signs or symptoms indicative of its abnormal state.

What are the 3 main drugs? ›

Drug categories
  • depressants – slow down the function of the central nervous system.
  • hallucinogens – affect your senses and change the way you see, hear, taste, smell or feel things.
  • stimulants – speed up the function of the central nervous system.
21 Jun 2021

What are the 10 classes of drugs? ›

Drug Classifications
  • Cannabis.
  • Depressants.
  • Dissociative anesthetics.
  • Hallucinogens.
  • Inhalants.
  • Opioids.
  • Stimulants.
8 Aug 2022

What are the 5 classes of drugs? ›

The five classes of drugs are narcotics, depressants, stimulants, hallucinogens, and anabolic steroids. This article discusses each of the five schedules of controlled substances and the different substances found under each classification.

What are the steps of diagnosis? ›

Steps to diagnosis
  1. taking an appropriate history of symptoms and collecting relevant data.
  2. physical examination.
  3. generating a provisional and differential diagnosis.
  4. testing (ordering, reviewing, and acting on test results)
  5. reaching a final diagnosis.
  6. consultation (referral to seek clarification if indicated)

What is direct diagnosis? ›

DxDiag ("DirectX Diagnostic Tool") is a diagnostics tool used to test DirectX functionality and troubleshoot video- or sound-related hardware problems. DirectX Diagnostic can save text files with the scan results.

What is final diagnosis? ›

A final diagnosis that is made after getting the results of tests, such as blood tests and biopsies, that are done to find out if a certain disease or condition is present.

What is the most common diagnosis? ›

Most Common Diagnoses for Inpatient Stays
RankPrincipal diagnosisRate of stays per 100,000
1Septicemia240.0
2Depressive disorders214.7
3Schizophrenia spectrum and other psychotic disorders186.4
4Diabetes mellitus with complication158.9
6 more rows
21 Apr 2021

What is the difference between diagnosis and treatment? ›

Abstract. The diagnostic process not only paves the way for treatment, but also functions as a type of treatment itself. Both behavioral and physical problems can respond to diagnosis properly used as a therapeutic tool.

What are the 4 types of infections? ›

The four different categories of infectious agents are bacteria, viruses, fungi, and parasites.

What is diagnostic testing? ›

Diagnostic tests are variety of procedures done by physicians to screen for, detect and monitor diseases and conditions. It is used to gather clinical information necessary for making a diagnosis.

How is infection diagnosed? ›

Your healthcare provider usually diagnoses infectious diseases using one or more lab tests. Your provider can look for signs of disease by: Swabbing your nose or throat. Getting blood, pee (urine), poop (stool) or spit (saliva) samples.

Which medication is used in the diagnosis of myasthenia gravis? ›

Pyridostigmine. The first medicine used for myasthenia gravis is usually a tablet called pyridostigmine, which helps electrical signals travel between the nerves and muscles.

What are the 10 common diseases? ›

Common Illnesses
  • Allergies.
  • Colds and Flu.
  • Conjunctivitis ("pink eye“)
  • Diarrhea.
  • Headaches.
  • Mononucleosis.
  • Stomach Aches.

What is metrizamide used for? ›

Metrizamide is a radiocontrast agent used to improve the contrast of internal body structures using different imaging techniques such as computed tomography scans (CT) or radiography (X-ray imaging).

What are the types of medicine? ›

Types of medicines
  • Liquid. The active part of the medicine is combined with a liquid to make it easier to take or better absorbed. ...
  • Tablet. The active ingredient is combined with another substance and pressed into a round or oval solid shape. ...
  • Capsules. ...
  • Topical medicines. ...
  • Suppositories. ...
  • Drops. ...
  • Inhalers. ...
  • Injections.

What is the best treatment for myasthenia gravis? ›

Treatment
  • Cholinesterase inhibitors. Medications such as pyridostigmine (Mestinon, Regonal) enhance communication between nerves and muscles. ...
  • Corticosteroids. Corticosteroids such as prednisone (Rayos) inhibit the immune system, limiting antibody production. ...
  • Immunosuppressants.
22 Jun 2021

What is the latest treatment for myasthenia gravis? ›

Another new drug is called efgartigimod. It leads to the rapid removal of antibodies, including the autoantibodies that cause myasthenia gravis. It has an effect similar to plasma exchange, but it uses an antibody to remove the autoantibodies that your body has made to attack the acetylcholine receptor.

What is the first line treatment for myasthenia gravis? ›

Pyridostigmine is the first line of therapy (see 'Dose and titration' above). If anticholinesterase medications are not sufficient, plasmapheresis or intravenous immune globulin (IVIG) may be used, but the benefits are transient.

What are called disease? ›

disease, any harmful deviation from the normal structural or functional state of an organism, generally associated with certain signs and symptoms and differing in nature from physical injury. A diseased organism commonly exhibits signs or symptoms indicative of its abnormal state.

What causes disease? ›

Infectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful. But under certain conditions, some organisms may cause disease.

What are the 4 types of infections? ›

The four different categories of infectious agents are bacteria, viruses, fungi, and parasites.

Is metrizamide used today? ›

Metrizamide was approved in the US in 1978. Its marketing is discontinued as of 2021.

What is iohexol used for? ›

Descriptions. Iohexol injection is used to help diagnose or find problems in the brain, back, heart, head, blood vessels, stomach, joints, pancreas, bladder, reproductive tract, and other parts of the body. It is an iodinated contrast agent.

What are the 7 types of drugs? ›

DREs classify drugs in one of seven categories: central nervous system (CNS) depressants, CNS stimulants, hallucinogens, dissociative anesthetics, narcotic analgesics, inhalants, and cannabis.

What are the 8 types of drugs? ›

The drug categories are:
  • Stimulants.
  • Inhalants.
  • Cannabinoids.
  • Depressants.
  • Opioids.
  • Steroids.
  • Hallucinogens.
  • Prescription drugs.
24 Jul 2019

What are the two types of drugs? ›

Drugs can be categorised by the way in which they affect our bodies: depressants – slow down the function of the central nervous system. hallucinogens – affect your senses and change the way you see, hear, taste, smell or feel things.

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