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Type 2, cytotoxic reaction. Drugantibody (IgG) complexes adhere to the surface of blood cells, where either circulating drug molecules or complexes already formed in blood accumulate. These complexes mediate the activation of complement, a family of proteins that circulate in the blood in an inactive form, but can be activated in a cascadelike succession by an appropriate stimulus.
Thus, several drugs (aspirin, antimalarials, etc. ) can provoke premature breakdown of red blood cells (hemolysis) in subjects with a glucose- 6-phosphate dehydrogenase deficiency. The discipline of pharmacogenetics deals with the importance of the genotype for reactions to drugs.


A related compound, both in terms of structure and activity, is dimercaptopropanesulfonic acid, whose sodium salt is suitable for oral administration. Shivering, fever, and skin reactions are potential adverse effects. Deferoxamine derives from the bacterium Streptomyces pilosus. The substance possesses a very high ironbinding capacity, but does not withdraw iron from hemoglobin or cytochromes.
Lipoprotein metabolism. Enterocytes release absorbed lipids in the form of triglyceride-rich chylomicrons. Bypassing the liver, these enter the circulation mainly via the lymph and are hydrolyzed by extrahepatic endothelial lipoprotein lipases to liberate fatty acids. The remnant particles move on into liver cells and supply these with cholesterol of dietary origin.


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