Ch 1-General Tox Principles (contd.) Flashcards
A toxic substance produced by biological systems is specifically as a… A. Toxicant B. Toxin C. Xenobiotic D. Poison
B. Toxin (differentiaiton b/w toxin and toxicant not always easy eg: arsenic)
A newly formed hapten complex usually stimulates the formation of a significant amount of antibodies in…. A. 1-2 minutes B. 1-2 hours C. 1-2 days D. 1-2 weeks
D. 1-2 weeks
Prolonged muscle relaxation in response to succinylcholine is an example of a/an…. A. IGE-mediated allergic reaction B. Idiosyncratic reaction C. Immune complex reaction D. Reaction related to a genetic increase in liver enzyme activity
Normally succinylcholine is broken down by butyrylcholinesterase/ pseudocholinesterase. SNPs cause reduced expression of butyrylcholinesterase
B. idiosyncratic reaction
Increased production of methemoglobin is due to a decrease in activity of…. A. Cytochrome P450 2B6 B. NADH cytochrome b5 reductase C. Cytochrome oxidase D. Cytochrome a3
B. NADH cytochrome b5 reductase
Excessive sensitivity to nitries and a few othe chemicals ( which can oxidize Hb to methHb and therfore lead to reduced O2 carrying capacity) is an example of
idiosyncratic reaction
Most recently recognized plausible cause for idiosyncratic reactions
Genetic polymorphisms
(also polymorphisms in immune genes like those of MHC)
Whats is the reason for idiosyncratic reaction to nitrites in some individuals?
deficiency in NADH-cytochrome b5 reductase activity (inherited autosomal recessive disorder)
The most common target organ of toxicity is the… A. Heart B. Lungs C. CNS D. Skin
C. CNS
The organs least involved in systemic toxicity are… A. Brain and peripheral nerves B. Muscle and bone C. Liver and kidney D. Hematopoietic system and lungs
B. Muscle and bone
If 2 organophosphate insecticides are absorbed into an organism, the results will be… A. An additive effect B. A synergistic effect C. Potentiation of effect D. Subtraction of effect
A. An additive effect
If ethanol and carbon tetrachloride are chronically absorbed into an organism, the result will be…. A. An additive effect B. A synergistic effect C. Potentiation of effect D. Subtraction of effect
B. A synergistic effect (due to acetone a metabolite of EToH?)
If isopropyl alcohol and carbon tetrachloride are chronically absorbed into an organism, the effect on the liver will be…. A. An additive effect B. A synergistic effect C. Potentiation of effect D. Subtraction of effect
C. Potentiation of effect (due to acetone a metabolite of IPA)
The treatment of strychnine-induced convulsions by diazepam is an example of… A. Chemical antagonism B. Dispositional antagonism C. Receptor antagonism D. Functional antagonism
D. Functional/ Physiological antagonism (2 drugs hit 2 different targets and cancel out the effect of each other)
eg:
- glucagon, glucocorticoids vs. insulin
- fall in BP with barbiturates vs. increase increase in BP via intravenous vasopressor such as norepinephrine or metaraminol
- convulsant vs. anitconvulsant (eg: benzodiazepines (eg, diazepam)
The use of antitoxin in the treatment of snakebites is an example of… A. Dispositional antagonism B. Chemical antagonism C. Receptor antagonism D. Functional antagonism
B. Chemical antagonism (chemical chelation/neutralization)
Eg:
1) Protamine sulfate (low MW) binds heaprin (anti-coagulant)
2) Caclium sodium edetate complex with Arsenic/Lead
3) DMSA( Succimer) chelates with metal ions such as arsenic, mercury, and lead
The use of charcoal to prevent the absorption of diazepam is an example of… A. Dispositional antagonism B. Chemical antagonism C. Receptor antagonism D. Functional antagonism
A. Dispositional antagonism / Physical antagonism
Eg:
- charcoal adsorb alkaloids
- ipecac syrup
- increased excretion of a chemical by administration of an osmotic diuretic or alteration of the pH
Note on functional antagonism
In some cases :
1) Parent cmpd. toxic—— metabolite less toxic
2) In some other cases: metabolite more toxic ——-parent cmpd. less toxic
In case of (2) have an inhibitor of microsomal enzyme activity (SKF-525A or piperonyl butoxide)
Types of receptor antagonism (called BLOCKERS)
Competitive (reversible at high concentrations OR irreversible)
COMPETITIVE (Antag competes to bind to the same active site as agonist)
Non competitive (irreversible)
Competitive REVERSIBLE receptor antagonism
forms weak bonds
effects overcome by increasing conc. of agonist
graph of COMPETITIVE receptor antagonism
Competitive IRREVERSIBLE receptor antagonism
- forms strong covalent bonds
- CANNOT be reversed at high concs. of agonist
Eg: dibenamine and norepinephrine at α1 adrenergic receptors
NONCOMPETITIVE receptor antagonism
binds to a site other than the agonist binding site
but this prevents receptor activation by agonist
Eg: Flumazenil (GABA receptor antag) comptes to bind to GABA receptor. Benzodiazepines (act as GABA receptor agonist) also binds to GABA receptor.
Flumazenil binds to a site different from Benzodiazepine. But binding of flumazenil to GABA receptor prevents binding and activation by benzodiazepine
The use of tamoxifen in certain breast cancers is an example of… A. Dispositional antagonism B. Chemical antagonism C. Receptor antagonism D. Functional antagonism
C. Receptor antagonism
Other egs. of competitive reversible receptor antagonism:
1) Atropine and acetocholine at muscarinic acetocholine receptors
Atropine blocks the acetocholine receptor to excess ACh
2) Naloxone and Morphine ( opiod) at opiod receptors
what sis an allosteric Ag/ Ant
A drug that binds to a receptor molecule without interfering with normal agonist binding but alters the response to the normal agonist
graph of NONCOMPETITVE receptor antagonism
In some cases even if 50% of the receptors are knocked down, the remaining 50% might be sufficient to still give 100% response
Chemicals known to produce dispositional tolerances are… A. Benzene and xylene B. trichloroethylene and methyl chloride C. Paraquat and diaquat D. Carbon tetrachloride and cadmium
D. CCl4 and Cd
Due to Cd binding to metallothionein
Tolerance is due to
- reduced responsiveness
- reduced amount of toxicant (dispositional tolerance)- more is known about this than 1.