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MLSCI 466 > Clinical toxicology testing and performing enhancing drugs > Flashcards

Clinical toxicology testing and performing enhancing drugs Flashcards

1
Q

what is impacted the most from society due to alcohol abuse

A

lost productivity

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2
Q

why is urine a preferred specimen

A

higher [] of drugs compared to others

screening assay compatible

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3
Q

limitations of urine as a specimen

A

dont know how much or when drugs were ingested

ritalin/methlyphenidate or oral hypoglycemics will NOT be detected

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4
Q

how long can weed stay in the urine

A

30 days

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5
Q

how long can herioin and alcohol stay in the urine

A

less than a day

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6
Q

what is the workflow for testing of drugs

A

1 immunoassay testing (screen)
2. GCMS = targeted scan
3. LC/MS/MS = opiod ID

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7
Q

What is KIMS immunoassay based on

A

competitive homogenous immunoassay by using R1 and R2

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8
Q

What does KIMS detect

A

THC
Benzodiazepines
Opiates (poppy seeds pos)

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9
Q

what is a false pos for KIMS

A

Oxaprozin aka daypro

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10
Q

How does a KIMS immunoassay work

A

when drug is not present - clumping of ab = high absorbance

when drug is present - binds to ab without clumping = low absorbance

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11
Q

How does EMIT and DRI immunoassays work

A

when drug is not present - G6PD binds to reagent 1 ab = no reaction

when drug is present - G6PD is free and converts G6P into NADH = absorbance change

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12
Q

what drugs can EMIT and DRI test

A

antidepressants

oxycodone (ONLY DRI)

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13
Q

what absorbance is EMIT and DRI use

A

340nm

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14
Q

how does CEDIA immunoassay work

A

when drug is not present - ED is bound to reagent 1 ab = no reaction

when drug is present - ED is bound to EA and converts CPR = absorbance change

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15
Q

what absorbance does CEDIA use

A

570nm

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16
Q

what drugs does CEDIA detect

A

Fentanyl

17
Q

what drugs are immunoassays good at for avoiding cross reactivity

A

lorazepam and temazepam glucuronide

18
Q

what factors is mass spec based on

A

based on retention time and fragmentation patterns

19
Q

what drug is seen as impurities

A

oxycodone

20
Q

3 ways of adulterating a sample

A
  1. internal and external dilution (drinking or adding water)
  2. tampering (adding agent)
  3. substitution (not your sample)
21
Q

how do we test if a sample has been tempered or adulterated

A

test pH

22
Q

how do we test if a sample has been substituted

A

test creatinine and specific gravity

23
Q

why are stat drugs not tested

A

does not rule out poisoning

no good information from acute care

many drugs cause similar symptoms

false pos possible

24
Q

what is the role of WADA in drug regulation

A

world anti doping association acredited by 1 lab

establishes banned substances

normal physiological proccess of athleetes

25
Q

what happens when you abuse steroids

A
  1. High BP/LDL
  2. liver and heart damage
  3. cancer
  4. premature epiphyseal fusion
26
Q

What synthetic PED causes liver damage when abused

A

anavar

27
Q

what endogenous PED causes organomegaly

A

insulin

28
Q

what stimulants cause cardiac arrest

A

amphetamines

29
Q

what stimulant causes bronchoconstriction

A

clenbuterol

30
Q

what biological PED causes acceleration of existing cancers

A

hCG

31
Q

what ratio of testosterone: epitestosterone indicates doping

A

> 6;1

32
Q

why is epitestosterone better to ID PED usage

A

more stable in blood

33
Q

what tests are used to confirm EPO

A

laminar flow immunoassay (chromatography - screening) and isoelectric focussing (electrophoresis - confirmatory) for exogenous doping rHuEPO and darbepoetin alpha

34
Q

how does WADA perform EPO testing

A

Biological passports

35
Q

what are issues with hGH detection

A
  1. cross reactivity (similar hormones related)
  2. hormone standardization (many forms of hGH)
36
Q

how do we test for hGH (avoiding issues with detection)

A

test for IGF-1

37
Q

what are the cons of immunoassay for PED screenign

A

easy to tamper
false pos = binding random compounds
false neg = poor binding affinity

38
Q

what are SARMS for and an example of

A

Ligandrol = for muscle growth

39
Q

why are exogenous use of endogenous hormones difficult to detect

A

endogenous hormones fluctuates and diurnal variation

MLSCI 466 (8 decks)

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