Drug Testing Flashcards
1
Q
Stimulant
A
drug increases action of central nerve central
2
Q
Depressant
A
drug decreases action of central nerve central
3
Q
Opiates
A
comes from Poppy Plant, morphine
4
Q
Hallocinogens
A
distorts reality
5
Q
Club Drug
A
ectasy, ruphiees
6
Q
Alcohol
A
chemical substance that changes behavior. Made in fermentation
7
Q
Hallucinogen
A
LSD, Sila Cibin
8
Q
Stimulant
A
Cocaine, Methamphetamines, Nicotine
9
Q
Depressant
A
Alcohol, Heroine, Marijuana, Rophnol
10
Q
THC
A
active ingredient in Marijuana
11
Q
Testosterone
A
anabolic steroids are derived from a chemical
12
Q
Nicotine
A
active ingredient in Tobacco
13
Q
Coca Plant
A
cocaine is from this
14
Q
Harmful things found in cigarettes
A
-dried, process tobacco leaves
-nicotine
-insecticide
15
Q
Harmful effects of smoking
A
-lung cancer -smell bad
-asthma - teeth are bad
-empeszena -can’t sell house
16
Q
Long term effects of alcohol
A
scar tissue, kidney damage, addiction, liver damage, ulsers, hipatatus c, brain cells, throat cancer, harsh heart
17
Q
Progression to addiction
A
abuse-> dependency->addiction
18
Q
Characteristics of teens at risk for addiction
A
depression, low self esteem, genetics, no extra circular activities
19
Q
BAC
Legal limit for a 21 year old to drive and what is the legal limit for a minor
A
Blood Alcohol Concentration
Adult- 0.08 Minor- 0.008
20
Q
Date Rape
A
Rophynol
21
Q
Mainstream smoke
A
inhale and exhale
22
Q
Sides stream
A
burning end of cigarette
23
Q
Four steps to recovery
A
Acknowledging Problem
Detoxfication
Rehabiliation
Support Groups
24
Q
Drugs Synirage
A
occurs when drugs interact to produce effects greater than those each drug
25
Drugs Antacion
occurs when each drug effects is cancelled out or reduced by other Ex. Speed Ball
26
Leokplakia
white patches that are caused from chewing tobacco
27
What happens to liver from too much alcohol
-Livers will fill with fat
-Suffer hepatitis (inflammation of liver)
28
Methods of use
1 inhale (fastest)
2 inject
3 internal nasal
4 injest (slowest)
29
Effects on the body from all drugs
addictive, becomes physically/psychologically dependent, makes your body want to use more, acts as an depressant
30
History of Drugs
Marijuana- 10,000 BC China {Paper}, 8,000 BC {Smoke}
Cocaine/Crack- Peru/Inca tribe, Pope used Cocaine in wine
LSD-Hippies. Albert Hoffman is the inventor and is a Harvard Professor
PCP/Speed- Hitler give it to soldiers, big lerch, cut off face and feed to dog.
Tobacco- Europe 1600s
Meth- Nazis
Poppy Seed- Afaganistan
31
MDMA
ectasy
32
made from potatoes
made from potatoes
33
Opium
chemical substance thats reps in the brain
34
Crack
energy
35
Steroids
Smaller testorenes and breast
36
Factors of BAC
gender, rate comsumton, body size, amount of food in stomach
37
Cigerattes Long Term Effects
High BP, rotten teeth, throat cancer, empezena
38
Alcohol Long Term Effects
Syrocis, destroy nerve cell in brain, FAS, liver damage, heart damage, digestive problems
39
Reverse Torelnce
10 beers to 5 beers a day
40
Purposes of Drug Testing
-Medical
-Legal
-Medicolegal
41
Medical Drug Testing
Monitor patient's progress
Determine presence of drugs before treatment
Simple, less expensive methods
Unlikely to be used as evidence in court
42
Legal Drug Testing
Determine use of drugs prior to accident or crime
Requires confirmatory test
43
Urine Drug Screens
Urine is specimen of choice
Collection is non-invasive
Most drugs/metabolites are excreted and concentrated in urine
Drugs/metabolites are stable in frozen urine
Usually a relatively clean matrix
Based on cut-offs, urine screen is reported as indicative/presumptive or negative
44
Cut-off Values
Substance Abuse and Mental Health Services Administration (SAMSHA) specifies cut-off values
SAMSHA requires 5 drug categories to be routinely included in urine screens
Amphetamines (methamphetamine, amphetamine, MDMA)
Cocaine metabolites
Marijuana metabolites
Opiate metabolites (morphine, codeine, 6-actylmorphine)
Phencyclidine
In specific cases, cutoff values may be lowered
45
Medicolegal Drug Testing
Used in employer drug abuse program to prevent drug-related accidents or crime
Used to identify and treat employees with drug abuse problems
46
Legal and Medicolegal Drug Testing
More stringent testing required
Must withstand technical criticism
Two-tiered testing program
-Urine screening test
-More specific, sensitive test (GC/MS)
Testimony upheld based on positive results obtained on two separate tests using two chemical methods
47
Types of Drug Tests
EMIT
RIA
TLC
GC/MS
48
EMIT
Most widely used test due to low cost
Designed as an initial screen
If test is positive, confirm with GC/MS
Easiest test to beat due to lack of specificity
49
RIA (Radioimmunoassay)
More specific and expensive than EMIT
Used by military
Specificity is better than EMIT but still can be 'beat'
Also requires confirmation test
50
Immunoassays
Easily automated
Currently the only practical tool for dealing with large sample numbers
Fast results
Can be run by small labs, clinics
51
Drug Testing - General Considerations
Cross-reactivity
Specificity
Cut-off level
Adulterants
52
GC/MS
Most sophisticated and expensive
Very specific
Used as confirmation test
53
What can be tested?
Breath (alcohol)
Urine
Blood
Hair
Saliva
Level of impairment
54
Urine Testing Procedures
Blind sample - negative or spiked sample submitted with donor's sample
Split sample
Single specimen split into two separate specimen bottles
Never collected from two different voids by donor
Bottle A - first specimen (30 ml)
Bottle B - second specimen (15 ml)
55
Urine Testing Procedures: part 2
Primary seal - lid/cap of specimen bottle with tamper proof seal
Secondary seal - leak-proof plastic bag in which specimen bottle is placed
Shipping container - must be sealed and have tamper proof seal
56
Urine Testing Procedures: part 3
Chain of custody - procedure used to document the handling of specimen from time of donation until it is destroyed
Fatal flaw - error that raises doubt about the integrity of a specimen or the information concerning the specimen
Medical Review Officer (MRO) - licensed physician who interprets the lab results
57
Negative Urine Screen
Does not mean drug was not present or not taken
It means drug was not detected
Examples of drugs not routinely detected
Androgenic steriods
GHB
Anticoagulants
Meperidine
58
Detection Times - Urine
Amphetamine: 2-5 days, possibly 2 weeks with heavy use
Cocaine metabolites (benzoylecgonine): Up to 2 weeks; 6 weeks w/chronic use
LSD: 1-2 days
Marijuana metabolite (COOH): 7-10 days; 1 month for chronic use
Opioids: 2-3 days
Methadone: 3-14 days
PCP: 2-10 days
59
How Drug Tests Are Beat
Note: Applies to initial screening tests
Dilution method:
-Consume large quantities of fluids
-Avoid morning urines for testing
-Diuretics
-Take vitamin B2 to add yellow color to urine
Substitution of clean urine
-Doping
-Powdered urine (from Internet supplier)
Adulterants
-Bleach
-Detergents
-Urinaid (does not work on RIA tests)
Niacin and golden seal
Drinking vinegar or visine
Interference with chain of custody
Hair Analysis
60
Factors Affecting Drug Concentrations in Hair
Exogenous exposure can mimic drug use
Physiochemical factors
-Drug concentration
-Time of exposure
-pH
-Cations (sodium)
Ethnic differences
Cosmetic treatments and hygiene
61
Home Drug Testing
Parents Alert, Inc - founded by mother of 2 teenagers - Smyrna, GA, 1995
Tests for: alcohol, marijuana, cocaine. amphetamine, PCP, LSD
62
Home Drug Testing Ethical Practices
Ethical/practical issues
-Usefulness of test
-Ability of parents to obtain sample
-Privacy rights of child
ACLU - "Parents have absolute rights to make decisions about their children."
Important Toxicological Tests
"Emotional pressure to give a sample would be tantamount to a command." High school junior
63
Important Toxicological Tests
Acetaminophen
Carboxyhemoglobin (CO poisoning)
Digoxin
Lithium
Salicylate
64
Acetaminophen Toxicity
Serum concentration obtained at least 4 hrs after acute ingestion can be used to assess whether the patient is at risk of APAP hepatoxicity
Rumak-Matthew Nomogram
-APAP nomogram
-Semi-log plot of serum APAP vs time
65
Characteristics of Specimens
Urine - window of detection typically 1-5 days;
-Can be adulterated
-Shy bladder
Hair - longest window of detection
-Usually 90 days based on collection of 1.5 in of hair (0.5 in/month)
-Non-invasive
-Expensive
-Will not detect recent use (7-10 days prior to test)
Saliva - reflects recent use (10-24 hrs)
-Noninvasive
-Drugs and metabolites do not remain in sample long
-Limited value
Sweat - limited value
-Few labs perform test
66
Type of Testing
Hospital alcohol testing
Measures alcohol dehydrogenase based assay
Usually is measuring serum or plasma rather than whole blood
Subject to interferences
Other alcohols
Lactate (lactate ringer's solution; muscle damage)
67
Interpretation of Drug Tests
Indicates that drug has been ingested
Unlikely to be able to relate to level of impairment
Usually not able to determine when most drugs were ingested
Requires confirmation test
Screening test not sufficient for determining exposure
68
Licensed physician certified in clinical pathology by the phil board of pathology with at least 2yrs of active lab experience in analytical toxicology
Head of the lab (confirmatory ab)
69
Plasma
Least most acceptable specimen for drug analysis
70
Benzodiazepine examples
Xanax, Valium, Klonopin
71
Can be used as general anesthetics at higher doses
Depressants
72
Medications given after surgery
Opioids
73
Causes a strong rush of euphoria after use
Heroin
74
Give temporary alertness and energy
Stimulants
75
Administration of cocaine
Ingestion, inhalation, or intravenous
76
Metabolite of cocaine and its half-life
Benzoylecgonine, 6-7 hrs
77
Area involved in mood, cognition, and perception
Prefrontal cortex
78
Should be avoided by persons with gastric ulcers, hemophilia, or hemorrhagic states
Salicylates
79
Most common form of LSD
Blotters
80
Other names for LSD
acid blotter, doses, hits, microdots, sugar cubes, trips, tabs, window panes
81
Traditionally been used for healing and religious purposes
Ayahuasca tea
82
Mechanism of most of the effects of aspirin and other salicylates
Inhibition of prostaglandin synthesis
83
Effects range from mild sedation to coma and may be used as sedatives, hypnotics or part of anesthesia
Barbiturates
84
Other names of PCP
Ozone, rocket fuel, love boat, hog, embalming fluid, or super weed
85
Digoxin and digitoxin exert their effects by?
Inhibiting ATPase activity
86
Also known as dimitri
Dimethyltryptamine
87
Precursor for glutathione
Acetylcysteine
88
Major metabolite of àcetaminophen ;Accumulates in the liver
N-acetylbenzoquinoneime
89
White crystalline powder, typically vaporized or smoked in a pipe
Synthetic DMT
90
Examples of barbiturates
Luminal (pgenobarbital),
Amytal sodium (amobarbital)
Secora (secobarbital)
91
Short-term treatment insomnia
Secora
92
Sometimes referred to as tranquilizers or sedatives
Benzodiazepines and barbiturates
93
Corrects chemical imbalances of neurotransmitters in the brain
Antidepressants
94
What plant is dmt naturally occuring
Amazonian plant species
95
Prevalent neurotransmitters specific to depression
Serotonin, dopamine, norepinephrine
96
Plant where cannabinoids are found
Cannabis sativa plant species
97
Also known as pain reliever
Analgesics
98
Used to treat pain and fever
Paracetamol
99
Active ingredient of cannabinoids
Delta-9-tetrahydrocannabinol
100
Time it takes to die from paracetamol overdose
3-5 days to 4-6 weeks
101
Nonpsychoactive cannabinoid , works to calm your high
CBD cannabidiol
102
Most common psychoactive cannabinoid
Tetrahydrocannabinol
103
Second most common cannabinoid
Cannabidiol CBD
104
Created from THC when cannabis is oxidized
Cannabinol CBN
105
Non-psychoactive drug, building block for THC and CBD
Cannabigerol CBG
106
Used for initial screening for drugs of abuse
Thin layer chromatography
107
For rapid screening of large number of samples
Immunoassay technique
108
Has the ability to rapidly separate a variety of different materials
HPLC
109
Known as COMPREHENSIVE DANGEROUS DRUGS ACTS OF 2002
Repuvlic act 9165
110
Repuvlic act 9165
COMPREHENSIVE DANGEROUS DRUGS ACTS OF 2002
111
Republic act 9165 mandates _____ to oversee and monitor the integration, coordination and supervision of all drug rehabilitation...
Department of health
112
___ is designed as the NATIONAL REFERENCE LABORATORY
for environmental and occupational health, toxicology and micronutrient assay
East avenue medical center
113
East avenue medical center is designed as the NATIONAL REFERENCE LABORATORY
for environmental and occupational health, toxicology and micronutrient assay BY VIRTUE OF?
Department order no. 393-E s. 2000
114
NRL in coordination with ___ shall assure the competence, integrity and stability of drug testing centers nationwide
Bureau of health facilities and services
115
2 levels of testing for drug of abuse:
-Emergency room testing
-Forensic testing
116
Test to detect the presence of DRUGS OF ABUSE in the patient's urine.
Emergency room testing
117
emergency room testing involves rapid, stat screening methods such as? (2)
EMIT (FPIA)
-Fluorescence polarization immunoassay
TLC
-Thin layer Chromatigraphy
118
Test for screening and independent confirmatory method
Forensic testing
119
2 independent confirmatory method for forensic testing
Note: valid if completely diff. Method for primary method
GC-MS
HPLC
120
Used for preliminary screening based on an antibody-antigen reaction.
Analytical method immunoassay
121
Used to separate mixture of substances in a stationary medium
Chromatography
122
Confirmatory which is a combination of 2 sophisticated tech
Hyphenated technique
123
2 sophisticated technologies
Gas chromatography
Mass-spectroscopy
124
Stimulant or sedative depends on strain
Smoked or eaten= high
TetrahydroCANNAbinol
125
3 physical effects of THC
Increase heart rate
Bloodshot eyes
Dry mouth
126
Use of THC causes (3)
RAD
Reduce ability to perform tasks
Alter sense of time
Decrease short-term memory and comprehension
127
Stimulant that increases in heart and respiratory rates
MetHAMphetamine
128
Methamphetamine causes
Elevated BP
Dilated pupils
Decrease apetite
129
Other name of Methamphetamine
Ecstasy
130
Users over a long period of time can develop? Which could include?
amPHETAmine psychosis
Includes: HDP
Hallucinations
Delusions
Paranoia
131
Test kit used (2)
MetHAMphetamine
TetraHYDROcannabinol
132
Method use in detection of methamphetamine and tetrahydrocannabinol
Chromatographic immunoassay
133
Principle of immunochromatography in drug testing
Rapid one step lateral flow chromatographic immunoassay designed for the simultaneous quantitative detection of methamphetamine and THC in the urine
134
Amount of urine and place into?
3-4 drops of urine in SAMPLE well (S)
135
3 lines appear : C, 2, 1
No matter which band appears first, indicates?
Color intensities and line : not equal
Negative result
136
2 lines appear: C,2
>/= 1,000 ng/mL (detectable level)
MetHAMphetamine-positive result
2 purple lines
137
2 lines appear : C, 1
>/= 50 ng/mL
THC-positive result
2 purple lines
138
Only one line appears : C
Detectable level?
MetHAMphetamine,
THC-positive result
>/= 1,000 ng/mL (M)
>/= 50 ng/mL (T)
139
Purple color band isn't visible within the result window after test
No control line
Invalid result
140
Solution for no control line
Repeat test using new device and carefully follow procedure
141
Causes of invalid result
Solution : RE-TEST
Directions is not followed correctly
Test is deteriorated
