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Clinical Chemistry > Drug Testing > Flashcards

Drug Testing Flashcards

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1
Q

Stimulant

A

drug increases action of central nerve central

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2
Q

Depressant

A

drug decreases action of central nerve central

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3
Q

Opiates

A

comes from Poppy Plant, morphine

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4
Q

Hallocinogens

A

distorts reality

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5
Q

Club Drug

A

ectasy, ruphiees

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6
Q

Alcohol

A

chemical substance that changes behavior. Made in fermentation

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7
Q

Hallucinogen

A

LSD, Sila Cibin

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8
Q

Stimulant

A

Cocaine, Methamphetamines, Nicotine

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9
Q

Depressant

A

Alcohol, Heroine, Marijuana, Rophnol

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10
Q

THC

A

active ingredient in Marijuana

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11
Q

Testosterone

A

anabolic steroids are derived from a chemical

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12
Q

Nicotine

A

active ingredient in Tobacco

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13
Q

Coca Plant

A

cocaine is from this

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14
Q

Harmful things found in cigarettes

A

-dried, process tobacco leaves
-nicotine
-insecticide

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15
Q

Harmful effects of smoking

A

-lung cancer -smell bad
-asthma - teeth are bad
-empeszena -can’t sell house

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16
Q

Long term effects of alcohol

A

scar tissue, kidney damage, addiction, liver damage, ulsers, hipatatus c, brain cells, throat cancer, harsh heart

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17
Q

Progression to addiction

A

abuse-> dependency->addiction

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18
Q

Characteristics of teens at risk for addiction

A

depression, low self esteem, genetics, no extra circular activities

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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

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20
Q

Date Rape

A

Rophynol

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21
Q

Mainstream smoke

A

inhale and exhale

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22
Q

Sides stream

A

burning end of cigarette

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23
Q

Four steps to recovery

A

Acknowledging Problem
Detoxfication
Rehabiliation
Support Groups

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24
Q

Drugs Synirage

A

occurs when drugs interact to produce effects greater than those each drug

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25
Q

Drugs Antacion

A

occurs when each drug effects is cancelled out or reduced by other Ex. Speed Ball

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26
Q

Leokplakia

A

white patches that are caused from chewing tobacco

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27
Q

What happens to liver from too much alcohol

A

-Livers will fill with fat
-Suffer hepatitis (inflammation of liver)

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28
Q

Methods of use

A

1 inhale (fastest)
2 inject
3 internal nasal
4 injest (slowest)

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29
Q

Effects on the body from all drugs

A

addictive, becomes physically/psychologically dependent, makes your body want to use more, acts as an depressant

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30
Q

History of Drugs

A

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

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31
Q

MDMA

A

ectasy

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32
Q

made from potatoes

A

made from potatoes

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33
Q

Opium

A

chemical substance thats reps in the brain

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34
Q

Crack

A

energy

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35
Q

Steroids

A

Smaller testorenes and breast

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36
Q

Factors of BAC

A

gender, rate comsumton, body size, amount of food in stomach

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37
Q

Cigerattes Long Term Effects

A

High BP, rotten teeth, throat cancer, empezena

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38
Q

Alcohol Long Term Effects

A

Syrocis, destroy nerve cell in brain, FAS, liver damage, heart damage, digestive problems

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39
Q

Reverse Torelnce

A

10 beers to 5 beers a day

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40
Q

Purposes of Drug Testing

A

-Medical
-Legal
-Medicolegal

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41
Q

Medical Drug Testing

A

Monitor patient’s progress
Determine presence of drugs before treatment
Simple, less expensive methods
Unlikely to be used as evidence in court

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42
Q

Legal Drug Testing

A

Determine use of drugs prior to accident or crime
Requires confirmatory test

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43
Q

Urine Drug Screens

A

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

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44
Q

Cut-off Values

A

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

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45
Q

Medicolegal Drug Testing

A

Used in employer drug abuse program to prevent drug-related accidents or crime

Used to identify and treat employees with drug abuse problems

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46
Q

Legal and Medicolegal Drug Testing

A

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

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47
Q

Types of Drug Tests

A

EMIT
RIA
TLC
GC/MS

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48
Q

EMIT

A

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

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49
Q

RIA (Radioimmunoassay)

A

More specific and expensive than EMIT
Used by military
Specificity is better than EMIT but still can be ‘beat’
Also requires confirmation test

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50
Q

Immunoassays

A

Easily automated
Currently the only practical tool for dealing with large sample numbers
Fast results
Can be run by small labs, clinics

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51
Q

Drug Testing - General Considerations

A

Cross-reactivity
Specificity
Cut-off level
Adulterants

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52
Q

GC/MS

A

Most sophisticated and expensive
Very specific
Used as confirmation test

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53
Q

What can be tested?

A

Breath (alcohol)
Urine
Blood
Hair
Saliva
Level of impairment

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54
Q

Urine Testing Procedures

A

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)

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55
Q

Urine Testing Procedures: part 2

A

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

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56
Q

Urine Testing Procedures: part 3

A

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

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57
Q

Negative Urine Screen

A

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
Q

Detection Times - Urine

A

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
Q

How Drug Tests Are Beat

A

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
Q

Factors Affecting Drug Concentrations in Hair

A

Exogenous exposure can mimic drug use

Physiochemical factors
-Drug concentration
-Time of exposure
-pH
-Cations (sodium)

Ethnic differences

Cosmetic treatments and hygiene

61
Q

Home Drug Testing

A

Parents Alert, Inc - founded by mother of 2 teenagers - Smyrna, GA, 1995

Tests for: alcohol, marijuana, cocaine. amphetamine, PCP, LSD

62
Q

Home Drug Testing Ethical Practices

A

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
Q

Important Toxicological Tests

A

Acetaminophen
Carboxyhemoglobin (CO poisoning)
Digoxin
Lithium
Salicylate

64
Q

Acetaminophen Toxicity

A

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
Q

Characteristics of Specimens

A

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
Q

Type of Testing

A

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
Q

Interpretation of Drug Tests

A

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
Q

Licensed physician certified in clinical pathology by the phil board of pathology with at least 2yrs of active lab experience in analytical toxicology

A

Head of the lab (confirmatory ab)

69
Q

Plasma

A

Least most acceptable specimen for drug analysis

70
Q

Benzodiazepine examples

A

Xanax, Valium, Klonopin

71
Q

Can be used as general anesthetics at higher doses

A

Depressants

72
Q

Medications given after surgery

A

Opioids

73
Q

Causes a strong rush of euphoria after use

A

Heroin

74
Q

Give temporary alertness and energy

A

Stimulants

75
Q

Administration of cocaine

A

Ingestion, inhalation, or intravenous

76
Q

Metabolite of cocaine and its half-life

A

Benzoylecgonine, 6-7 hrs

77
Q

Area involved in mood, cognition, and perception

A

Prefrontal cortex

78
Q

Should be avoided by persons with gastric ulcers, hemophilia, or hemorrhagic states

A

Salicylates

79
Q

Most common form of LSD

A

Blotters

80
Q

Other names for LSD

A

acid blotter, doses, hits, microdots, sugar cubes, trips, tabs, window panes

81
Q

Traditionally been used for healing and religious purposes

A

Ayahuasca tea

82
Q

Mechanism of most of the effects of aspirin and other salicylates

A

Inhibition of prostaglandin synthesis

83
Q

Effects range from mild sedation to coma and may be used as sedatives, hypnotics or part of anesthesia

A

Barbiturates

84
Q

Other names of PCP

A

Ozone, rocket fuel, love boat, hog, embalming fluid, or super weed

85
Q

Digoxin and digitoxin exert their effects by?

A

Inhibiting ATPase activity

86
Q

Also known as dimitri

A

Dimethyltryptamine

87
Q

Precursor for glutathione

A

Acetylcysteine

88
Q

Major metabolite of àcetaminophen ;Accumulates in the liver

A

N-acetylbenzoquinoneime

89
Q

White crystalline powder, typically vaporized or smoked in a pipe

A

Synthetic DMT

90
Q

Examples of barbiturates

A

Luminal (pgenobarbital),
Amytal sodium (amobarbital)
Secora (secobarbital)

91
Q

Short-term treatment insomnia

A

Secora

92
Q

Sometimes referred to as tranquilizers or sedatives

A

Benzodiazepines and barbiturates

93
Q

Corrects chemical imbalances of neurotransmitters in the brain

A

Antidepressants

94
Q

What plant is dmt naturally occuring

A

Amazonian plant species

95
Q

Prevalent neurotransmitters specific to depression

A

Serotonin, dopamine, norepinephrine

96
Q

Plant where cannabinoids are found

A

Cannabis sativa plant species

97
Q

Also known as pain reliever

A

Analgesics

98
Q

Used to treat pain and fever

A

Paracetamol

99
Q

Active ingredient of cannabinoids

A

Delta-9-tetrahydrocannabinol

100
Q

Time it takes to die from paracetamol overdose

A

3-5 days to 4-6 weeks

101
Q

Nonpsychoactive cannabinoid , works to calm your high

A

CBD cannabidiol

102
Q

Most common psychoactive cannabinoid

A

Tetrahydrocannabinol

103
Q

Second most common cannabinoid

A

Cannabidiol CBD

104
Q

Created from THC when cannabis is oxidized

A

Cannabinol CBN

105
Q

Non-psychoactive drug, building block for THC and CBD

A

Cannabigerol CBG

106
Q

Used for initial screening for drugs of abuse

A

Thin layer chromatography

107
Q

For rapid screening of large number of samples

A

Immunoassay technique

108
Q

Has the ability to rapidly separate a variety of different materials

A

HPLC

109
Q

Known as COMPREHENSIVE DANGEROUS DRUGS ACTS OF 2002

A

Repuvlic act 9165

110
Q

Repuvlic act 9165

A

COMPREHENSIVE DANGEROUS DRUGS ACTS OF 2002

111
Q

Republic act 9165 mandates _____ to oversee and monitor the integration, coordination and supervision of all drug rehabilitation…

A

Department of health

112
Q

___ is designed as the NATIONAL REFERENCE LABORATORY

for environmental and occupational health, toxicology and micronutrient assay

A

East avenue medical center

113
Q

East avenue medical center is designed as the NATIONAL REFERENCE LABORATORY

for environmental and occupational health, toxicology and micronutrient assay BY VIRTUE OF?

A

Department order no. 393-E s. 2000

114
Q

NRL in coordination with ___ shall assure the competence, integrity and stability of drug testing centers nationwide

A

Bureau of health facilities and services

115
Q

2 levels of testing for drug of abuse:

A

-Emergency room testing

-Forensic testing

116
Q

Test to detect the presence of DRUGS OF ABUSE in the patient’s urine.

A

Emergency room testing

117
Q

emergency room testing involves rapid, stat screening methods such as? (2)

A

EMIT (FPIA)
-Fluorescence polarization immunoassay

TLC
-Thin layer Chromatigraphy

118
Q

Test for screening and independent confirmatory method

A

Forensic testing

119
Q

2 independent confirmatory method for forensic testing

Note: valid if completely diff. Method for primary method

A

GC-MS
HPLC

120
Q

Used for preliminary screening based on an antibody-antigen reaction.

A

Analytical method immunoassay

121
Q

Used to separate mixture of substances in a stationary medium

A

Chromatography

122
Q

Confirmatory which is a combination of 2 sophisticated tech

A

Hyphenated technique

123
Q

2 sophisticated technologies

A

Gas chromatography
Mass-spectroscopy

124
Q

Stimulant or sedative depends on strain

Smoked or eaten= high

A

TetrahydroCANNAbinol

125
Q

3 physical effects of THC

A

Increase heart rate
Bloodshot eyes
Dry mouth

126
Q

Use of THC causes (3)

A

RAD

Reduce ability to perform tasks

Alter sense of time

Decrease short-term memory and comprehension

127
Q

Stimulant that increases in heart and respiratory rates

A

MetHAMphetamine

128
Q

Methamphetamine causes

A

Elevated BP
Dilated pupils
Decrease apetite

129
Q

Other name of Methamphetamine

A

Ecstasy

130
Q

Users over a long period of time can develop? Which could include?

A

amPHETAmine psychosis

Includes: HDP

Hallucinations
Delusions
Paranoia

131
Q

Test kit used (2)

A

MetHAMphetamine
TetraHYDROcannabinol

132
Q

Method use in detection of methamphetamine and tetrahydrocannabinol

A

Chromatographic immunoassay

133
Q

Principle of immunochromatography in drug testing

A

Rapid one step lateral flow chromatographic immunoassay designed for the simultaneous quantitative detection of methamphetamine and THC in the urine

134
Q

Amount of urine and place into?

A

3-4 drops of urine in SAMPLE well (S)

135
Q

3 lines appear : C, 2, 1

No matter which band appears first, indicates?

Color intensities and line : not equal

A

Negative result

136
Q

2 lines appear: C,2

> /= 1,000 ng/mL (detectable level)

A

MetHAMphetamine-positive result

2 purple lines

137
Q

2 lines appear : C, 1

> /= 50 ng/mL

A

THC-positive result

2 purple lines

138
Q

Only one line appears : C
Detectable level?

A

MetHAMphetamine,
THC-positive result

> /= 1,000 ng/mL (M)
/= 50 ng/mL (T)

139
Q

Purple color band isn’t visible within the result window after test

No control line

A

Invalid result

140
Q

Solution for no control line

A

Repeat test using new device and carefully follow procedure

141
Q

Causes of invalid result

Solution : RE-TEST

A

Directions is not followed correctly

Test is deteriorated

Clinical Chemistry (7 decks)

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