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Pharm II > Exam 3 Toxicology > Flashcards

Exam 3 Toxicology Flashcards

1
Q

4 areas of study in toxicology

A
  1. occupation safety
  2. environmental toxicology
  3. analytic toxicology
  4. forensic toxicology
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2
Q

term describing the range of response per dose, an individual may require a higher/lower dose to produce the desired effect

A

biological variation

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3
Q

term describing a greater than normal reaction to a drug

A

hypersusceptibility

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4
Q

term describing the response of the patient to the drug when it is qualitatively different from the usual or expected response

A

drug idoiosyncrasy

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5
Q

Geriatric patients have less ___ ___ (decreased plasma proteins), less _____ (decreased liver function) and decreased renal function which allows for normal doses of drugs to act at ____ levels. Give ___ dose

A

binding capacity
metabolism
overdose
lower

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6
Q

In a pt with liver disease, drug ___ is reduced due to diminished function of ____ ____ system, dosing must be reduced.

A

metabolism

cytochrome P450

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7
Q

In a pt with renal disease, renal impairment of ___ ___ occurs, dosing must be modified on the basis of renal ____ ___ of the drug

A

drug excretion

clearance values

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8
Q

___ ____: increasing amounts of drug are required to produce a consistent effect, usually associated with drugs that cause ____ ____.

A

drug tolerance

physical dependence

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9
Q

____: rapid development of tolerance

A

tachyphylaxis

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10
Q

what does TD50/ED50 mean?

A

Therapeutic index
TD50 = dose of the drug that causes a toxic response in 50% of the popultion
ED50 = dose of the drug that is therapeutically effective in 50% of the population

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11
Q

The therapeutic index provides a single number that quantifies the relative ____ of ___ of a drug in population of people. A large Ti represents a ___ therapeutic window and a small TI represents a ___ therapeutic window = requires monitoring

A

margin of safety
wide
narrow

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12
Q

____ toxicity occurs as a result of a single, large ___ to the toxic agent. Effects are usually ____ within minutes to hours. Occasionally, signs of acute toxicity are not visible for ___ to ___ following the initial exposure.

A

Acute
exposure
visible
weeks to months

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13
Q

____ toxicity = the effect of toxic insult that occurs over a ____ period of time. Often it is manifested after ___ of exposure. May also manifest long after the individual is no longer exposed to the ____.

A

Chronic
prolonged
years
toxin

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14
Q

Study of the absorption, distribution, metabolism, and excretion of toxic parent compounds and metabolic products

A

toxicokinetics

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15
Q

4 types of GI toxins

A
  1. ingested
  2. contaminants in food (mercury in fish)
  3. majority of therapeutic agents (drugs)
  4. lead in dirt and paint
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16
Q

4 types of inhaled toxins

A
  1. air pollutants
  2. cigarette smoking
  3. industrial chemicals
  4. agents of chemical warfare
17
Q

What toxin can passively diffuse through the 7 layers of skin after prolonged contact?

A

insecticides

18
Q

8 mechanism of toxicity

A
  1. Interference with cellular function
  2. Macromolecular damage
  3. Reactive species
  4. inflam/immune mediated mechanisms
  5. Enzyme/receptor mediated
  6. Carcinogenesis
  7. Teratogenesis
  8. Organ directed toxicity
19
Q

What type of toxicity mechanism is described: carbon monoxide binds strongly to the iron in the active site of hemoglobin, preventing oxygen binding and reducing oxygen carrying capacity.

A

Receptor mediated

20
Q

What type of toxicity mechanism is described: nerve gasses/pesticides are acetylcholinesterase inhibitors which causes excessive concentration of ach in synaptic cleft resulting in slowed HR, difficulty breathing, sweating, pinpoint pupils

A

Enzyme mediated (common toxins interfere with NT, cardiac rhythm, oxygen deliver, ATP generation, or intracellular ca balance)

21
Q

What type of toxicity mechanism is described: cyanide binds to the heme iron in the active site of the enzyme cytochrome C oxidase causing reduction in the generation of ATP

A

Enzyme mediated (many compounds are toxic bc they alter important metabolic pathways, signaling pathways, or interact with critical receptors)

22
Q

What type of toxicity mechanism is described: toxins damage tissue by altering the structure of proteins, lipids, carbs, and nucleic acids so severely that cellular integrity is lost

A

macromolecular damage - tissue damaging agents are nonspecific

23
Q

What type of toxicity mechanism is described: React chemically with biologic macromolecules and other chemicals, more specific in their site of action, example: carbon tetrachloride

A

Reactive species - when carbon tetrachloride is metabolized by the liver, reacts with oxygen to form toxic organic free radicals which cause toxicity

24
Q

What type of toxicity mechanism is described: hypersensitivity and autoimmune reactions

A

Inflammatory and immune mediated mechanisms - the immune system removes cell damaged by toxins and releases immune mediators that are important in repairing tissue damage

25
Q

What type of toxicity mechanism is described: the transformation of a normal cell to a neoplastic cell

A

carcinogenesis - involves multiple genetic changes

26
Q

Development of cancer: Initiators damage ____, interfere with DNA replication or ___ mechanisms. Most initiators are ___ ___ that chemically modifies the structures of DNA, preventing accurate ____ which causes DNA _____. Mutations are passed along during cell ____.

A 
DNA
repair
reactive species
replication
mutation
replication
27
Q

Carcinogens can also promote the development of cancer by causing what?

A

chronic tissue damage in organs capable of tissue repair (alcoholism -> cirrhosis -> liver cancer)

28
Q

What type of toxicity mechanism is described: substances that can inhibit intracellluar signals are potent, they can induce a birth deft and also alter DNA or chromosomes

A

Teratogenesis - effect of any substance is dependent on the development timing of the exposure

29
Q

What type of toxicity mechanism is described: organs with regenerative capacity may recover after toxic exposure and organs with limited or no regenerative function lose function as tissue is destroyed from toxic exposure (heart/nerves)

A

Organ directed toxicity - blood brain barrier prevents many toxins from entering the CNS

30
Q

3 mechanisms of selected toxicity by drugs

  1. Attack targets that are unique to the pathogen but are not ______
  2. Attack target in the pathogen or cancer cell that are similar ___________
  3. Attack targets in the pathogen/cancer cell that are shared _________
A
  1. present in the host
  2. but not identical to those in the host
    3, by the host but that vary in importance between pathogen and the host
31
Q

Drugs exhibit the ____ toxicity when they target a ___ ___ between the pathogen and host cell
Drugs exhibit the ___ toxicity when they target ___ ___ shared by both the pathogen and the host cell.

A

Least
unique difference
most
common pathway

32
Q

A highly ___ drugs like penicillin is prescribed ___ because of the large difference between the therapeutic and ___ concentrations.Drugs that are less selective means that they affect both the pathogen and host cells and are ___ ___ and have a ____ therapeutic index.

A 
selective
safely
toxic
not safe
narrow
33
Q

4 examples of unique targets (present in pathogen bu lacking in host)

A
  1. metabolic pathways
  2. enzymes
  3. mutated genes
  4. gene products
34
Q

_______: when the host and the pathogen share a common biochemical or physiologic pathway

A

Common targets - narrow therapeutic index

35
Q

With common targets their are adverse side effects, name 5

A
  1. loss of hair
  2. mouth sores
  3. skin problems
  4. GI problems
  5. infertility
36
Q

drugs that affect only 1 phase of the cell cycle

A

cell cycle specific

37
Q

drugs that affect any/all phases of the cell cycle

A

cell cycle non specific (most antineoplastic drugs affect either S or M phase)

38
Q

3 phases of carcinogenesis

A
  1. transformation
  2. proliferation
  3. metastasis

Pharm II (18 decks)

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