Gen Path Final - Tobacco Flashcards
__________ chemicals (xenobiotics) are absorbed through inhalation, ingestion, or skin contact
Exogenous
Exogenous chemicals can be _________ through exhalation or cause local damage (direct-acting) and/or absorption into blood and distributed throughout body
eliminated
Many exogenous chemicals are _________, requiring metabolism to a water-soluble product (detoxification) and excretion in urine or feces
lipophilic
Some exogenous chemicals are chemically changed to a _________ ___________; this is an indirect-acting chemical
toxic metabolite
1 cause of preventable death in the US
Smoking-related illness
What are the 3 fates of a xenobiotic once it has entered the body?
Storage
Excretion
Toxicity
Xenobiotics that have become toxic have effects on __________ ___________ such as enzymes, receptors, membranes, DNA
cellular molecules
T/F: More than 10x as many people in the US have died as a result of cigarette smoking than have died in all the wars fought by the United States in its entire history
True
Main components of tobacco
Nicotine
Formaldehyde
CO
> 60 carcinogens
Which component of tobacco?
Basis for addiction, not carcinogenic
Nictoine
Which component of tobacco?
Toxic to cilia
Formaldehyde
Which component of tobacco?
Causes hypoxia
CO
Which component of tobacco?
2 biggest groups are polycyclic aromatic hydrocarbons + nitrosamines
Carcinogens
What are the 2 key steps of carcinogenesis?
Initiation
Promotion
Initiation or promotion?
Tobacco’s chemicals form adducts mainly w/ DNA (covalently bound)
Initiation
Initiation or promotion?
If unrepaired, DNA replication predisposes to mutation; oncogenes (RAS) + tumor suppressor genes (p53) are common targets
Initiation
Initiation or promotion?
Do not cause mutations, but they induce cell proliferation of initiated/mutated cells
Promotion
Initiation or promotion?
Increased division of mutated cells predisposes to new mutations that can lead to cancer formation
Promotion
Initiation or promotion?
Examples: hormones, drugs, chronic inflammation
Promotion
What is associated with the following cancers?
Lung, oral, laryngeal, esophagus, stomach, pancreas, kidney, bladder, cervix, bone marrow, liver, colon
Tobacco smoke
Relative cancer risk is dose dependent, increasing with ________. Expressed as pack-years. Packs smoked each day multiplied by number of years smoking
time
T/F: There is a multiplicative/synergistic risk of cancer from cigs when combined with alcohol
True
What does tobacco smoking increase and decrease in the body?
Increases platelet aggregation + O2 demand
Decreases O2 supply
What does the following effect of tobacco smoke lead to?
Increases platelet aggregation + O2 demand
Decreases O2 supply
Atherosclerosis
MI
Stroke
Tobacco smoke has direct irritants which produce inflammation + increased mucus. What does this lead to?
Chronic bronchitis
Tobacco smoke recruits PMNs, which causes elastase production. What does this lead to?
Emphysema
COPD
What does tobacco smoke increase the risk of developing?
Type 2 diabetes
RA
Macular degeneration
Ectopic pregnancy
ED
What does tobacco smoke exacerbate?
Asthma
Diabetes
Vascular disease
Osteoporosis
What are the oral risks of tobacco smoke?
Oral cancer
Perio
Halitosis
Reduced taste
Yellow teeth
T/F: There is no risk-free exposure level to environmental tobacco smoke
True
Causes or exacerbates many conditions
(cancer, respiratory infections, asthma): caused 1/10 of all deaths from smoking-related diseases since 1964 Surgeon General’s report
Secondhand smoke
Increased cancer (1.3x higher), atherosclerosis and MI, childhood respiratory infections and asthma, and sudden infant death syndrome (SIDS)
Secondhand smoke
Chemicals from smoked tobacco build up on surfaces over time and may remain for months. There is particular risk to small children but long-term risks are not well
studied
Thirdhand smoke
Nicotine has a fast onset. How long does it take to reach the brain?
8-20 seconds
Nicotine is broken down in the liver. How long is the 1/2 life?
2 hrs
Nicotine binds _________ __________ brain receptors, stimulating catecholamines release from sympathetic neurons. This increases HR, BP, and CO. What does this lead to?
nicotinic acetycholine
CHF, peripheral vascular disease, atherosclerosis
Nicotine causes “kick” due to adrenaline release from adrenals. What does this lead to?
Glucose release -> raises concentration
Nicotine indirectly causes release of __________ in pleasure center of brain leading to euphoria and relaxation, which reduces anxiety
dopamine
Nicotine affects ________ and ___________ brain development and contributes to preterm and still birth
fetal; adolescent
What are the side effects of nicotine?
Dizziness
Irregular sleep
GI problems
Increased clotting
Atherosclerosis
Solutions variably contain nicotine, propylene glycol and/or vegetable glycerin, flavorants (diacetyl), heavy metals, volatile
organic compounds and carcinogens
Vapes
Highly addictive, not for young people or those who do not smoke already (in 2016 FDA made <18yrs illegal)
Vapes
How long after quitting is there a great reduction in overall mortality and risk of death from cardiovascular diseases?
5 yrs
Chemical/medicinal effects and textile fiber found in marijuana/hemp
Cannibis sativa
T/F: Marijuana has up to 50% higher levels of carcinogens than tobacco
True
Psychoactive portion of marijuana that causes euphoria
Tetrahydrocannabinol (THC)
Non-intoxicating portion of marijuana that has analgesic and anti-inflammatory activities
Cannabidiol (CBD)
Cannabis with > 0.3% THC
Marijuana
Cannabis with < 0.3% THC
Hemp
T/F: The % of THC has increased over time
True
What has the FDA approved medical marijuana for?
Seizures
Nausea from chemo
What effect of marijuana?
Distorts sensory perception and motor coordination
Acute effects
What effect of marijuana?
Affects cognition (judgement of time, speed, distance), associated with disrupted memory, attention, learning, reduced educational attainment, psychosis/schizophrenia, mood + anxiety disorders, suicidal behaviors
Chronic effects
T/F: Marijuana causes lung disease because it has 3x tar levels as tobacco (bronchitis, asthma)
True
What % of users are addicted to marijuana?
30%
