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Toxicology Lec > Midterm > Flashcards

Midterm Flashcards

1
Q

Study of exogenous clinical compounds that profoundly influence bodily functions, either in a deleterious way or for therapeutic benefits

A

TOXICOLOGY

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2
Q

enables physicians to adjust and optimize the dosage on an individual basis

A

Therapeutic drug monitoring (TDM)

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3
Q

identify the offending drug/s (what function)

A

Identification of drugs in acute intoxication

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4
Q

establish diagnosis, assess level of intoxication, suggest course of therapy (what function)

A

Identification of drugs in acute intoxication

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5
Q

pre-employment and medico-legal cases (what function)

A

Urine testing for drugs of abuse

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6
Q

4 areas : CLINICAL TOXICOLOGY LABORATORY

A
  1. drugs of abuse
  2. therapeutic drugs
  3. environmental carcinogens
  4. toxins
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7
Q

Test animals are used

A

-Direct administration: ingestion, application to the skin, inhalation, gavage, etc.
-Indirect: test animal is exposed to the substance in its environment (H20 or air)

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8
Q

Toxicity is measured as clinical “endpoints”:

A
  • Mortality (death)
    -Teratogenicity (cause birth defects)
    -Carcinogenicity (cause cancer)
    -Mutagenicity (cause changes in the DNA)
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9
Q

-Received regular maintenance doses of the drug for about five half-lives of the drug (OPTIMAL TIME FOR BLOOD SPECIMENS)

A

Steady state concentration

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10
Q

For most orally taken drugs (OPTIMAL TIME FOR BLOOD SPECIMENS)

A

Just before the next dose

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11
Q

-Shortly after receiving the drug
- For patients who exhibit toxic symptoms
(OPTIMAL TIME FOR BLOOD SPECIMENS)

A

Peak or post-dose level

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12
Q

TECHNIQUES FOR DRUG ANALYSIS
•Immunologic

A
  • Enzyme immunoassay systems
  • Fluorescence immunoassay
  • radioimmunoassay
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13
Q

TECHNIQUES FOR DRUG ANALYSIS
•Chromatographic

A

-HPLC
-GLC
-TLC

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14
Q

TECHNIQUES FOR DRUG ANALYSIS
•Spectrophotometry

A

-Visible spectrum, ultraviolet spectrum and fluorescence

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15
Q

–Serum + antibody + enzyme- labelled drug + substrate

A

ENZYME MULTIPLIED IMMUNOASSAY TECHNIQUE (EMIT)

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16
Q

Measured enzyme activity of EMIT

A

drug concentration

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17
Q

More rapid than RIA

A

ENZYME MULTIPLIED IMMUNOASSAY TECHNIQUE (EMIT)

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18
Q

1st homogenous Enzyme Immunoassay

A

ENZYME MULTIPLIED IMMUNOASSAY TECHNIQUE (EMIT)

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19
Q

most useful; less likely to be affected by serum constituents (in EMIT)

A

MDH (Malate dehydrogenase) & G-6-PD (glucose-6-phosphate dehydrogenase)

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20
Q

Measures drugs (mg/L) & drug metabolites in biological fluids

A

EMIT

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21
Q

Some drugs detected in EMIT

A

Cocaine & metabolites, cannabinoides, opiates & barbiturates

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22
Q

Drug to be measured is the hapten

A

ENZYME-LINKED IMMUNOSORBENT ASSAY (ELISA)

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23
Q

Specific antibodies bound to a solid state carrier

A

ENZYME-LINKED IMMUNOSORBENT ASSAY (ELISA)

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24
Q

Separation of the bound drug from the unbound

A

ENZYME-LINKED IMMUNOSORBENT ASSAY (ELISA)

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25
Q

Digoxin and digitoxin tests

A

ENZYME-LINKED IMMUNOSORBENT ASSAY (ELISA)

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26
Q

Rodenticides, weed killers, insecticides

A

Arsenic

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27
Q

Interacts w/ enzyme SH (sulfhydryl) groups > disrupts multiple metabolic systems

A

Arsenic

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28
Q

Acute fatal dose of arsenic

A

120 mg

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29
Q

Toxicity manifested w/in the first hour : GI symptoms (diarrhea)

A

Arsenic

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30
Q

Analysis of urine, hair and nails: Ion Emission Spectroscopy

A

Arsenic

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31
Q

Treatment for Arsenic

A
  • Gastric lavage or emesis
  • Dimercaprol or BAL
  • Hemodialysis
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32
Q

Acute poisoning common in young children

A

Iron

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33
Q

Toxic amount of Iron

A

> 30mg/kg

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34
Q

Once absorbed, removal is difficult

A

Iron

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35
Q

Hepatic cell damage, shock, lactic acidosis

A

Iron

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36
Q

initial manifestation of Iron

A

Vomiting

others: Severe gastroenteritis, melena, abdominal pain and hematemesis

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37
Q

Diagnosis of Iron

A

• Serum iron concentration
• TIBC (Total Iron Binding Capacity)

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38
Q

Treatment of Iron

A
  • Supportive treatment
  • Emesis or gastric lavage
  • Chelation therapy: deferoxamine
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39
Q

Forms of Mercury

A
  1. Elemental or metallic: toxic when inhaled
  2. Mercurous/ Mercuric: salt form
  3. Alkyl mercury: environmental pollutants
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40
Q

Acute toxicity of Mercury

A

24 hr. urine levels

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41
Q

Chronic toxicity of mercury

A

hair analysis

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42
Q

Treatment of mercury

A

• Treatment: gastric lavage or emesis
- Dimercaprol and succimer

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43
Q

Organic and inorganic _____: highly toxic

A

lead

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44
Q

Interacts with -SH, -COOH & PO4 in proteins (e.g. enzymes)

A

lead

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45
Q

effect CNS (Central Nervous System) and PNS (Peripheral Nervous System)

A

lead

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46
Q

introduce in the body by Inhalation or ingestion

A

lead

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47
Q

Fatal dose of lead

A

0.5mg absorbed/day - chronic toxicity
0.5 g absorbed - acute toxicity

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48
Q

Acute toxicity: Signs and symptoms of lead

A

—CNS symptoms:
Encephalopathy (enlargement of brain), convulsions, stupor
—GI symptoms: colic

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49
Q

Chronic toxicity of lead

A

Accumulation in blood, soft tissues and bone

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50
Q

Low-level exposure of lead

A

ADHD & decrease in I.Q

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51
Q

Characteristic of lead

A

“wrist drop or foot drop” manifestation

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52
Q

LEAD TOXICITY
•Bone - 96% of burden

A
  • Half-life of lead in bone is 32 years mas madami
  • Reservoir for endogenous intoxication
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53
Q

•Lab. Diagnosis of lead

A

•basophilic stippling in RBCs
• gama ALA in urine

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54
Q

Diagnosis of lead

A

• AAS
•Anode stripping voltametry.

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55
Q

Treatment of lead

A

•Supportive
• Gastric lavage
• Dilute MgSO4 or Na2SO4
•Chelating agents: dimercaprol, calcium disodium acetate & succimer

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56
Q

esters of H3PO4 or thiophosphoric acid

A

•Organophosphates

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57
Q

synthetic derivatives of carbamic acid

A

•Carbamates

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58
Q

• Widely used as pesticides
•Interfere with neurotransmission

A

•Carbamates

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59
Q

•Inhibit acetylcholinesterase: ORGANOPHOSPHATE AND CARBAMATES

A

hydrolyzes acetylcholine after it has effected an action potential

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60
Q

excitatory neurotransmitter of ORGANOPHOSPHATE AND CARBAMATES

A

•Acetyl choline

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61
Q

Signs and Symptoms of ORGANOPHOSPHATE AND CARBAMATES

A
  • Parasympathetic manifestations: salivation, lacrimation, urination and defecation
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62
Q

Autonomic manifestations of ORGANOPHOSPHATE AND CARBAMATES

A

-Muscular weakness, tachycardia, hypertension

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63
Q

CNS manifestations of ORGANOPHOSPHATE AND CARBAMATES

A

-Confusion, slurred speech, ataxia, convulsions

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64
Q

Diagnosis of ORGANOPHOSPHATE AND CARBAMATES

A

• Assay of cholinesterase activity

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65
Q

Treatment of ORGANOPHOSPHATE AND CARBAMATES

A
  • Respiratory support
    -Gastric lavage or emesis
    -Atropine
    -Pralidoxime (organophosphate)
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66
Q

aromatic compounds produced in cigarettes and in exhaust of engines → lung cancer

A

Benzopyrene

67
Q

preservative of red meat → colon cancer

68
Q

produced by Aspergillus; hepatocellular carcinoma

69
Q

benzene → acute leukemia

A

Aromatic hydrocarbon

70
Q

angiosarcoma

A

Vinyl chloride

71
Q

multiple malignancies

A

Benzidine dyes

72
Q

lung cancer and mesothelioma

73
Q

used in gas chamber

A

Hydrogen cyanide

74
Q

floor cleaner

75
Q

industrial solvent

76
Q

white ant poison

77
Q

lighter fuel

78
Q

insecticide

79
Q

paint stripper

80
Q

Benzopyrene

81
Q

moth balls

A

Naphthalene

82
Q

car batteries

83
Q

car exhausts

A

Carbon monoxide

84
Q

known cancer causing substance

A

Vinyl chloride

85
Q

Any substance that produces physiological or psychological change within a short period of time after ingestion of a specified dose

A

Working Definition of a Drug

86
Q

When an individual becomes strongly attached to a drug

A

Nature of Drug Dependence

87
Q

Dependency is subdivided into two categories

A

physiological and psychological

88
Q
  • The body continually needs to have the drug
  • A person experiences sickness if drug is discontinued
A

Physiological Dependence

89
Q
  • A person develops an uncontrollable “craving” (mental or emotional need) for a drug
  • The craving is a desperate need to continue
A

Psychological Dependence

90
Q

drug of abuse

A

any substance that is used for some purpose (w/ a desirable effect) other than that intended.
-the possession or supply is restricted by law because of its potential harmful effect on the user.
-Such drugs are known as controlled or scheduled substances.

91
Q

•According to the WHO, scheduled drugs are ‘abused’ rather than ‘misused’. T or F

92
Q

Drugs of abuse may or may not lead to physical or ‘psychological dependence’, a term used by the WHO in preference to ‘addiction’ . T OR F

93
Q

taken as painkillers (analgesic)

A

Narcotic Drugs

94
Q

taken to increase mental and physical energy

A

Stimulants

95
Q

taken to change one’s mental state

A

Hallucinogens

96
Q

taken to dull one’s senses, to reduce anxiety, or induce sleep

A

Depressants, Hypnotics, & Tranquilizers

97
Q

taken to enhance one’s enjoyment of a party or other social activities

A

Club Drugs

98
Q

taken to build muscles, endurance, or enhance athletic performance

A

Performance Enhancing Drugs

99
Q

Derived from Papaver somniferum

A

Opiates or Narcotic Drugs

100
Q

produced from the drying resin of unripe capsules of the opium poppy

101
Q

Use of Opiates or Narcotic Drugs

A

treatment of GIT pain & diarrhea for infants

102
Q

are psychologically addictive drugs; withdrawal causes severe physiological symptoms

103
Q

1° active drug in opium

104
Q

word comes from the Greek word “Morpheus”

105
Q

Uses of morphine

A

analgesic, light anesthetic or sedative

106
Q

Mode of administration of morphine

A

Intravenous

107
Q

Street Names of morphine

A

M, dreamer, emma, emsel, pulbos

108
Q

2nd most abundant component; strong painkiller and cough suppressant

109
Q

Street Name of codeine

110
Q

white powder (diamorphine HCI & minor amounts of opium alkaloids)

111
Q

brown powder (diamorphine base, opium-derived alkaloids & adulterants)

112
Q

is treated to extract the morphine & the extract is acetylated with Acetic anhydride to produce diamorphine

113
Q

Mode of administration of diamorphine

114
Q

site of injection for diamorphine

A

Inside of arm (beginners - middle biceps to middle of forearm)
Arm toward the back of the hand
• Feet, legs, thighs & groin

115
Q

other site of injection for diamorphine

A

• veins of the neck
• under the tongue
• Breast (for females)
• Dorsal veins of the penis (for males)
CLUES: Needle tracks & sclerosing of veins

116
Q

pharmacologically related to heroin

117
Q

Used for treatment of heroin addiction

118
Q

relief of moderate pain

A

Propoxyphene (Darvon)

119
Q

Abused stimulants

A

Amphetamine, methamphetamine, and cocaine

120
Q

is the drug most commonly produced in clandestine labs

A

Methamphetamine

121
Q

Resemble epinephrine & norepinephrine

A

AMPHETAMINE & METHAMPHETAMINE

122
Q

Used for the treatment of obesity

A

AMPHETAMINE & METHAMPHETAMINE

123
Q

Common adulterants for Amphetamine:

A

—Caffeine (increase stimulant effect or mask low levels)
—Sugars (e.g. lactose) used as diluent

124
Q

Normally produced as amphetamine sulfate, hydrochloride or phosphate
More commonly abused in Europe

A

AMPHETAMINE

125
Q

Produced as methamphetamine hydrochloride
More popular in North America and Japan

A

METHAMPHETAMINE

126
Q
  • derived from genus Erythroxylum
127
Q

sniffed through the nose (snorting”)

A

Cocaine HC

128
Q
  • base form; vaporized by heat in a pipe and inhaled
A

“Crack”

129
Q

Local anaesthetic, vasoconstrictor & powerful psychostimulant

130
Q
  • Cause a significantly altered mental state, often including hallucinations
  • Marijuana is one of the oldest
A

HALLUCINOGENS

131
Q
  • Cause a significantly altered mental state, often including hallucinations
  • Marijuana is one of the oldest
A

HALLUCINOGENS:

132
Q

PHENCYOIDINE ROD: Street Names

A

Angel Dust, Angel Hair, Crystal, Keeler Weed

133
Q

Used as surgical anaesthetic during World War I (patented by Parke-Davis in 1957 as “Sernyl”)

A

PHENCYOIDINE ROD

134
Q

Side-effects of PHENCYOIDINE ROD

A

delirium, paranoia, hallucinations & euphoria

135
Q

Very popular as a drug of abuse in the 1960s & 1970s (hippy movement”)

A

LYSERGIC ACID DIETHYLAMIDE (LSD)

136
Q

starting material; derived from rye ergot fungus

A

Lysergic acid

137
Q

Refers to all parts of the plant Cannabis sativa L., except the seeds & mature woody stalk material

A

MARIJUANA (HERBAL CANNABIS)

138
Q

major psychoactive agent of MARIJUANA (HERBAL CANNABIS)

A

Delta-9-tetrahydrocannabinol

139
Q

Effects of marijuana

A

euphoria & heightened sensory awareness and distortion of time, sound and color, feeling of relaxation

140
Q
  • Cannabis resin made from the flowering tops of the plant
141
Q

Metabolites of Marijuana:

A

Delta-9-carboxy-THC
111-hydroxy-delta-9-THC

142
Q

OTHER NATURAL HALLUCINOGENS

A

a. Peyote - bud of a particular cactus
• Main active ingredient: “mescaline”
b. Magic mushrooms: Genus Psilocybe
Active components: psilocin and psilocybin

143
Q
  • most abused depressant in the world
144
Q
  • physiologically active depressants, resulting in a physical & mental state similar to alcohol-induced intoxication
A

Barbiturates

145
Q

Phenobarbital (long-acting)
›anticonvulsant
Amobarbital (intermediate-acting)
Pentobarbital (short-acting)
Thiopental (ultra-short-acting) > sedative-hypnotic

A

Barbituric acid

146
Q

Condensation product of urea and matonic acid

A

Fat soluble: easily crosses BBB
Low doses: sedation, drowsiness and sleep
Higher doses : anesthesia
Very high doses : stupor, coma and death
Toxicity: depression, cyanosis, hypothermia, hypotension

147
Q

Most are now rarely prescribed; illicit synthesis is rare
U.S.: Lorazepam & Alprazolam (typically abused); Flunitrazepam (banned)

A

BENZODIAZEPINES

148
Q
  • tranquilizer drug designed to relieve anxiety
149
Q
  • a major drug of abuse at raves and the club scene
A

Rohypnol or “roofies”

150
Q

prepared by clandestine labs, or obtained legally from other countries

A

CLUB DRUGS:

151
Q

most common drug encountered in “ecstasy” tablets
increase in secretion & inhibition of re-uptake of serotonin, dopamine & norepinephrine in the brain

A

METHYLENEDIOXYMETHAMPHETAMINE (MDMA) - “love drug”

152
Q

causes euphoria, a feeling of empathy, increased energy and tactile sensation

153
Q

Short-term health risks: MDMA

A

hypertension, hyperthermia & dehydration

154
Q

Long-term effect: MDMA

A

severe depression due to permanent disruption of serotonin production in the CNS

155
Q

Synonyms: Sodium oxybate, gamma OH, Somtomax, “GHB” and liquid ecstasy
acts as a CNS depressant and hypnotic; chemically related to GABA
Gained notoriety for its use in drug-facilitated sexual assault

A

GHB (gamma hydroxybutyrate) and analogues

156
Q
  • anesthetic and animal tranquilizer; causes anterograde amnesia
157
Q

have been implicated in cases of drug-facilitated sexual assaults “date-rape” drugs

A

Rohypnol, GHB, and ketamine

158
Q

The first drug controlled because of their abuse by athletes were

A

anabolic steroids

159
Q

promote cell growth resulting in growth of muscle tissue and sometimes bone size and strength

A

Anabolic steroids

160
Q

SCHEDULE OF DRUGS

A
  • I - for research only; no approved medical use
  • II - Rx drugs; special prescription; unrefillable
    -I and II: high potential for abuse
  • III and IV - available by prescription;
  • may have 5 refills in 6 months
  • V - Over the Counter (OTC)
161
Q

Schedule

A

× Schedule I
• Marijuana
• Hashish
• Heroin
• LSD

× Schedule II
Opium
• Cocaine
• Amphetamine
Methamphetamine

Schedule III
Phenobarbital
• Diazepam
Anabolic steroids

162
Q

OTHER COMMONLY ABUSED DRUGS

A
  1. Nicotine - cigarettes, tobacco
  2. Ethyl alcohol - liquor, beer, wine
  3. Dextromethorphan
    - cough and cold medications
  4. Inhalants
    - solvents (paint thinners, gasoline, glues), gases (butane, propane), nitrites
163
Q

Republic Act No 9165: June 7,2002

A
  • Comprehensive Dangerous Drugs Act of 2002
  • repealed Republic Act No 6425 (Dangerous Drugs Act of 1972)

Toxicology Lec (1 decks)

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