Other Toxic Substances Flashcards
Edible form of alcohol
Ethanol
Organ that detoxifies alcohol
Liver
Ethanol is converted to -___________ by ADH -> ALDH -> acetic acid
acetone
Chronic consumption of ethanol progresses to:
Hepatic fibrosis and hepatic cirrhosis
causes severe acidosis
Ethanol
alcohol that is converted to formaldehhyde -> ALDH -> Formic Acid
Methanol
Causes blindness and death
Methanol
Ethylene glycol is converted to
Oxalic and glycolic acid
Having sweet odor and taste
Often used as an anti-freeze agent
Ethylene glycol
Signs of poisoning in methanol:
Increased amounts of calcium oxalates monohydrate crystals
Metabolic acidosis
Products are: acetone and acetic acid
Isopropyl alcohol
alcohol that has longer metabolism than ethanol
Isopropyl alcohol
Reference method for Alcohol
Gas liquid chromatography
General formula of alcohol conversion:
Alcohol — ADH —> Aldehyde –ALDH–> Acid
Common indicator of ethanol abuse
GGT
AST
AST/ALT
HDL
MCV
Increases can be seen before onset of pathologic consequence
Increases in serum activity; can occur in many non-ethanol conditions
GGT
Increases in serum activity; can occur in many non-ethanol conditions
AST
Ratio greater than 2.0 is highly specific for ethanol related liver conditions
AST/ALT Ratio
High serum level is specific for ethanol consumption
HDL
High serum level is specific for ethanol consumption
HDL
Increased erythrocyte _______ is commonly seen with excessive ethanol consumption
Not related to folate or Vit B12 deficiency
MCV
Irreversible bind with RBC
CO carbon monoxide
Tissue hypoxia leads to
Carboxyhemoglobin
Screening of carbon monocide
Cherry red color of the blood
Qualitative test for CO2: 5mL 40% NaOH + 5mL blood -> _______
pink color (20% or greater)
Quantitative test for CO2
Differential spectrometry, GCMS
Typical COHB% in non smmokers
0.5
Typical COHB% range of values seen in smokers
5-15
Typical COHB% SOB with vigorous exercise
10
Typical COHB% SOB moderate exercise
20
Typical COHB% severe headavhes, fatigue, impairment of judgement
30
Typical COHB% confusion, faining on exertion
40-50
Typical COHB% unconsciousness, respiratory failure, death with continuos exposure
60-70
Typical COHB% immediately fatal
80
Often used as rodenticide/insectide
Cyanide
Tissue and cellular hypoxia is caused by
Cyanide
Analysis of Cyanide
Ion-Selective Electrode
Diagnosis and Manifestations:
Odor: Better almonds
Altered mental status
Tachypnea
Cyanosis
Metabolic acidosis
Cyanide
Insecticide/Rodenticide/Herbicide, presercative, paints, ceramimcs
Arsenic
Absorption of arsenic is through:
Skin, GIT, Lungs
True or False: Arsenic cannot cross placenta
False- can cross
Manifestations of arsenic:
Garlic odor of breath
Metallic taste
Diagnostic of Arsenic is through:
Urine, Hair, and Nails
Method of detection for arsenic
Atomic Absorption Spectrophotometry
Component of Battery
Cadmium
Kidney accumulation of cadmium leads to
renal dysfunction
vitamin D deficiency which leads to osteoporosis and osteomalacia
Itai-itai disease
Half life of Cadmium
10-30 years
Method of detection for cadmium
AAS - urine or blood
Binds to proteins and inhibits enzymes
Mercury
Effects of Mercury in intestinal absorption
bloody diarrhea due to ulceration and necrosis
proteinuria and loss of tubular function is caused by
mercury
Method of analysis for Mercury
AAS and Anodic Strippin Voltammetry
Forms of mercury
Metallic/Elemental
Mercurous
Mercuric
Alkyl Mercury
Long term effect on CNS and GIT
Lead
May be ingested or inhaled
Lead
Common component of paint, crayons, ceramics
Lead
Half life of lead:
32 years
Inhibits heme synthesis and enzyme activity
lead
Method of detection: Lead
AAS and Anodic Strippin Voltammetry
Blood tube for Lead
tan EDTA
Most Effective Screening urine:
Aminolevulnic acid and protophyrins
Most effective screening :
Caused by inability of Red cell to extrude remaining DNA ( impairment of pyrimidine nucleotidase - present in nucleated cells)
Basophilic stippling (remnants of DNA)