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Toxicology > ToxExam1Breakdown > Flashcards

ToxExam1Breakdown Flashcards

1
Q

Any substance that, when administered to living organisms, produces a change in function.

A

Drug

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2
Q

Study of the adverse effects of chemical, physical or bio agents on living organisms and the ecosystem.

A

Toxicology

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3
Q

Study of the science of drugs including their uses, effects, and modes of action.

A

Pharmacology

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4
Q

What is the intended physiological effect of a drug.

A

Therapeutic effect

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5
Q

Medical conditions or diseases for which the drug is meant to be used?

A

Indication

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6
Q

Conditions/circumstances for which the drug should NOT be used?

A

Contraindications

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7
Q

Conditions or types of patients that warrant closer observation for specific side effects.

A

Caution

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8
Q

Unintended effects other than therapeutic effect, may or may not be negative.

A

Side effect

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9
Q

A side effect that is negative, undesirable, unpleasant, or even dangerous.

A

Adverse effect

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10
Q

Adverse effect of a drug resulting in drug poisoning, can be life-threatening.

A

Toxic effect/Toxicity

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11
Q

Drugs, supplements, or foods that may alter the effect of the drug, and usually should not be given during the same course of therapy.

A

Interaction

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12
Q

Location w/in the body where the drug exerts its therapeutic effect.

A

Site of action

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13
Q

How a drug produces its effects.

A

Mechanism of action

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14
Q

Action usually begins after drug attaches itself to some chemical structure, usually specific location.

A

Receptor site

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15
Q

Drugs that bind to a specific receptor and produce an action.

A

Agonist

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16
Q

Drugs that bind to specific receptors, prohibiting an effect.

A

Antagonists

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17
Q

When both agonist and antagonist drugs bind to the same receptor and are administered together.

A

Competitive antagonism

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18
Q

Which drug action is beneficial for overdoses: agonists, antagonists, or competitive antagonists?

A

Competitive antagonists

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19
Q

Amount of drug given to produce an effect.

A

Dose (dose-response relationship)

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20
Q

How often the drug is given.

A

Frequency (time-response relationship)

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21
Q

Smallest amount of a drug that will produce a therapeutic effect.

A

Minimum dose

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22
Q

Initial high dose used to quickly elevate blood levels of the drug.

A

Loading dose

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23
Q

Dose that is customarily given to produce a desired effect.

A

Therapeutic dose

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24
Q

Largest amount of a drug that will produce a desired effect w/out producing symptoms of toxicity.

A

Maximum dose

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25
Q

Dose required to keep the drug blood levels steady in order to maintain the desired effect.

A

Maintenance dose

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26
Q

Amount of a drug that will produce harmful side effects or symptoms of poisoning.

A

Toxic dose

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27
Q

Dose necessary to produce half of the maximum response, used to compare potency of drugs.

A

Effective Dose 50 (ED50)

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28
Q

First attempt to protect consumers in manufacture of drugs and foods.

A

1906 Pure Food and Drug Act

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29
Q

What 2 things did the 1906 Pure Food and Drug Act require drug makers to do?

A
  1. Label dangerous ingredients

2. All drugs to meet minimal standards of strength, purity, and quality

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30
Q

Drug Law passed after a drug company distributed a sulfa drug to pediatric patients.

A

1938 Federal Food, Drug, and Cosmetic Act (FD and C)

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31
Q

The 1938 FD and C authorized the FDA to demand what 3 things of drug makers?

A
  1. ) Evidence of safety for new drugs
  2. ) Issue standards for Foods
  3. ) Conduct factory inspections
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32
Q

Drug Law defining drugs that could only be purchased if the patient had a prescription form a licensed practitioner.

A

1951 FDandC Durham-Humphrey Amendment

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33
Q

Drug Law requiring approval of all new food additives.

A

1958 FDandC Food Additives Amendment

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34
Q

What are the Food Additives Amendment Exemptions?

A
  1. ) “Generally recognized as safe (GRAS)”

2. ) substances approved prior to amendment

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35
Q

Drug Law requiring all colors (natural or synthetic) must be approved.

A

1960 FDandC Color Additives Amendment

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36
Q

Drug Law requiring drug manufacturers to use standard labeling, listing adverse reactions and contraindications.

A

1962 FDandC Kefauver-Harris Amendment

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37
Q

Drug Law designed to regulate the dispensing of drugs that have the potential for abuse.

A

1970 Comprehensive Drug Abuse Prevent and Control Act

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38
Q

What Schedule is described as:

–High abuse potential, no accepted medical use.

A

Schedule 1

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39
Q

What are examples of Schedule 1 substances?

A

Heroin
LSD
Marijuana
Methaquilone (qualudes)

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40
Q

What schedule is defined as:

–High abuse potential, accepted medical use.

A

Schedule 2

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41
Q

What are examples of schedule 2 substances?

A

Vicodin
Cochin
Demerol
Adderall

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42
Q

What schedule is defined as:

–Moderate abuse potential and accepted medical use.

A

Schedule 3

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43
Q

What are examples of schedule 3 substances?

A

Tylenol w/ codeine
Ketamine
Anabolic steroids

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44
Q

What schedule is defined as:

–Low abuse potential and accepted medical use.

A

Schedule 4

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45
Q

What are examples of Schedule 4 substances?

A

Xanax
Valium
Ativan
Ambien

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46
Q

What schedule is defined as:

–Limited abuse potential and accepted medical use.

A

Robitussin AC (codeine)
Lomotil
Lyrics
Motown

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47
Q

Drug Law allowing FDA to take action against any unsafe dietary supplement.

A

1994 Dietary Supplements Health and Education Act

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48
Q

What Drug Law reinvestigated pesticide tolerance levels?

A

1996 Food Quality Protection Act

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49
Q

Prior to FDA approval for use in humans, every drug must fulfill what 2 requirements?

A
  1. ) Efficacy

2. ) Safety

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50
Q

Dose that will kill 50% of animals tested?

A

Lethal Dose (LD50)

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51
Q

What is used to establish dosage levels in animal trials?

A

Therapeutic Index (TI)

52
Q

Highest dose w/out any adverse effects?

A

No Observed Adverse Effect Level (NOAEL)

53
Q

Lowest dose found by experiment or observation at which there was a statistically significant observed adverse effect

A

Lowest Observed Adverse Effect Level (LOAEL)

54
Q

Drug acts as an antigen and body produces antibodies against the drug.

A

Drug Allergy

55
Q

A drug allergy causes release of what 2 compounds from mast cells?

A

Histamine and inflammatory compounds

56
Q

What are the 2 categories of drug allergy?

A

Hypersensitivity and anaphylaxis

57
Q

Milder response, usually rash, hives, itching, runny nose.

A

Hypersensitivity

58
Q

Severe, possibly fatal reaction - urticaria, vascular collapse, low BP, shock, cyanosis, laryngeal edema, bronchoconstriction, dyspnea.

A

Anaphylaxis

59
Q

Genetic variations in enzymes, alters drug metabolism resulting in an unexpected response.

A

Idiosyncrasy

60
Q

What drug effect creates an opposite effect from what is expected?

A

Paradoxical

61
Q

Decreased response that develops after repeated doses are given?

62
Q

Acquired need for a drug, may produce psychological or physical symptoms of w/draw all when discontinued.

A

Dependence

63
Q

What drug response is described as:

–Patient give sedative to sleep, but continues to sleep all night and well into the day.

A

Idiosyncrasy

64
Q

What FDA Prgenancy category is described as:

–Drug studies in pregnant women have not yet demonstrated risk to the fetus.

A

Pregnancy category A

65
Q

What FDA Pregnancy Category is described as:

–Drug studies have not been performed in pregnant women; animal studies have not demonstrated fetal risk.

A

Pregnancy category B

66
Q

What FDA Pregnancy Category is described as:
–Drug studies have not been performed in pregnant women or in animals, or animal studies revealed some teratogenic potential but the risk to the fetus is unknown.

A

Pregnancy Category C

67
Q

What FDA Pregnancy Category is described as:
–Drug studies have revealed adverse risk to the fetus. The benefit-to-risk ratio of the drug must be established before use during pregnancy.

A

Pregnancy Category D

68
Q

What FDA Pregnancy Category is described as:
–Drug studies have revealed teratogenic effects in women and/or animals. Fetal risk clearly outweighs benefit. Drug is contraindicated in pregnancy.

A

Pregnancy category X

69
Q

What FDA Pregnancy Category is described as:

–Drug has not yet been rated by FDA

A

Pregnancy category NR

70
Q

What are the Teratogenic effects of Carbazepine (Tegretol)?

A

craniofacial and fingernail deformities

71
Q

What are the Teratogenic effects of Diethylstilbestrol (Synthetic estrogen)?

A

Vaginal tumors and genital malformations in offspring

72
Q

What are the Teratogenic effects of Phenytoin (Dilantin)?

A

craniofacial and limb deformities, growth retardation

73
Q

What are the Teratogenic effects of Thalidomide?

A

Phocomelia (limb deformities)

74
Q

What are the Teratogenic effects of Warfarin (Coumadin)?

A

Facial, cartilage, and CNS defects

75
Q

What are the Teratogenic effects of Depakote?

A

heart problems, spina bifida, facial & limb deformities, cleft plate/lip

76
Q

What organs are most susceptible to damage for direct toxicity?

A

liver, kidneys, lungs

77
Q

Why is the liver a specific organ targeted for damage from direct toxicity?

A

b/c its metabolically active

  • -exposed to many toxic substances via GI tract
  • -recieves ~25% of C.O.
78
Q

If you detect liver damage, what biomarkers in the blood will be high and what will be low?

A

High: AST, ALT, Bilirubin

Low: Albumin

79
Q

Why is the liver a specific organ targeted for damage from direct toxicity?

A

role in filtering waste

80
Q

If you detect Kidney damage, what biomarkers in the blood will be high?

A

Blood Urea Nitrogen (BUN) and Creatinine

81
Q

If you detect Kidney damage, what biomarkers will be present during a Urinalysis?

A

Y-Glutamyltransferase

N-acetylglucosaminidase

82
Q

Why is the lung a specific organ targeted for damage from direct toxicity?

A

position and function

83
Q

If you detect Lung damage, what biochemical tests can be used to determine?

84
Q

What tests can you do to determine if lung damage is present?

A

spirometry (Forced Expiratory Volume)

tissue biopsy

85
Q

What are the effects of Pharmacokinetic-based drugs?

A

increased concentration of the compound or active metabolite

86
Q

What are the effects of Pharmacodynamic-based drugs?

A

altered responsiveness of the target site

87
Q

What are the pharmocological effects of insecticides and nerve gasses?

A

respiratory failure

88
Q

What are the pharmocological effects of organophosphate insecticides?

A

CNS disturbances

89
Q

What are the pharmocological effects of RX meds?

A

altered BP or blood sugar

90
Q

What are the pharmocological effects of industrial solvents (hydrazine)?

A

altered blood sugar

91
Q

What are the pharmocological effects of toxic solvents (carbon tetrachloride, vinyl chloride)?

A

anesthesia/unconsciousness

92
Q

What are the pharmocological effects of furosemide, caffeine, ehtanol, mercury?

A

electrolyte imbalances

93
Q

When are Teratogens most susceptible/damaging?

A

during organogensis (~18-55 days)

94
Q

What are the 2 possible reactions for immunotoxicity?

A

immunosuppression or allergic reax (immediate/delayed or localized/widespread)

95
Q

W/ Mutagenesis, drugs interact directly w/ DNA. What is the result?

A

base substitutions, additions or deletions

96
Q

What are the results of clastogenesis?

A

chromosomal damage

97
Q

What are the results of aneugenesis?

A

acquistition or loss of complete chromosomes

98
Q

What are the 3 possible outcomes of carcinogens?

A

unusual tumors
increased incidence of typical tumors
appearance of tumors earlier

99
Q

What are the 3 phases of drug activity?

A

pharmaceutic
pharmocokinetic
pharmacodynamic

100
Q

What phase of drug forms occurs after the drug is given and involves disintegration and dissolution of the dosage form

A

pharmaceutic phase

101
Q

What phase of drug happens as the drug moves through the body?

A

pharmacokinetic phase

102
Q

What phase of drug has an action on living tissue?

A

pharmacodynamic phase

103
Q

What is the most common way drugs are absorbed?

A

passive diffusion

104
Q

What factors impact drug absorption?

A 
drug ionization
lipid solubility
presence or absence of food in the stomach
drug formulation
circulation/rout of administration
105
Q

In order for Ionized molecules to be absorbed, what needs to happen?

A

need to be un-ionized

106
Q

Acid drugs mostly unionized when in what type of fluids?

A

acidic fluids

107
Q

Basic drugs mostly unionized when in what type of fluids?

A

alkaline fluid

108
Q

To increase excretion of basic drugs, what changes to urine pH are required?

A

acidic urine

109
Q

High doses of what 2 substances acidifies urine?

A

Vit C or ammonium chloride

110
Q

To increase the excretion of acid drugs, what changes to urine pH are required?

A

alkaline urine

111
Q

High doses of what substance alkalinizes urine?

A

sodium bicarbonate

112
Q

What are benefits of lipid soluble drugs and what is an example of what?

A

easier to pass through cell membranes

–anesthesia

113
Q

What affect does food have on drug absorption?

A

slows it down

114
Q

The % of a dose that reaches the bloodstream is referred to as the…

A

bioavailability of a drug

115
Q

What is the bioavailability of oral medications to reach the blood?

116
Q

What enzyme is needed for the metabolism of drugs?

A

Cytochrome P450

117
Q

What are the 2 outcomes of drug metabolism?

A

excretion or return to circulation

118
Q

What is the difference between enzyme induction and enzyme inhibition?

A

induction speeds up drug metabolism of all drugs

inhibition slows the drug metabolism of all drugs

119
Q

After oral administration, some drugs are metabolized significantly as they pass through the liver the first time.

A

first pass metabolism

120
Q

What are the 5 major routes of excretion?

A

urine, bile, lungs, GI tract, breast milk

121
Q

What are the 4 types of drug interactions?

A

drug-drug
drug-dietary supps
drug-food
nutrient depletions

122
Q

How does St. John’s Wort affect drug interactions?

A

can reduce the concentration of meds in the blood, b/c it’s an inducer of CYP450 enzyme

123
Q

What are some examples of Grapefruit-Drug interactions?

A
  • -Ca+ channel blockers (hypotension)
  • -Statins (myopathy)
  • -Antihistamines (cardiac effects)
  • -Cyclosporine (transplant rejection)
124
Q

What veggies should be avoided if taking warfarin?

A

green leafy veggies and avocados

125
Q

Patients on MAOI’s need to avoid what types of foods to prevent spikes in BP?

A

Tyramine “Wisconsin” foods

–(aged cheesses, alcohol, sauerkraut, sausage/pepperoni/salami)

126
Q

What types of food/supplements induce CYP450?

A

alcohol, caffeine, St John’s Wort

127
Q

What types of food/supplements inhibit CYP450?

A

echinacea, grapefruit, peppermint

Toxicology (6 decks)

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