TOXICOLOGY Flashcards by pink popcorn

Explains the effects of xenobiotics
Basis for rational therapy design and the development of
tests

MECHANISTIC TOXICOLOGY

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Predicts what level of exposure will be harmful to humans

DESCRIPTIVE TOXICOLOGY

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Set standards which defines the level of exposure that will
not be harmful to the public

REGULATORY TOXICOLOGY

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Biologically synthesized either in the living organism or in
microorganism

Toxins

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S depressants
● Exposure leads to:
○ Disorientation, confusion, euphoria
○ May progress: unconsciousness, paralysis and
death and coma 🔊Happens with

ALCOHOL

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Oxidation of alcohol results
to generation of hydrogen
ions which can lead to
accumulation of ____which results to
acidosis

ketones &
lactate

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Antidote for intoxication:
🔊This is for alcohol

diazepam

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ETHANOL METABOLITES

Metabolites: acetaldehyde & acetyl coenzyme A

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🔊Ethanol is converted to acetaldehyde and acetyl
coenzyme A
➔ Through the action of hepatic____

Alcohol
Dehydrogenase

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ALCOHOL Methods for testing:
PREFERRED METHOD:

○ Enzymatic method, gas-liquid chromatography,
electrochemical oxidation
○ Enzymatic method

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COMMON INDICATORS OF ALCOHOL

HIGH
-GGT
-AST
-HDL
-MCV
AST/ALT RATION

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___ is an excellent marker for alcohol abuse

GGT

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Half life of GGT: ____and may be elevated
especially if there is damage in the liver

14-26 days

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➔ If AST and ALT ratio is ___, it is related to ethanol abuse
or ethanol related liver disease

> 2.0

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CONT. Ethanol
● Toxic blood level:

○ >400 mg/L
○ >500 mg/L for hemodialysis

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Otherwise known as Wood alcohol
🔊First product of metabolism is ___

METHANOL, formaldehyde

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ISOPROPANOL
● Metabolite: ___
Antidote: ___

Acetone
Activated charcoal

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Found in hydraulic fluid and antifreeze substance

ETHYLENE GLYCOL

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ETHYLENE GLYCOL
Metabolite:

oxalic acid and glycolic acid

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ETHYLENE GLYCOL
Mode of treatment:

ADH inhibition

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🔊Preferred method used is HPLC or High Performance liquid
chromatography

ETHYLENE GLYCOL

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🔊Common victims are children because it has a sweet
taste

ETHYLENE GLYCOL

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Rapidly absorbed into the circulation 🔊Colorless, tasteless and odorless substance but a very
toxic substance

CARBON MONOXIDE

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Higher affinity with hemoglobin and impairs O2
transport
🔊 200x faster than oxygen

CARBON MONOXIDE

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CARBON MONOXIDE Indication of acute toxicity

○ Cherry red color of the face 🔊Due to carboxyhemoglobin

Death may occur in less than hour upon exposure to the toxic level

CYANIDE

Most common substance used for suicidal attempts 🔊Product of pyrolysis or the burning of plastic ➔ Encourage not to burn plastics

CYANIDE

CYANIDE INHIBTS

Inhibits cellular respiration, electron transport, and ATP formation

Indication of toxicity: ○ “odor of bitter almonds” breath ○ Altered mental status

CYANIDE

CYANIDE ANTIDOTE

Antidote: Sodium thiosulfate, amyl and sodium nitrite

CYANIDE TOXIC LEVEL

Toxic level: >2μg/mL

METALS 🔊All metals can be toxic, especially if they are ingested in large quantities or ingested in their ionized form

1. Arsenic 2. Cadmium 3. Lead 4. Mercury

Found in ant poisons, rodenticides, paints and metal alloys

ARSENIC

ARSENIC INHIBITS

sulfhydryl enzymes throughout the body

Has high affinity to the thiol groups in proteins.

ARSENIC

ARSENIC 🔊Sample of choice:

Hairs and Nails.

Toxic forms: 🔊Most toxic form of arsenic

○ Sodium of arsenate ○ Copper arsenite ○ Carbarsone ○ Tryparsamide ○ Arsine gas

Indication of toxicity: ○ Garlic odor breath ○ Metallic taste

ARSENIC

ARSENIC Acute fatal dose:

○ 120 mg (arsenic trioxide) ○ 30 ppm (arsenic gas)

ARSENIC Antidote:

British anti-lewisite (BAL)

ARSENIC Method:

Reinsch Test, AAS

🔊Metal used for electroplating and galvanizing

CADMIUM

Results from ingestion of acidic food stored or prepared in metal containers

CADMIUM

CADMIUM TOXIC EFFECTS

Toxic effects: Destruction of type 1 epithelial cells in the lungs Decreased ⬇ resistance to bacterial infection

🔊Toxic indicator for cadmium in kidney:

Elevated levels of GGT enzyme in the urine (positive for GGT)

LEAD An active enzyme inhibitor ● Blocks:

Delta aminolevulinic acid synthetase Pyrimidine-5’-nucleotidase Na-K ATPase

is found greatly among paints & gasoline

🔊Lead

Indications of toxicity: ○ Urinary aminolevulinic acid 🔊Because lead inhibits the enzyme delta aminolevulinic acid synthase ○ Free RBC porphyrins ○ Presence of Basophilic Stippling in the RBC 🔊Indicators of toxicity with Lead

LEAD

HALF LIFE OF LEAD

32 YEARS

Why can’t we use serum or plasma for lead?

➔ Lead is rapidly eliminated from the plasma or serum ◆ Results to falsely decreased levels of lead in plasma or serum which is why whole blood for chronic and urine for short term (Measurement of Delta-ALA) is use

MERCURY 🔊Has the ability to bind with ____

sulfhydryl proteins

MERCURY INHIBITS

Inhibits COMT (Catechol-O-Methyl-Transferase)

TOXIC EFFECT OF ELEMENTAL MERCURY

-ACRODYNIA -ERETHISM

Toxic effect of alkyl mercury:

Congenital Minamata Disease

MERCURY USES THE METHOD

Method: Reinsch test

■ Reference method for the confirmation of most drug of abuse

GC-MS

Indication: Treatment of narcolepsy and attention-deficit disorder

AMPHETAMINES

___is a drug used to treat hyperactive children

🔊Ritalin

administered daily 🔊 Commonly referred to as ECSTASY

METHYLENEDIOXYAMPHETAMINE (ECSTASY)

METHYLENEDIOXYAMPHETAMINE (ECSTASY) HALF LIFE

Half-life: 8-9 hours

METHYLENEDIOXYAMPHETAMINE (ECSTASY) Elimination:

hepatic metabolism

METHYLENEDIOXYAMPHETAMINE (ECSTASY) Onset of Effect:

30-60 minutes

Chemically-related to testosterone ● Used as a treatment or another drug for male hypogonadism

ANABOLIC STEROIDS

ANABOLIC STEROIDS Screening test:

Screening test: ○ Testosterone:Epitestosterone (T/E Ratio)

These are groups of psychoactive compounds that are found on marijuana or Hashish

CANNABINOIDS

Marijuana ○ Came from ___

Cannabis sativa

● Most active component of marijuana

Tetrahydrocannabinol

Tetrahydrocannabinol Metabolite:

THC-COOH ● THCOOH (11-nor-delta tetrahydrocannabinol)

Commonly known as “Crack” because some are in powdered form; these are alkaloid salts extracted from “coca plant

COCAINE

Local anesthetic particular for persons going for nasopharyngeal surgery

COCAINE

COCAINE TREATMENT

● Treatment: Benzodiazepine

COCAINE INHIBITOR

PROZAC (fluoxetine)

COCAINE URINE METABOLITE

e: Benzoylecgonine

Capable of analgesia (pain reliever), sedation, and anesthesia

OPIATES

Chemically modified opiates:

Heroin Hydromorphone Oxycodone (Percodan)

HALF LIFE OF OPIATES

6-8 MINS

🔊 Commonly tested form of Opiates is ___

Morphine and Codeine

____ are major metabolites of Heroin

Morphine and Acetylmorphine

Common Synthetic Opiates

Meperidine (Demerol) Methadone (Dolophine) Propoxyphene (Darvon) Pentazocine (Talwin) Fentanyl (Sublimaze)

Antagonist: __

Naloxone (Narcan)

HALF LIFE PHENCYCLIDINE

11-12 HRS

PHENCYCLIDINE TREATMENT:

isolation

Has therapeutic roles used as a therapy and depressants 🔊 Used to increased the effectiveness of Heroin ➔ Can be used along with heroin

SEDATIVE HYPNOTICS

Commonly used:

○ Valium (diazepam) 🔊Therapeutic drug ○ Librium ○ Lorazepam (Ativan)

Commonly abused:

○ Phenobarbitals ○ Secobarbital ○ Pentobarbital ○ Thiopental

Most common adverse effects: panic reaction 🔊Bad trip ● Toxic Effects: Blurry Vision, synesthesia.

LYSERGIC ACID DIETHYLAMIDE (LSD)

___ is a neurologic condition wherein the information to stimulate one other senses stimulates several of your senses

Synesthesia

Toxic Effects: Blurry Vision, synesthesia.

LYSERGIC ACID DIETHYLAMIDE (LSD)

Can be removed from the circulation using activated charcoal

METHAQUALONE ● Sedative-hypnotic property also co

🔊 Also produce or producing pleasant feelings as amphetamines do.

PIPERAZINES

🔊 A form of Serotonin or a derivative of serotonin ● E.g. N,N-dimethyltryptamine (DMT), psilocin 🔊DMT is a short term for hallucinogen

TRYPTAMINES