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Chem I > Toxicology > Flashcards

Toxicology Flashcards

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1
Q

What is the highest incidence of toxic exposure in the US?

A

young kids younger than 5 > teens > adults

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2
Q

Definition of toxicology

A

Study of adverse effects of xenobiotics in humans

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3
Q

Xenobiotics

A

Chemicals and drugs that are not normally found in or produced by the body. Describe the environmental exposure to chemicals or drugs.

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4
Q

What are the 3 major disciples of toxicology?

A

Mechanistic, Descriptive, and Regulatory

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5
Q

What is mechanistic toxicology?

A

Explain the cellular, molecular, and biochemical effects of xenobiotics within the context of a dose-response relationship between the xenobiotic and its adverse effects​

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6
Q

What is descriptive toxicology?

A

Uses the results from animal experiments to predict what level of exposure will cause harm to humans (risk assessment)

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7
Q

What is regulatory toxicology?

A

Combines data from mechanistic and descriptive studies to establish standards that define the level of exposure that will not pose a risk to public health or safety​

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8
Q

What are the three toxicology specialties?

A

Forensic, clinical, environmental

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9
Q

What is the purpose of forensic tox?

A

Primarily concerned with the medical and legal consequences of exposure​

Major focus is establishing and validating the analytic performance of test methods used to generate evidence in legal situations—including cause of death​

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10
Q

What is the purpose of clinical tox?

A

Focuses on relationships between xenobiotics and disease states​

Emphasis on diagnostic testing and therapeutic intervention​

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11
Q

What is the purpose of environmental tox?

A

The evaluation of environmental chemical pollutants and their impacts on human health​

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12
Q

Which of the following is an exogenous substance?

Xenobiotics

Poisons

Toxins

A

Xenobiotics and Poisons

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13
Q

Poisons

A

Describe substances from an animal, plant, mineral, or gas

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14
Q

Toxins

A

Endogenous substance biologically synthesized either in living cells or in microorganisms. Toxicant and toxic refers to substances that are not produced within a living cell or microorganism and are more commonly used to describe environmental chemicals

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15
Q

Populations in which we see majority of poisoning cases

A

50% Suicide (highest mortality)
30% Accidental (most frequent in children)
20% Homicide/Occupational (industry or agriculture)

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16
Q

What are the most common routes of exposure/

A

Ingestion, inhalation, transdermal absorption

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17
Q

T/F:

Ionized substances can undergo passive diffusion

A

FALSE

Ionized CANNOT
Hydrophobic CAN

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18
Q

List some factors that can influence absorption

A

rate of dissolution, GI motility, resistance to degradation in GI tract, other substances

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19
Q

What is the central theme to toxicology?

A

The concept that all substances have the potential to cause harm

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20
Q

What is the purpose of the toxicity rating? (dose-response relationship of oral dose)

A

Useful system to compare relative toxicities of substances as the predicted endpoint is death​. It evaluates data from a frequency histogram to toxic responses over a range of doses and will evaluate the responses over that wide range of concentration

5mg/kg can be lethal

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21
Q

What is TD50?

A

The toxic dose

the dose that would produce a toxic response in 50% of the population

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22
Q

What is LD50?

A

The lethal dose

the dose that would produce a lethal response in 50% of the population

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23
Q

What is ED50?

A

The effective dose

the dose that would produce a therapeutic/beneficial/effective response in 50% of the population

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24
Q

What is the therapeutic index?

A

Ratio of TD50 OR LD50 to the ED50

TD50:ED50

OR

LD50:ED50

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25
Q

What does it mean when you have a large therapeutic index?

A

That there are fewer toxic/adverse effects when the dose is in the TR

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26
Q

Does the following statement refer to Acute or Chronic toxicity:

Generally associated with repeated and frequent exposure for extended time periods at doses that are insufficient to cause an immediate acute response​

A

Chronic

Acute refers to a single, short term exposure to a substance in which the dose can cause immediate toxic effects

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27
Q

T/F:

Signs and symptoms are often non-specific and relies on lab testing​

A

TRUE

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28
Q

What are common specimen types for tox testing?

A

Urine and blood

Forensics often use serum, plasma, nails, hair, oral fluid

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29
Q

Define toxicokinetics

A

Toxic agents exhibit unique absorption, distribution, metabolism and elimination

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30
Q

Analysis of toxic agents is typically a two step process consisting of __1__ and __2__

A

1) screening (qualitative)

2) confirmatory (quantitative)

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31
Q

What are the methods used in toxic agent analysis?

A

Immunoassays (most common), GC, LC-MS, Inorganic compounds, NMR

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32
Q

State the most significant metabolism pathway for alcohols:

A

1) Alcohol
2) ADH (alcohol dehydrogenase)
3) Aldehyde
4) ALDH (hepatic aldehyde dehydrogenase)
5) Acid

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33
Q

What tubes are preferred for blood for toxic analysis?

A

Royal Blue trace free unless lead testing then we want a tan top

These are known to be free of certain chemicals

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34
Q

____ are known to have a common depressant effect on the CNS, mediated by changes in membrane properties

A

Alcohols

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35
Q

___ is in the top 10 causes of hospital admissions

A

ETOH (ethanol- most common)

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36
Q

What is fetal alcohol syndrome caused by and what is the result?

A

Ethanol consumption during pregnancy. It can result in delayed motor and mental capabilities

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37
Q

Chronic consumption of ___ affects the liver the most. What is the mechanism?

A

Ethanol

It causes an accumulation of lipids in hepatocytes and 20% develop toxic hepatitis. Cirrhosis is common

38
Q

What is the mechanism that is used to mediate the pathological effects of long term ethanol use?

A

Adduct formation with the aide of acetaldehyde. The adducts can change the structure and function of various proteins

1) Ethanol
2) Acetaldehyde
3) Acetate
4) Acetaldehyde adducts

39
Q

Methanol

A

Is a common lab solvent found in household cleaners

Accident consumption occurs from homemade alcohol (moonshine)

Neuropathy and blindness

Formic acid = severe metabolic acidosis

40
Q

Isopropanol

A

Rubbing alcohol

CNS depressant similar to ethanol but can have severe acute phase symptoms

41
Q

Ethylene glycol

A

Common component of hydraulic fluid and antifreeze. It has a sweet taste so you can see ingestion in kids and animals.

Severe metabolic acidosis

42
Q

Alcohol determination for BAC can be performed on serum, whole blood, and plasma. Which of these is the most preferred specimen and why?

A

Serum is the preferred specimen of choice as it has a higher body water than whole blood and the ethanol is uniformly dispersed in total body water.

43
Q

How is serum osmolality effected with serum ethanol?

A

Serum osmo increases 10 mOsm/kg per 60mg/dL increase in serum ethanol

(freezing point lowers with more alcohol)

44
Q

How is carbon monoxide produced?

A

By the incomplete combustion of carbon-containing substances

45
Q

CO and __ compete for the same binding sites

A

O2

46
Q

What are the greatest hazards for CO poisoning?

A

Aspiration and ingestion

47
Q

T/F:

CO is odorless but has a taste

A

FALSE

CO is odorless and tasteless

48
Q

Cyanide

A

Very toxic substance in solid, liquid, or gas form. Binds to heme iron

Can be poisoned via inhalation, ingestion, transdermal. Used in industrial processes, insecticides, and rodenticides

49
Q

High lactic levels are commonly found in ___ poisoning

A

Cyanide

50
Q

Arsenic

A

Both natural and manmade substances and the toxicity depends on the valent state, solubility, rate of absorption and elimination.

51
Q

What are the three major groups of arsenic?

A

Arsine gas, inorganic forms, organic forms (foods)

52
Q

Cadmium

A

Used in electroplating and galvanizing. It is a significant environmental pollutant. SLOW half like of 30yr

53
Q

What diseases/conditions are associated with Cadmium poisoning

A
  • concomitant parathyroid dysfunction
  • Vit D deficiency
  • Itai-Itai disease
54
Q

Lead

A

Component of byproduct of many industrial processes. Distributed in the body and mostly in the bone and soft tissues with a much longer half time in the bones.

55
Q

T/F:

Children are more sensitive to lead than adults

A

TRUE

56
Q

____ is a potent inhibitor of many enzymes

A

Lead

57
Q

What are the 3 forms of mercury?

A
  • Elemental (liquid at RT)
  • Inorganic salts
  • Component of organic compounds
58
Q

Give an example for each form of mercury with its toxicity level

A

Elemental mercury (Hg0): no significant effects

Cationic mercury (Hg2+): moderately toxic

Organic mercury (methyl mercury CH3Hg+): extremely toxic

59
Q

What is the most common route for mercury into the human body that is the primary factor that determines mercury toxicity in the human body?

A

GI absorbance

60
Q

T/F:

The inorganic form of mercury is rapidly and efficiently absorbed

A

FALSE

the ORGANIC forms are

61
Q

_____ binds with proteins and inhibits many enzymes

A

Mercury

62
Q

Function of pesticides

A

Intentionally added to harm or kill something.

63
Q

What is the primary concern with pesticides?

A

High level exposure. Those most at risk are people handling exposures without appropriate PPE​

64
Q

Salicylates

A

Acetylsalicylic (ASPIRIN)

Interference with PLT aggregation and GI function

Reye’s syndrome in viral infection in kids

Acute ingestion of high doses causes metabolic acidosis, hyperventilation, excess ketone formation, mixed acid-base disturbance

65
Q

Acetaminophen

A

TYLENOL - common analgesic

Overdose associated with severe hepatotoxicity

Concern with MFO: more susceptible in alcoholics

66
Q

MFO

A

Mixed-function oxidase

Hepatic system can become overwhelmed

67
Q

T/F: DOA POSITIVE can tell us whether the patient has used the drug a single time or if they are a chronic user

A

FALSE, a positive result cannot tell us if this was a single use or a chronic substance abuse.

68
Q

What is the typical method for a drugs of abuse screening

A

A urine screen to detect recent drug abuse

69
Q

What are substances of abuse

A

OTC, prescription, illicit drugs

70
Q

T/F:
DOA testing is a 2 tiered approach

A

TRUE: Screening and confirmation

71
Q

What are things that can cause detection alteration

A

Urine tamp, pH, SG, and creatinine

72
Q

The following statements describe which part of the DOA testing process:

  • Simple, rapid, inexpensive
  • “Spot tests:
  • Lateral flow assays
    Detects classes of drugs based on similarities in chemical configurations
A

SCREEN

73
Q

What is a drawback of DOA test screening

A

May also detect chemical related substances with little to no abuse potential

74
Q

Confirmation testing must use methods with high __a__ and __b__

A

Sensitivity and specificty

75
Q

What is the reference method used the most for DOA confirmation?

A

GC-MS

76
Q

T/F:

DOA confirmation can provide quantitative or qualitative information

A

TRUE

77
Q

Amphetamines/Methamphetamines

A

Therapeutic drugs used for narcolepsy and ADD. These are stimulants with high abuse potential. Chronic use can lead to develop tolerance and physiological dependency

78
Q

Sedatives-hypnotics

A

CNS depressants with a wide range of roles and abuse potential.

Serious toxic effect with respiratory depression and hypotension

Toxicity potentiated with ethanol use

Overdose symptoms include lethargy, slurred speech, and possible coma

79
Q

Barbiturates

A

A sedative that has a high abuse potential

Originally a sleep inducer

Used as a “downer” after a cocaine or amphetamine “high”

Long half life

80
Q

Benzodiazepines

A

A sedative that is more commonly found at a greater availability compared to barbiturates.

Metabolized quickly and long acting. Has a high efficacy, safety, and low addiction potential with minimal side effects.

Used as a sedative and for anti-anxiety uses

81
Q

Tetrahydrocannabinol (THC)

A

Cannabinoid: psychoactive component of marijuana

Abundant and potent that causes a sense of well-being or euphoria

Lipophilic substance that is rapidly removed from circulation by passive diffusion into hydrophobic compartments (brain and fat)

Slow elimination

82
Q

Cocaine

A

Low concentrations = local anesthetic

Higher concentration = potent CNS stimulator with a sense fo excitement and euphoria

Alkaloid salt that is administered directly or inhaled as a vapor (crack)

83
Q

The primary factor that determines toxicity of cocaine is the __a__ and the __b__

A

a) dose
b) route of administration

84
Q

What route of administration is the greatest hazard regarding cocaine use?

A

IV is the greatest hazard followed by smoking

85
Q

Opioids

A

Capable of analgesia, sedation, and anesthesia

Derived from opium poppy

Naturally occurring, chemically modified, synthetic

High abuse potential that can cause physical and psychological dependence.

Acute overdose results in respiratory acidosis due to depression of respiratory centers, myoglobinuria, possibly including some cardiac markers

86
Q

Opium, morphine, and codeine are collectively known as what?

A

Opiates (naturally occurring)

87
Q

Tricyclic Antidepressants (TCA)

A

Used to treat depression and mood disorders

Commonly used in suicide attempts

Blocks the reabsorption and serotonin and norepinephrine, increasing the levels of those neurotransmitters in the brain

3 ring chemical structure

88
Q

Methylenedioxymethamphetamine (MDMA)

A

Amphetamine derivative “ecstasy”

Administered orally but can be admin from inhalation, injection, and smoking

20% eliminated in the urine unchanged

Hallucination, euphoria, empathic and emotional responses, increased visual and tactile sensistivity

89
Q

Phencyclidine (PCP)

A

“angel dust”

Illicit drug with stimulant, depressant, anesthetic, and hallucinogenic properties

Overdose cases stupor and coma

Ingested/inhaled by smoking PCP-laced tobacco or marjuana

LIPOPHILIC = dist into fat and brain

Slow elimination

90
Q

Anabolic Steroid

A

Chemically related to testosterone

Used to increase muscle mass and improve athletic performance

Chronic use is associated with toxic hepatitis and accelerated atherosclerosis = abn aggregation of plts

MALE: testicular atrophy, sterility, impotence

FEMALES: development of masculine traits, breast reduction, sterility

Chem I (14 decks)

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