Toxicology Flashcards
T/F highest incidence is with adults, then teens then kids
False, highest incidence is with Kids <5yrs, then teens then adults
Describe Toxicology
study of adverse effects of xenobiotics in humans
Describe Xenobiotics
chem/drug not normally found in human body/nor produced
What are the three disiplines of toxicology
Mechanistic
Descriptive
Regulatory
Describe mechanistic toxicology
wdrb
cellular/molecular/biochem effects with dose response basis for developement
Describe Descriptive toxicology
Animal experiments to predict levels in humans/risk assesment
Describe regulatory Toxicology
combined data with mechanistic/descriptive to create standards, levels of exposures and works with most government agencies
Briefly describe the Specialities in toxicology
Forensics: A
Clinical: DS
Environmental
Forensics: establish analytical test methods, cause of death
Clinical: Relationship xeno/disease states/diagnosis
Environmental: Chemicals/enviroments
Describe Xeno poisons
hint: what kind of agents
exogenous Agents
T/F: xeno environment exposures are ABX, anti-depr
true
Describe poisions
Toxins
Toxic
animal/plant/mineral/gas
Toxins - endogenous, biosynth in living cells (botulism/snakes)
Toxic - not produced in living cells
T/F 50% of poisions are by suicides
30% accidental
rest is occupational/homicides
true
What are common routes in posionings
ingestion,inhalation,transdermal
Describe Ingestions briefly
what kind of effect?
how is it diffused?
must be able to?
what kind of lipid solubility?
systemic effect - must be absorbed into circulation
PASSIVELY DIFFUSED
must be able to cross barrier
hydrophobic
T/F toxins not absorbed are local effects with diarrhea and bleeding
true since it is not in cirulatory system
Describe dose response relation
central theme
establish/correlate?
central theme: all substances have possibility to cause harm
establish index
must correlate with dose that will cause harmfull effect
Describe oral dose responses and their lethal compounds
single acute dose…..
most xenos…
super toxic
single acute dose w probability of lethal compound in a 154lb male
most xenobiotics produce pathos other than death
SUPER TOXIC <5MG/DL
Describe TD50
LD50
ED50
Toxic dose 50%
lethal/death 50%
Effective dose 50%
What is the theraputic index
Large TI
Quantal dose relationship
ratio of TD50 to LD50 to the ED50
Large TI: fever/toxic/adverse effects when dose is in T.R
Q-dose: change in health effects of a defined population based on exposure to xenobiotic
Acute vs Chronic Toxicity
A- single short term exp to substance, dose is sufficient to cause immed toxic effect
C - repeated exp. to peroids of time, doses insufficient to cause response
T/F chronic toxicity may affect different systems than acute
true
Analysis of agents
D
H
Targetting:
e
s
c
drug screen
heavy metal panels
Targetting: environmental risk, supportive invest
clinical susp
Analysis of agents: Specific types
examples of samples
blood/urine
forensic: serum/plasma/hair
Describe Toxokinetics
unique?
coordinates with?
t?
uniqure absorb, distrib, metab, elim
Coordinate w selection of specimen
timing of collection
T/F “trace elements free” blood collect tubes - ROYAL BLUE TOPS
Tan tops - lead testing
True
Describe the two step process
GC-MS
LC-MS
ICP-MS
screening/rapid/simple
LACK SPECIFICITY
Confirmatory
GC-MS (organic)
LC-MS (analytical tech)
ICP-MS (inorganic)
Describe Alcohols
Toxic effect
most common what
biotransformation
Met pathway
toxic effect gen/specific
most have sim effect to equiv. [ ]
MOST COMMON DEPRESSANT ON CNS
biotransf of alc - toxic
met path:
ALC - ADH - ADLEHYDE - ALDH ACID
Describe Ethanol
Exposure
top 10…
affects what organ
Key role
Met pathway
exposure common
excessive consumption
Top 10 causes of hosp. admission
LIVER
adduct formation w/ ACETALDEHYDE (KEY ROLE)
ETH - ACETALD - ACE- ACETALD ADDUC
What is the legal limit for Alc/eth
.08mg/dl
Describe Methanol
common in
ingestion of what
whats the bad acid in it and what does it cause
common lab solvent
house hold cleaner
accidental ingest w homemade liquor
FORMIC ACID - severe met. acidosis
Describe Isopropanol
what kind of product
similar to?
acute phase?
end product of acetone
similar CNS depressant like ethanol
severe acute phase
Describe Ethylene glycol
what is it found in
taste?
who?
causes?
hydrolic fluid/antifreeze
sweet
alcohol dependency/kids
severe met acidosis/renal damage
T/F Ethanol uniformly distributes in body - use serum to test BAL
true
What do you use on a sample to prevent bacterial fermentation
Sodium Fluoride
What are some analytical methods of toxicology
what kind of testing? (ex. osm)
increase osmolarity =
increae serum osmo =
osmom,chromatography,enzyme
Incr osmolarity = inc ethanol
Incres serum osmo = 10/60 ethanol
T/F osmol gap = measured - calc osmo and is not specific to ethanol
true
T/F enzymatic methods dont use non human term of ADH to oxidize ethanol to acetaldehyde and NAD - NADH
false, they do use non human
Headspace GC coupled w flame ionization —
ref method?
v?
compared to?
ref method saturation sodium chloride - volitile into headspace
compared to standard n-propanol
Describe Carbon Monoxide
imcomplete combustion of
characteristics
COHB
binding sites
Ingestion vs aspiration
incompl. combustion of carbon containing substances
Colorless/tasteless/smellless
COHB - 200x affinity for O2
Competes for binding sites (treat w 100% O2 therapy)
INGESTION GREATEST HAZARD
aspiration pulmonary edema
Describe Cyanide
toxic?
common in?
high what levels
binds to?
clearance in?
supertoxic
common suicide agent
HIGH LACTIC LEVELS
binds to heme iron
Clearance in kidney
Describe Arsenic
where is it found
people?
3 groups
organic is found in?
natural/manmade
env. exposure/occupational
homicide/suicide
Groups:
Arsine gas
ingorganic form
organic form
Organic in seafood
t/f arsenic does not bind to proteins and cant change structures
false it does bind to proteins and can change structures
Describe Cadmium
Electro…galu
found in
hazards?
foods?
toxic to which organ
what dysfunction
electro/galunizing
paint/plastics
batteries
Environmetal hazard - tobacco
Cadmium rice
Toxic to kidneys
PARATHYROID DYSFUNC AND VIT D
Describe Lead
found in?
wide
inhibits
accum?
whos at worse risk?
indust. products
paint/gasoline
widely dissem. in body
inhibits enzymes
Accum in kidneys
infants at worst risk/kids
Describe mercury
what 3 metal forms
how does it get inside people?
Elemental form
Calfonic form
organic form?
metal 3 forms:
environ.
inorgan salts
compound of organic compounds
Accidental igestion industrial setting common
Elemental mercury - poor effects
caflonic mercury - moderatley toxic
Organic mercury - toxic extreme
T/F Most common route of mercury is ingestion
true
What are some disease states mercury posioning causes?
organic forms?
thyroditis and necrosis of intestines
binary inhibits enzymes
Organic forms are rapidly absorbed and increased in the brain
Describe pesticides
where is it found
toxic effects? how long does it last?
Where is the most frequent route
insecticides..etc
occupational and in homes
potential toxic effects
short term
contaminated food - frequent route of exposure
Describe Salicylate
type of drug?
common name?
what syndrome?
Acute injestion causes?
Treatment?
Theraputic drugs
Asprin
Reyes syndrome w/ viral infection in kids
Acute injestion: metabolic acidosis (hyperventilation)
Treatment: neutralize acid
T/F common method of salicylate testing is with chromogenic assay
true
Describe Acetomenophen
common name
overdose causes?
binds to?
most concern?
Tylenol - common analgesic
Overdose - hepatictoxicity
Bind high to proteins/low free fractions
MOST CONCERN MPO onset hepatic damage - 3-5 days
Describe drugs of abuse
d/o
substance abuse:
typically found:
drug overdose (ID agent)
Substance abuse: OTC
use of recreational drugs
Typically found in urine (recent drug abuse)
T/F DOA testing cant show difference between acute/chronic abuse/time frame/dosage
true
Describe DOA testing
what kind of approach
may auto detect?
screening pannel
two tiered approach screen and spot test/may auto detect chemicals of related substances
High spec/sensitivity
GC-MS
Screening pannel: + drug above cut off
- drug blow cut off
Describe methaphetimines/amphetimines
therapy for?
Stim?
Chronic use?
Overdose?
Otc?
Cross reactivity?
Confirmation?
Therapy for ADD/narcolepsy
Stimulator with high abuse potential
Chronic use: dependancy/tolerance
Overdose rare
OTC-ephedrine/pseudo are related chemicals
Urine cross react with OTC
Confirm with GC-MS
Describe sedatives/hypnotics
What do they do?
What types are most common for abuse and most found?
what does it cause?
What increases potency?
CNS depressants
wide roles/abuse
BARBITURATES/BENZODIAZEPINES
(most common for abuse and most found)
Respiratory depression - serious toxic effect
Potency increased with ethanol use
Describe Barbiturates
how quick?
presence?
Sleep inducers
“downers” after cocaine high
fast acting
presence use within 3 days
Describe Benzodiazapines
addiction?
met?
found?
diazapam?
+?
CNS depressants
eff/low addiction
metabolized quickly
only found in urine
5-20 +
DIAZAPAM - IN URINE WITHIN 30 MIN
Describe Cannaboids THC
what type of compound
most abundant?
chronic use/elim?
major product?
testing sensitivity?
phsychoactive compound in weed
THC most abunt - hashish
Chronic use not well established
Slow elimination
MAJOR PRODUCT - THC-COOH
tetsing is sensitive: passive inhalation
T/F THC is not rapidly removed by lipophine
false it is?
T/F THC is passively diffused into the brain and fats
true
Describe Cocaine
local?
high?
alk…
acute tox
rapid?
local anesthetic
High concentration potent CNS stimulator
Alkaloid salt
Acute toxicity- hypertension
Rapid hepatic hydrolysis to inactive metabolism excreted in urine
T/F cocaines primary factor that determines toxicity is dose and route?
whats worse?
true, worse is IV then smoking
Describe Opioids
an
related
chem mod:
common synth:
abuse?
acute overdose/high level overdose?
anesthesia
related to opium poppy
Chem mod: heroine, oxy
Common synth: Fentanyl
High abuse
Acute overdose: respiratory acidosis
High level overdose: death
Describe TCAs
attemps
blocks?
depression/mood disorders
suicide attempts
block serotonin/noepinephrine
3 ring chemical structure
Describe MDMA
how is it taken?
eliminated?
how much in urine?
ecstacy
200 types
orally, eliminated hepatic
20% in urine
Describe PCP
what kind of drug?
adverse effects?
chronic use?
“angel dust”
illicit drug/anetsthetic
Adverse: paranoia/agitation
Chronic heavy use 30 times a day
T/F PCP laced things are lipophilic
true and they go to your brain and fat
Describe Anabolic steroids
testosterone
increase muscle mass
underground labs -
toxic hepatitis/stroke/myocardial infarction
Enlarged heart
Males: testicular atrophy/sterility
Females: breast reduction/masculine traits
