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clinical chem 1 > toxicology > Flashcards

toxicology Flashcards

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1
Q

define toxicology

A
  • the study of adverse effects of xenobiotics
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2
Q

define xenobiotics

A
  • chemicals and drugs that are not normally found in or produced by the body
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3
Q

list 3 major disciples of toxicity

A
  • mechanistic
  • descriptive
  • regulatory
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4
Q

describe mechanistic toxicology

A
  • cellular, molecular and biochemical effects of xenobiotics w/in dose response
  • assess degree of exposure
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5
Q

describe 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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6
Q

describe regulatory toxicology

A
  • combines mechanistic and descriptive to establish levels of exposure
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7
Q

describe forensic toxicology

A
  • medical and legal consequences of exposure
  • validating analytic performance of tests
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8
Q

describe clinical toxicology

A
  • relationship between xenobiotics and disease states
  • emphasis on diagnostic testing
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9
Q

describe environmental toxicology

A

evaluation of environmental chemical pollutants and their impacts on human health

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10
Q

define toxins

A

endogenous substance biologically synthesized in living cells or in microorganisms
- toxicant and toxic = not produced in living cell

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11
Q

list most common route of exposure

A
  • ingestion
  • inhalation
  • transdermal abs
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12
Q

describe ingestion exposure

A
  • must be absorbed into circulation by GI
  • most passively diffuse
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13
Q

define dose-response relationship

A

correlates a single, acute oral dose range with the probability of a lethal outcome in an average 154 pound man

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14
Q

define therapeutic index

A

ratio of TD50 or LD50 to the ED50

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15
Q

define quantal dose-relationship

A

describe the changes in health effects of a defines population based on the exposure to the xenobiotic

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16
Q

define acute toxicity

A

usually short term exposure to a substance in which the dose is sufficient to cause immediate toxic effects

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17
Q

define chronic toxicity

A

generally associated w/ repeated frequent exposure for extended period of time at doses that are insufficient to cause an immediate acute response
- affects different systems than acute

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18
Q

list common specimen types

A

bloor or urine

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19
Q

what tube top is used for analysis of toxic agents for trace elements

A

royal blue top (trace element free)

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20
Q

what tube top is used for lead testing

A

tan top

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21
Q

list and describe steps of toxic agent analysis

A
  1. screening: rapid, simple, qualitative intended to detect presence of substances -> sensitive but lack specificity
  2. confirmatory: quantitative, report concentration of a substance (high specificity and sensitivity)
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22
Q

common methods used in screening and confirmatory test

A
  • immunoassays (drug screen)
  • gas chromatography with mass spectrometry
  • liquid chromatograph with tandem mass spec (LC-MS)
  • inorganic compounds use ICP-MS and AA
23
Q

alcohol metabolism pathway

A

alcohol -(ADH)-> aldehyde -(ALDH)-> acid

24
Q

describe effects of ethanol

A
  • accumulation of lipids in hepatocytes - 20% develop toxic hepatitis, cirrhosis is common
25
Q

list common indicators of ethanol abuse

A
  • liver markers: GGT, ALT, AST, HDL
26
Q

describe ethanol metabolic pathway

A

ethanol -> acetaldehyde -> acetate -> acetaldehyde adducts

27
Q

describe methanol

A
  • common lab solvent
  • accidental ingestion from homemade alcohol
  • formic acid final metabolite causes metabolic acidosis
28
Q

describe isopropanol

A
  • rubbing alcohol
  • metabolized by hepatic ADH to acetone
  • CNS depressant
  • can have severe acute like response over long time
29
Q

describe ethylene glycol

A
  • immediate effects similar to ethanol
  • in antifreeze
  • calcium oxalate crystals damage renal tubules
30
Q

how is alcohol determined

A
  • serum, whole blood, plasma
  • ethanol is uniform in body water = use serum
  • osmo, chromatographic, enzymatic (non human ADH to NADH)
31
Q

what is the established reference method for alcohol determination

A

headspace GC coupled with flame ionization

32
Q

describe carbon monoxide

A
  • produced by incomplete combustion of carbon substances
  • makes carboxyhemoglobin
  • treatment w/ 100% O2
33
Q

describe cyanide

A
  • inhalation, ingestion, skin abs
  • used in industrial processes, insecticides and rodenticides
  • cleared by kidneys
  • binds heme iron
34
Q

describe arsenic

A
  • natural and manmade
  • 3 main groups (gas, inorganic, organic)
  • rate of abs depends on form
35
Q

describe cadmium

A
  • significant environmental pollutant (taken up by crops and tobacco)
  • toxic to kidneys
  • concomitant parathyroid dysfunction and vitamin D def
  • itai-itai disease and cadmium rice
36
Q

describe lead

A
  • found mostly in bone and soft tissue (long half life)
  • renal elimination
  • dose dependent toxicity
  • abdominal or neurological symptoms after ACUTE exposure
37
Q

what does lead inhibit

A
  • enzymes
  • specifically vitamin D metabolism and heme synthesis
38
Q

describe mercury

A
  • 3 forms
  • contaminated food source (more common) or accidental ingestion
  • binds w/ proteins
39
Q

describe salicylates(aspirin)

A
  • can cause excess ketone formation
  • interferes w/ plt aggregation and GI function
  • high dose metabolic acidosis
  • chromogenic assay = trinder reaction
40
Q

describe acetaminophen

A
  • tylenol
  • hepatotoxicity at low doses
  • low free fraction
41
Q

confirmation testing must use what levels of specificity and sensitivity

A

high and high but different methods

42
Q

what is the most common refernce method of DOA confirmation testing

A

gas chromatograph - mass spec

43
Q

describe amphetamines

A
  • hypertension overdose but rar
  • urinalysis
44
Q

describe sedative - hypnotics

A
  • CNS depressant
  • barbiturates and benzodiazepines most common
    -> barbit: higher abuse potential
    -> benzo: more commonly found
45
Q

describe barbiturates

A
  • high abuse potential
  • sleep inducer
  • phenobarbital
46
Q

describe benzodiazepines

A
  • CNS depressant
  • used for anti-anxiety meds
  • metabolites found in urine
47
Q

describe THC

A
  • THC is a lipophilic substance and removed from circulation by passive diffusion
48
Q

describe cocaine

A
  • CNS stimulator
  • alkaloid salt
49
Q

describe opioids

A
  • chemically related to opium poppy
  • acute overdose = respiratory acidosis
50
Q

describe TCA overdose

A
  • block reabsorption of serotonin and norepinephrine
51
Q

describe MDMA

A
  • amphetamine derivative ‘ecstasy’
  • GC-MS or LC-MS
52
Q

describe PCP

A
  • angel dust
  • lipophilic drug into fat and brain
53
Q

describe anabolic steroids

A
  • toxic hepatitis
  • can cause enlargement of heart

clinical chem 1 (23 decks)

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