Toxicology Flashcards
Results from a single, short-term exposure to a substance causing immediate toxic effects
Acute toxicity
Results from repeated, prolonged exposure at doses insufficient to cause immediate response; may affect different systems
Chronic toxicity
THERAPEUTIC DRUGS COMMONLY ABUSED
Analgesic, antipyretic, anti-inflammatory; causes mixed acid-base disorders (metabolic acidosis → respiratory alkalosis), Reye’s syndrome
Acetylsalicylate (Aspirin)
THERAPEUTIC DRUGS COMMONLY ABUSED
Preferred over aspirin in patients with bleeding disorders; toxic effect: hepatotoxicity
Acetaminophen (Tylenol)
ILICIT DRUGS
Stimulants: Local anesthetic, primary metabolite: benzoylecgonine; short half-life of 1-2 hours
Cocaine
ILICIT DRUGS
Used to treat narcolepsy, commonly known as ‘shabu’
Stimulants: Amphetamines (Methamphetamine)
ILICIT DRUG
Designer drugs: Euphoria-producing synthetic phenylethylamine
MDMA (Ecstasy)
ILICIT DRUGS
Depressants classification: Barbiturates (Secobarbital, Pentobarbital, Amobarbital, Phenobarbital)
Sedative-hypnotics
THERAPEUTIC DRUGS COMMONLY ABUSED
Depressants classification: benzodiazepines (Diazepam, Chlordiazepoxide, Lorazepam)
Minor tranquilizers
THERAPEUTIC DRUGS COMMONLY ABUSED
Depressants: Not structurally similar to barbiturates but has similar properties
Methaqualone (Quaalude)
THERAPEUTIC DRUGS COMMONLY ABUSED
Opiates/Narcotics: Naturally occurring (Opium, Morphine, Codeine), Chemically modified (Heroin, Hydromorphone, Oxycodone)
Used for sedation, analgesia, anesthesia
THERAPEUTIC DRUGS COMMONLY ABUSED
Opiates/Narcotics classification: Fully synthetic (Meperidine, Methadone, Propoxyphene, Pentazocine, Fentanyl)
Pain relievers
THERAPEUTIC DRUGS COMMONLY ABUSED
Primary cannabinoid component of Marijuana (Cannabis sativa)
THC; major urinary metabolite: THC-COOH
THERAPEUTIC DRUGS COMMONLY ABUSED
Structurally similar to serotonin, produces panic reactions and undulating vision
Lysergic acid diethylamide (LSD)
THERAPEUTIC DRUGS COMMONLY ABUSED
Tricyclic compound with paradoxical symptoms
Phencyclidine (PCP)
THERAPEUTIC DRUGS COMMONLY ABUSED
Used as anesthetic for short surgical procedures in pediatric medicine
Ketamine
THERAPEUTIC DRUGS COMMONLY ABUSED
Derivatives of serotonin with hallucinogenic properties
Tryptamines (e.g., dimethyltryptamine, psilocin/psilocybin)
THERAPEUTIC DRUGS COMMONLY ABUSED
Produce effects similar to amphetamines
Piperazines
THERAPEUTIC DRUGS COMMONLY ABUSED
Psychoactive designer drugs that produce amphetamine- or cocaine-like effects, can give false positive meth result
Synthetic cathinones (Bath salts)
THERAPEUTIC DRUGS COMMONLY ABUSED
Used as sleep aids
Non-benzodiazepine agents (e.g., Zolpidem, Zopiclone)
THERAPEUTIC DRUGS COMMONLY ABUSED
CNS depressants used in pain management of musculoskeletal conditions
Muscle relaxants (e.g., Carisoprodol, Meprobamate)
OTHER TOXIC SUBSTANCES
Most commonly abused substance in the world, chronic exposure associated with toxic hepatitis and cirrhosis
Ethanol
OTHER TOXIC SUBSTANCES
Subclinical impairment, no obvious impairment
0.01-0.05% w/v BAC
OTHER TOXIC SUBSTANCES
Mild euphoria, some impairment of motor skills
0.03-0.12% w/v BAC
OTHER TOXIC SUBSTANCES
Legal intoxication in the US
> 0.1% w/v BAC
OTHER TOXIC SUBSTANCES
Loss of critical judgment, memory impairment
0.09-0.25% w/v BAC
OTHER TOXIC SUBSTANCES
Mental confusion, strongly impaired motor skills
0.18-0.30% w/v BAC
OTHER TOXIC SUBSTANCES
Impaired consciousness
0.27-0.40% w/v BAC
OTHER TOXIC SUBSTANCES
Complete unconsciousness, deep, possibly fatal coma
0.35-0.50% w/v BAC
OTHER TOXIC SUBSTANCES
Respiratory arrest
> 0.45% BAC
Enzymatic method for ethanol detection: Ethanol + NAD ADH → acetaldehyde + NADH instrument
UV
Reference method for ethanol detection
Gas-liquid chromatography (GLC)
Method for ethanol detection, measures osmolal gap
Osmometry
OTHER TOXIC SUBSTANCES
Causes acidosis, blindness, and death due to formaldehyde and formic acid formation
Methanol
OTHER TOXIC SUBSTANCES
Produces severe, acute ethanol-like symptoms that persist for a long period
Isopropanol
OTHER TOXIC SUBSTANCES
Causes severe metabolic acidosis and renal tubular damage
Ethylene glycol
OTHER TOXIC SUBSTANCES
245x greater affinity for Hb compared to oxygen, shifts oxyhemoglobin dissociation curve to the left (hypoxia)
Carbon monoxide
OTHER TOXIC SUBSTANCES
Typical in nonsmokers COHb (%)
0.5% COHb
OTHER TOXIC SUBSTANCES
Range of values seen in smokers COHb (%)
5-15% COHb
OTHER TOXIC SUBSTANCES
Shortness of breath with vigorous exercise COHb (%)
10% COHb
OTHER TOXIC SUBSTANCES
Shortness of breath with moderate exercise COHb (%)
20% COHb
OTHER TOXIC SUBSTANCES
Severe headaches, fatigue, impairment of judgment COHb (%)
30% COHb
OTHER TOXIC SUBSTANCES
Confusion, fainting on exertion COHb (%)
40-50% COHb
OTHER TOXIC SUBSTANCES
Unconsciousness, respiratory failure, death with continuous exposure COHb (%)
60-70% COHb
OTHER TOXIC SUBSTANCES
Immediately fatal COHb (%)
80% COHb
Cyanide characteristic odor
bitter almonds
Arsenic characteristic odor
garlic odor and metallic taste
Cadmium exposure effects
renal tubular damage (acute tubular necrosis)
Lead enzymes inhibited in heme synthesis pathway
ALA dehydrogenase/ PBG synthase (high urinary delta-ALA); ferrochelatase/heme synthase (high EEP - free erythrocyte porphyrin)
Mercury forms
Elemental (Hg°); Cationic/inorganic (Hg+ and Hg2+); Organic (alkyl, aryl, alkoxyalkyl forms)
Most toxic mercury form
methyl-Hg (associated with Minamata disease)
Garlic Breath
Selenium, arsenic, organophosphate
