Toxicology Flashcards
Carbon monoxide
binds to hgb 200-225x more than 02
results in tissue hypoxia & anoxia
leftward shift in o2 dissociation curve
CO specimen
EDTA whole blood
Cadmium
significant environmental pollutant
ingestion & inhalation
toxic to the kidney tubules
cadmium lab result
proteinuria
glucouria
aminoaciduria
cadmium analysis
whole blood or urine by atomic absorption
Lead general
long half life in blood, tissue, & bone
leads to anemia, GI tract, CNS damage & renal disease
lead inhibits:
delta-aminoleuvlinic acid dehydrase (ALA)
ferrochelatse
hinders vit D active forms
lead specimen
whole blood or urine & hair
atomic absorption or anodic stripping voltammetry
caustic agents
strong acids or bases in household or occupations
inhalation - pulmonary shock, edema, rapid death
ingestion - lesions in esophagus & GI tract, perforations, hematemesis, abdominal pain & shock
results in metabolic acidosis or alkalosis
Cyanide
used in industry
inhale, ingest or absorb through skin
home insulation fire produces CO & cyanide gas
cyanide mechanism
cyanide binds to heme iron, uncouples oxidative phosphorylation, depletes cell ATP levels
cyanide methods
assay by ISE on blood, & spectro methods for thiocyanate in urine
pesticides
organophosphates & carbamates inhibit acetylcholinesterase in insects & humans
acetylcholinesterase
degrades acetylcholine so it can activate the nerve impulse again
when it is inhibited the acetylcholine is not reduced & nerve is static
Acetaminophen
overdoses untreated go to hepatic toxicity & necrosis
acetaminophen & liver
detoxified by liver MFO system & is saturated -> see depletion of glutathione & increase free radical formation & damages cells
Amphetamines clinical use
used for narcolepsy & attention-deficit disorder
riddalin
amphetamine effects
initial sense of mental & physical capabilities beyond normal
then feelings of irritability & psychosis
amphetamine overdose
hypertension, cardiac arrhythmias, convulsions, paranoia & death
amphetamine cross-reacts w/
over the counter meds : ephedrine, pseudoephedrine & phenylpropanolamine
problems during immunoassays
Anabolic steroids chronic use
toxic hepatitis, accelerated atherosclerosis, abnormal plt aggregation (stroke, AMI) enlargement of heart muscle w/o necessary vascularization
sudden death
testicular atrophy, sterility & impotence
screening for anabolic steroids
look for ratio of testosterone to epitestosterone T/E ratio
elevated T/E ratio
means exogenous testosterone present
cannabinoid active ingredient
THC
delta-9-tetrahydrocannabinol
lipid soluble- slow to eliminate
cocaine effects
CNS stimulate
euphoria
increased alertness
toxicity: hypertension (stroke), arrhythmias, seizures, MI
cocaine metabolism
half life is 30 mins-1 hr
metabolized by liver hydrolysis (!)
cocaine analysis
look for benzoylecgonine metabolite in urine
opiates
natural: opium, morphine, codeine
chemically modified: heroin, hydromorphine, oxycodone
synthetic: merperidine, methadone, propoxyphen, pentazocine, fentanyl
antidote for opiate overdose
naloxone
opiate effects
pain relief
acute toxicity: decreased respiratory rate, MYOGLOBINURIA, CARDIAC DAMAGE
Barbiturates
CNS depressants, sedative hypnotics
lethargy & slurred speech followed by respiratory depression & hypotension
Benzodiazepines
act on CNS to potentate GABA
overdose - lethargy & slurred speech followed by respiratory depression & hypotension
