Toxicology Flashcards
What is the general drug class for cotinine?
Other drugs of abuse
What is the general drug class for amphetamine?
Stimulants
What is the general drug class for opiates?
Narcotics
What is the general drug class for nortiptyline?
Tricyclic antidepressants
What is the general drug class for acetaminophen?
Analgesics
What is the general drug class for lysergic acid diethylamide (LSD)?
Hallucinogens
What is the general drug class for desipramine?
Tricyclic antidepressants
What is the general drug class for ketamine?
Other drugs of abuse
What is the general drug class for ecstasy (MDMA)?
Stimulants
What is the general drug class for benzodiazepines?
Depressants
What is the general drug class for cannabinoids (THC)?
Hallucinogens
What is the general drug class for imipramine?
Tricyclic antidepressants
What is the general drug class for acetylsalicylic acid?
Analgesics
What is the general drug class for methadone?
Narcotics
What is the general drug class for cocaine?
Stimulants
What is the general drug class for short- and long-acting barbiturates?
Depressants
What is the general drug class for phenothiazines?
Other drugs of abuse
What is the general drug class for amitriptyline?
Tricyclic antidepressants
What is the general drug class for phencyclidine (PCP)?
Hallucinogens
What is the general drug class for buprenorphine?
Narcotics
What is the general drug class for methamphetamines?
Stimulants
How does CO poisoning cause its clinical effects?
Dosage makes a difference; it holds on to hemoglobin more than oxygen so it cannot transport oxygen
How do you calculate a % alcohol concentration from a result of mg/dL?
- Divide EtOH in serum (mg/dL) by 1000
- Can use a breathalyzer result x 1000 = EtOH in mg/dL
What is the toxic metabolite for EtOH?
Acetaldehyde
What are the toxic metabolites for MeOH?
Formaldehyde and formic acid
What is the toxic metabolite for isopropanol?
Acetone
What are the toxic metabolites for ethylene glycol?
Oxalic acid and formic acid
MeOH
- Osmolal gap
- Anion gap
- Metabolic acidosis
- Acetone
- Urinary oxalate crystals
- Osmolal gap: increased
- Anion gap: increased
- Metabolic acidosis: present
- Acetone: negative
- Urinary oxalate crystals: none
Isopropanol
- Osmolal gap
- Anion gap
- Metabolic acidosis
- Acetone
- Urinary oxalate crystals
- Osmolal gap: increased
- Anion gap: Normal
- Metabolic acidosis: no
- Acetone: positive
- Urinary oxalate crystals: none
EtOH
- Osmolal gap
- Anion gap
- Metabolic acidosis
- Acetone
- Urinary oxalate crystals
- Osmolal gap: increased
- Anion gap: normal
- Metabolic acidosis: no
- Acetone: negative
- Urinary oxalate crystals: none
Ethylene glycol
- Osmolal gap
- Anion gap
- Metabolic acidosis
- Acetone
- Urinary oxalate crystals
- Osmolal gap: increased
- Anion gap: increased
- Metabolic acidosis: present
- Acetone: negative
- Urinary oxalate crystals: present
In volatile ingestion, the anion gap is ____ if metabolized to acids
Increased
When metabolysis to acids occurs, it lowers the ____
pH
Who is prone to aluminum toxicity?
Dialysis and renal failure patients
Sources of lead in lead poisoning
- Heavy metal found in the environment
- Lead-based paint
- Dirt
- Lead crystal
- Lead pipes
- Ceramics
What biosynthetic pathway is inhibited in lead poisoning?
Heme synthesis
- Avid inhibition of porphobilinogen synthase → protoporphyrin accumulates in RBCs
5 typical laboratory results seen in lead poisoning
- Increased blood lead
- Increased retics
- Basophilic stippling
- Increased delta-ALA
- Increased zinc protoporphyrin
What enzyme is decreased in organophosphate and carbamate poisoning?
Acetylcholinesterase
7 categories of drugs of abuse
- Stimulants
- Depressants
- Narcotics
- Hallucinogens
- Analgesics
- Antidepressants
- Other drugs of abuse
16 drugs that are typically included in a drug of abuse urine screening test
- Amphetamine, barbituates
- Benzodiazepine, buprenorphine
- Cocaine, cotinine
- Ecstasy, ketamine
- Marijuana, methadone,
- Methamphetamines, opiates
- Oxycodone, phencyclidine
- Propoxyphene, tricyclic antidepressants
8 commonly used opiates
- Morphine
- Codeine
- Propoxyphene
- Hydrocodone
- Meperidene
- Naloxone
- Heroin
- Methadone
3 screening (qualitative) tests ofr DOA
- Immunoassays
- “Spot” urine tests
- Thin layer chromatography (TLC)
3 confirmatory (quantitative) tests for DOA
- Gas-liquid chromatography (GLC)
- High performance liquid chromatography (HPLC)
- GC-MS
5 factors that determine the level of toxicity of potentially harmful agents
- Amount of agent introduced (dose)
- Route of administration
- Number of doses
- Period of time over which the agent was administered
- LD50 (lethal dose for 50% of the population) for the agent
What organ is affected by acetaminophen toxicity?
Liver
Therapeutic uses of methadone (synthetic opioid)
- Pain relief
- Opioid abstinenece syndrome
- Treat heroin addicts to wean them from illicit drug use
Therapeutic uses for high-dose buprenorphine (semi-synthetic opioid)
- Treat opioid addiction in higher doses (>2mg)
- Control moderate acute pain in non-opioid-tolerant individuals in lower dosages (~200ug)
- Control moderate chronic pain in dosages ranging from 20-70ug/hour
What are the effects of MeOH toxicity?
- Nausea
- Headache
- Coma
- Convulsions
- Temporary or permanent blindness
What are the effects of isopropanol toxicity?
- Hypothermia
- Hypotension
- Cardiovascular complications
- Come
What are the effects of ethylene glycol toxicity?
- CNS depression
- Hypertension
- Renal failure
Symptoms associated w/ Hg toxicity
- Memory loss, mental confusion
- Allergies, irritability
- High blood pressure and heart problems, weight gain
- Fatigue, digestion problems
- Skin rashes, joint stiffness
- immune dysfunction (
- Cold feet
- Balance problems
- Acrodynia (“pink disease”)
- Myasthenia
List the common sources of MeOH
Solvent in paint products
List the common sources of isopropanol
?
List the common sources of ethylene glycol
Antifreeze
