Toxicology And Illicit Drug Confirmation Flashcards
1
Q
What is toxicology ?
A
Examination of biological samples for the presence of drugs
2
Q
What is toxicology divided into ?
A
Criminal toxicology and road traffic toxicology
3
Q
What is a receptor ?
A
A molecule on the cell membrane that responds only to specific hormones, antigens or drugs
4
Q
What is an agonist ?
A
An agonist is a drug that binds to and fully activates a receptor
5
Q
What is an antagonist ?
A
An antagonist is a drug that binds to and inhibits receptor activity
6
Q
What is a partial agonist ?
A
A partial agonist binds to a receptor weakly, it does not elicit a full effect and is blocking the receptor from being activated fully by an agonist thus has antagonist like effects
7
Q
How does GABA work ?
A
Causing membrane depolarisation by increasing the flow of negative CI ions across the membrane
8
Q
What activates GABA receptors ?
A
GABA or numerous drugs
9
Q
How does glutamate work ?
A
Increases the frequency of NA+ and CA+ ions across the membrane
10
Q
What is dopamine associated with ?
A
Pleasure and addiction
11
Q
What is the substance in alcohol that makes it alcohol ?
A
Ethanol
12
Q
What are the different types of alcohol of forensic interest ?
A
-methanol
-iso-propanol
-ethylene glycol
13
Q
What is the mechanism of alcohol ?
A
Alcohol binds to alpha sub unit of GABA receptor and increases the likelihood and potency of the GABA ligand
14
Q
How does memory loss occur ?
A
Inhibition of GABA
15
Q
Where is alcohol absorbed from ?
A
Duodenum
16
Q
How much alcohol enters the bloodstream from the stomach ?
A
20%
17
Q
Why does consumption of food slow down absorption of alcohol ?
A
Delays gastric emptying
18
Q
What is the fatal level of alcohol ?
A
> 400mg
19
Q
What does CNS depressants and the use of alcohol cause ?
A
Synergistic effect
20
Q
Why is heroin never found in toxicology results when tested for ?
A
Metabolises fast
21
Q
When can you state that it’s a heroin overdose ?
A
If 6-MAM is present in results
22
Q
What is the mechanism of heroin ?
A
- Morphine binds to opiate receptors
- Morphine inhibits GABA release
- Dopamine release no longer inhibited
23
Q
What is speedballing ?
A
Mixing heroin and cocaine and taken by injection
24
Q
What two ways does Heroin OD typically occur ?
A
-prolonged absence
-relapse
25
What is the mechanism for cocaine ?
-dopamine retake blocked by cocaine
-build up of dopamine in synaptic cleft
-effects are intense and short lived
26
What do toxicology tests for cocaine show ?
Benzoylecgonine
27
What is the psychoactive and toxic element of cocaine ?
Cocaethylene
28
What is cocaine OD typically related to ?
-cardiovascular complications
-binge use
29
What is cocaine OD accompanied by ?
-convulsions
-foaming of the mouth
-loss of consciousness
30
What is the base form of cocaine ?
Crack
31
How are crack rocks formed ?
-baking soda
-heated
-cooled quickly
32
In what form is cocaine more addictive ?
when smoked
33
What i8s the mechanism for benzodiazepines ?
-bind to gamma sub unit on GABA receptor
34
What is doctor shopping ?
visiting multiple physicians to obtain multiple prescriptions
35
What affect does ecstasy (MDMA) ?
Serotonin shock syndrome (heatstroke)
- lowers the bodies ability to regulate body temperature
36
what is the mechanism for MDMA ?
-blocks the reuptake pump for serotonin/ dopamine
-levels increase
-mental relaxation/ euphoria
37
How long can MDMA last for ?
4-8 hours
38
What conditions do amphetamines have use for ?
Narcolepsy and ADHD
39
How are amphetamines typically taken ?
Snorted or mixed with a drink- foul tasting
40
What are common side effects of methamphetamines ?
Nausea, panic attacks, compulsive repetitive behaviour and jaw clenching
41
What is road traffic toxicology ?
A branch of toxicology that focuses exclusively on drink or drug impairment when in control of motorised transport
42
What does road traffic toxicology typically involved ?
Motorists who’s driving has been adversely affected by drink or drugs
43
What officers might road traffic toxicology include ?
-Royal Navy
-airline pilots
44
What is Henry’s Law ?
Is a gas law that states that the amount of dissolved gas in a liquid is directly proportional at equilibrium to its partial pressure above liquid
45
What is the Licensing Act of 1872
Made it an offence to be ‘drunk while in charge on the highway or other public places of any carriage, horse, cattle or steam engine’
46
What happened in 1927 ?
Licensing act was extended to cover ‘any mechanically propelled vehicle’
47
What was published in 1927 by the BMA ?
‘Tests of drunkenness’
48
What is the Road Safety Act 1967 ?
Introduced the present 80mg% and 107mg% blood and urine alcohol limit (and overall 70mph speed limit)
49
What is the grand rapids study ?
Grand rapids is a town in Michigan where the first large scale epidemiological study was carried out.
50
What was the method for the grand rapids study ?
Breath samples were taken from nearly 6,000 drivers in accidents and about 7,600 drivers not in accidents
51
What was derived from the results of the grand rapids study ?
-Grand rapids curve
-related blood alcohol levels to the increased probability of being involved in an accident
52
What were the results of the grand rapids study ?
- BAC above 40-50mg you are at an increased risk of being involved in an accident
-legal limit 80mg increased risk of about 400%
- at 50mg the increased risk becomes significant
-at 100mg the increased risk becomes 600%
53
What are the effects of alcohol on driving ?
- impairs reaction time
-can induce drowsiness and fatigue (higher doses)
-can induce overconfidence and recklessness
-impairs motor coordination and impairs steering and tracking
-drivers often overcompensate by excess speed reduction
-unable to respond to challenges
54
What plant is cannabis derived from ?
Cannabis sativa
55
What is the main active ingredient in cannabis ?
Delta-9 tetrahydro-cannabinol (THC)
56
What are the three main forms of cannabis ?
-marijuana
-hashish
-hash oil
57
What form of cannabis is the least potent ?
Marijuana
58
What form is marijuana taken ?
Smoked or taken as edibles
59
What is marijuana made from ?
Dried leaves and flowers from the cannabis plant
60
What is hashish made from ?
Resin (a secreted gum) of the cannabis plant
61
How is hashish taken ?
Dried and pressed into blocks and smoked or can be added to food and eaten
62
What is the most potent form of cannabis ?
Hash oil
63
Where is hash oil obtained from ?
Thick oil obtained from hashish
64
How is hash oil taken ?
Smoked
65
How is cannabis smoked ?
-hand-rolled cigarettes
-special water pipes (bongs)
66
What are the effects of cannabinoids on the body ?
- feeling of well-being, talkativeness
-drowsiness
-loss of inhibition
-decreased nausea
-increased appetite
-loss of co-ordination (bloodshot eyes)
-dryness of the eyes, mouth and throat
-anxiety and paranoia
67
What is dabbing or budding ?
-The use of butane or carbon dioxide to extract high purity THC from cannabis resin
- The extract is typically a sticky wax oil that can be 80-90x the potency of cannabis
68
What long term effects can cannabinoids have ?
-not physiologically addictive
-habitual addiction
-effects learning and motivation
-worsen underlying mental health issues
69
How does cannabis work ?
- Cannabinoids
-endocannibinoid receptors
-The endocannabinoid system is involved in regulating a variety of physiological processes
70
What are the effects of cannabinoids on driving ?
-reduced coordination
-slower reaction times
-slower information processing
-confusion
-changes in vision, hearing and time and space perception
-cannabis has a slow elimination rate
-long term users are especially prone to a ‘baseline high’
-the effects of cannabis on driving are not noticeable until a driver is challenged
-5ng is the same risk as 150mg BAC
71
What did the government do in 2015 regarding drugs ?
Introduced fixed limits for drug driving
72
What is the THC fixed limits ?
2 ug
73
What is the benzoylecgonine fixed limits ?
50 ug
74
What is the cocaine fixed limit ?
10 ug
75
What is the 6-AM fixed limit ?
5 ug
76
What is the amphetamine fixed limit ?
250 ug
77
What is the LSD fixed limit ?
1 ug
78
What is the MDMA fixed limit ?
10 ug
79
What is the ketamine fixed limit ?
20 ug
80
What is the methylamphetamine fixed limit ?
10 ug
81
What is the morphine fixed limit ?
80 ug
82
What is the methadone fixed limit ?
500 ug
83
What are the different impairment tests ?
-pupillary examination
-modified Romberg balance test
-walk and turn test
-one leg stand test
-finger and nose test
84
Where are preliminary impairment tests conducted ?
Police station
85
What are problems with the impairment tests ?
-subjective (no scoring system, dependent on police officer)
-movements are unnatural
-hard to pass sober
-Don’t take into account emotional state/ shock
86
What is road traffic toxicology typically divided into ?
-drink driving
-drug driving
87
What is a section 4 of the RTA ?
Impairment based legislation, there is no limit, once a drug is found in your system then impairment must be proved
88
What is section 5A of the RTA ?
Drug limit legislation
89
What is the uncertainty of BAC ?
+/- 6mg
90
What are some of the main issues with psychoactive substances ?
- unknown metabolic rate and effect
-hard to detect
-cheaper to source
91
What are designer drugs ?
Chemical variants of controlled substances that have a similar effect to the controlled substance
92
Where could psychoactive drugs be bought ?
headshops
93
What were psychoactive substances in headshops often should as ?
-bath salts
-herbal scents
-research chemicals
94
What loop holes were used in headshops, meaning drugs could be sold legally ?
Magic mushrooms aren’t psychoactive when wet
95
How are illegal drugs turned into legal drugs ?
Small easy to make synthesis changes
96
What is the price of spice ?
3 grams in foil sachet about £20
97
Who was spice distributed by ?
‘Psyche Deli’- then based in London
98
What is spice declared as ?
Mixture of the usual herbal high materials that are sprayed with chemicals
99
What is the spice range ?
-spice diamond
-spice gold
-spice silver
100
What did reports on spice say about the effects reported by users ?
-naive users
-placebo effect
-psychosomatic effect
101
What was identified in 2008 (spice) ?
JWH-018 the major component of spice, which a synthetic cannabinoid receptor agonist
102
Why were forensic scientist’s wrong about spice ?
Mass spectrometry didn’t know what it was looking for
103
What happened when researchers were looking for cannabinoids for medical use ?
They discovered materials that make users really high and weren’t useable in medical applications
104
Why is it argued in some cases whether drugs were the cause of death ?
Actions might not have happened if the individual wasn’t under the influence
105
What are the withdrawal symptoms of spice ?
Headaches, anxiety, low mood, difficulty concentrating and irritability
106
What is the difference between spice and cannabis ?
- JWH-018 doesn’t accumulate in peripheral tissues or albumin deposits, whereas THC accumulates in tissues for weeks
- No time delay in absorption, No metabolic break down product, whereas THC has a 10-15 min delay following inhalation
-spice appears to cause withdrawal symptoms whereas THC doesn’t cause significant withdrawal or hallucinogenic episodes
107
What has the UK drafted to control spice products ?
Five generic controls on known ‘families’ of materials in spice
108
What is the problem with the UK controls drafted for spice ?
Suppliers rapidly switch to ‘second generation materials outside the control materials which are even more potent
109
What did research in 1973 show ?
Effects of benzylpiperazines (BZP) similar to amphetamines
110
Where did BZP appear ?
In New Zealand as ingredients of ‘party pills’
111
How do BZP’s work ?
Affect serotonin release and uptake
-mild stimulant and some hallucinogenic effects
112
What is mephedrone structurally similar to ?
Amphetamine
113
What does mephedrone cause ?
Euphoria and feelings of pleasure
114
Where is mephedrone popular ?
-raves
-working professionals
-same sex drug users
115
How does mephedrone work ?
Acts as both serotonin agonist and blocks the reuptake of serotonin and dopamine
116
What is the legal status of mephedrone ?
Officially banned as register as a Class B drug in 2010
117
Why have CNS depressants not been touched by designer drugs ?
The ease of access, cost and purity means that there was no real gap in the market
118
What is the most notorious CNS depressant ?
Etizolam, an unclassified benzodiazepine that is 10x the strength of Valium
119
What are the challenges in forensic science of designer drugs ?
Typical confirmatory analysis (GC-MS and LC-MS) identify compounds by using an analytical library
-if the compounds is not contained in that library you will not be able to detect it
120
What is the analogue approach ?
- controlled substance analogue
-similar structure, similar effect and intended for human use
-has to be argued in court
121
What is the neurochemical approach ?
-classify by the effects on brain, not by chemical structure
122
What is a blanket ban ?
General prohibition on sales- all psychoactive materials banned from sale
123
What are the exemptions in the blanket ban ?
Medicines, alcohol, nicotine, caffeine and foods
124
What country is believed to be the main source of NPS ?
China
125
What is chinas view on NPS ?
‘We don’t have an NPS problem in china, our producers don’t know that their product is misused’
126
What is the world anti-doping agency ?
Set up WADA to have equal representation from the Olympic movement and public authorities
127
What does WADA do ?
-Conduct unannounced out of competition doping control
-Developing the world anti-doping code
-funding scientific research to develop new detection methods
128
What is the Uk branch of WADA ?
UKAD set up in 2009
129
What is the definition of doping ?
The use of expedient (substance or method) which is potentially harmful to athletes health and/or capable of enhancing their performance
130
What does doping include the attempt of ?
Masking the use of suspected drugs or attempts to avoid/ distrust testing
131
What drugs are used in shooting ?
Beta blockers
132
What effects do steroids have on?
Androgenic effects that increases bodily hair growth, deepening of voice, skin and sex organ changes
133
What is the purpose of steroids ?
Increases muscle synthesis, increases fat loss, decreases fatigue and improves recovery
134
What is the major goal of all steroids ?
To directly or indirectly increase testosterone production
135
What side effects do steroids have ?
- liver cirrhosis
-natural testosterone production stops
136
How do steroids work ?
-Testosterone binds to Androgen receptor (AR).
-AR receptor is activated (5a reductase/ DHT) phosphorylation and dimerization)
-AR translocate to the nucleus where it activates transcription factors and increase protein synthesis and muscle production
137
How are steroids tested ?
First using radioimmunassay, now using mass spectrometry
138
What is relied on for the testing of steroids ?
The ratio of epitestosterone to testosterone to find steroid abuse. (4:1 testosterone to epitestosterone)
139
What did BALCO develop ?
An undetectable performance enhancing drug- the ‘cream’ and the ‘clear’
140
What was the cream and the clear ?
- Tetrahydrogestine is a androgen agonists that promotes muscle production very similar to DHT
- The ‘cream’ was a topical mixture of testosterone and epitestosterone that would allow users to sue up to a 100mg a day without detection
141
How can steroids be taken ?
Taken orally or injected
142
When does doping occur ?
-doesn’t occur at the event
-done out of competition
-alt helmets use a steroid cycle and cycle off steroids as competition approaches
143
What did WADA impose to regulate steroid cycling ?
A whereabouts system and a three strike missed test
144
What is the Human growth hormone ?
A naturally occurring hormone, that is typically produced in teenagers and early adolescents
145
How is HGH medically used ?
To treat children with thyroid/ stunted growth
146
What are the side effects of using HGH ?
-acromegaly
-swelling of hands and feet
-dentition problems
147
What is blood doping ?
Extraction, storage and re-injection of blood
148
Why do athletes use blood transfusions ?
boost red blood cells that aren’t depleted ( have O2)
149
What is the mechanism of blood doping ?
-EPO is produced in the kidney and binds to active EPOR sites on the erythroid progenitor.
-The resultant JAK and STAT activation in turn activates cell proliferation and survival.
150
What is EPO ?
A naturally occurring hormone produced by the kidneys that elevates RBC production
151
What was EPO originally used for ?
Medical treatment of anaemia in kidney disease and cancer patients
152
What sport required the use of EPO ?
Cycling
153
What did numerous riders die from the use of EPO ?
Myocardial infraction and ischaemia
154
What was introduced to try and control the abuse of EPO ?
A 50% haemocrit level
155
What was the problem with the haemocrit level for EPO ?
By injecting a bag of saline it would reduce the level of red blood cells
156
What are the two types of blood transfusion ?
Autologous or homologous
157
What is the biological passport for blood doping ?
Works by measuring reticulocytes and haemoglobin ratio
158
What would happen when taking EPO according to the biological passport ?
Lead to an increase in reticulocytes
159
What is a therapeutic use exemption ?
A special dispensation that allows an athlete to use a medicinal product without the risk of ban
160
What drugs are typically allowed for a TUE ?
Corticosteroids anti-congestants or painkillers
161
What is the problem with TUE ?
The use of these drugs especially at elevated doses can infer a competitive advantage
162
What is the most commonly reported prohibited substance to IOC laboratory’s ?
Salbutamol
163
What does dop mean ?
A narcotic potion for racehorses to reduce their performance
164
Why is doping tested in racehorses ?
- to ensure that outcomes are manipulated illegally
- to safeguard the welfare of animals
-stud and animal sales issue
165
How are samples taken for racehorses to test for doping ?
There is no predictable pattern, but liable selection can include:
-winners
-much better performers than expected
-much worse performers than expected
166
How are samples taken from the horse ?
-escorted to sampling unit
-analysed by immunoassay and by GC-MS
-any positive results are reported to the authorities
