Toxicology, Meds, & Drugs of abuse

Question 1

Anticonvulsants

Answer 1

Anticonvulsant or antiepileptic drugs
Administered orally
Absorbed from GI tract
Undergo hepatic metabolism and renal excretion

Question 2

Cardiac Glycosides

Answer 2

Digoxin

Question 3

Antiarrhythmics

Answer 3

Drugs induce and regulate normal cardiac rhythm
Quinidine
Lidocaine
Procainamide

Question 4

Bronchodilators

Answer 4

Theophylline

Question 5

Antimicrobial Agents

Answer 5

Aminoglycosides causing inhibition of bacterial cell walls.
Gentamycin
Tobramycin
Vancomycin

Question 6

Immunosuppresants

Answer 6

Cyclosporin

Question 7

Antineoplastics

Answer 7

Active agents against malignancy.
Methotrexate: interferes with normal cellular metabolism
Used to treat acute leukemia in children and solid tumors (ie sarcomas)
Rescue dose of leucovorin given to protect normal tissue
Therapeutic range: dose dependent on patient
Toxic effects: nephrotoxicity, nausea, vomiting, thrombocytopenia
Half-lie: does dependent

Question 8

Alcohol

Answer 8

Causes: relaxation, flushing, dizziness and inhibition.
Toxicity: unconsciousness, paralysis, death.
Complications: liver, heart and pancreas.
May also cause brain and CNS damage; malnutrition

Question 9

Alcohol
Method of Testing:

Answer 9

Alchohol dehydrogenase concerts ethanol to acetaldehyde which is coupled to the conversion of NAD to NADH

Question 10

Barbiturates

Answer 10

CNS Depressants used in
medicine as sedatives, in
seizure control and to induce sleep.
Administration: Oral, rectal, injected
Street names: Barbs, downers, red devils…
Characterized as long or short acting.
Common drugs: secobarbital, pentabarbital, phenobarbital
Effects: low doses –relaxation, memory loss, drowsiness; high doses-sleep, CNS & respiratory depression & death.

Question 11

Benzodiasepines

Answer 11

Sedatives –similar effects to alcohol & barbiturates
Valium, Librium, Ativan
Commonly used in suicide attempts: overdose rarely fatal unless used with other drugs & ETOH
Toxicity: minor respiratory depression, hypotension, coma

Question 12

Cannabinoids

Answer 12

Hallucinogens
Psychoactive compound: Tetrahydrocannabinol (THC)
Administration: Smoked or injected
Medical Use: treats nausea in chemotherapy
THC metabolite can be detected up to 3-5 days after a single use and as long as 4 weeks after chronic use because it is fat soluble

Question 13

Cocaine medical use

Answer 13

Medical Use: Local Anesthetic
Administration: IV, inhaled, smoked
Mode of action: potent CNS stimulator that elicits a sense of excitement and euphoria

Question 14

Cocaine abuse

Answer 14

Dangerous and addictive drug.
Can cause hallucinations, confusion and violence.
Death from acute cardiovascular insult
Deterioration of nasal septum
Nervousness, mood swings

Question 15

Opiates

Answer 15

Chemically modified opiates: heroin, hydromorphone, oxycodone
(percodan)
Synthetic opiates: demerol, darvon, talwin, sublimaze
Administration: oral, injection or inhaled
Effects: depression of respiratory center, cardiac damage & failure.
Treatment: opiate antagonist naloxone

Question 16

natural opiates

Answer 16

Natural Opium is derived from the opium poppy which is illegal to grow in the U.S.
Naturally occurring opiates: opium, morphine, codeine

Question 17

PHENCYCLIDINE (PCP)

Answer 17

Not a major drug in Denver area
Effects dependent upon dosage
Administration: ingested or inhaled.
Fat soluble so detected on drug screens for 7 to 30 days after use.

Question 18

Tricyclic Antidepressants

Answer 18

Antidepressants
Administration: Oral
Common drugs: amitriptyline, desiparamine, imipramine, nortriptyline
Toxicity: sweating, photosensitivity, manic excitement, tremors, blurred vision, arrhythmias

Question 19

Drug Testing:
Testing Methodologies

Answer 19

Drug Screening
EIA (ELISA) Methodology
Do Specific Gravity on Sample for adulteration
Confirmatory testing (legal & forensic cases)
GLC, HPLC
Thin Layer Chromatography