Toxicology, Therapeutic Drug Monitoring and Drugs of Abuse Flashcards
chemicals that are not normally found/produced by the body
Xenobiotics
Routes of exposure:
ingested, inhaled, or intradermal absorption
Local effects are most common in
Intradermal absorption
Wider range of circulation
Systemic
Toxic effects can be assessed by measuring:
ALT and GGT
Most affected organ in toxicology
Liver
single exposure with violent response - severe
Acute
Multiple small dosage such as alcohol consumption
Chronic
qualitative testing (presence or absence) (immunochromatography)
Screening
high specificity and sensitivity (quantitative) (mass spectrometry: GCMS, LCMS, ICP-MS, AAS for metals)
Confirmatory
:movement of drugs and metabolites in the body in relation to time and administration
Toxicokinetics
Useful method for screening and qualitative detection
24 hour urine specimen
Recommended volume for urine specimen
60 mL
Common preservative of urine
Concentrated acid
Tube collection for most metals
Royal blue
Tube collection for Lead
Tan
Prone to loss by metabolism
Mercury and arsenic
Dose of drug: concentration of the drug at which 50% of treated individulas will experience
ED50
Dose of drug in which 50% of individuals will experience toxic adverse effects
TD50
Dose of drug in which 50% of individuals will result in mortality
LD50
CNS stimulator; elicits sense of excitement and euphoria
COCAINE
Half life of cocaine
4-7 hours
Urine metabolite of Cocaine
Benzoylecgonine
Clearance time of cocaine
3 days single use
up to 20 days for chronic use
Acute intoxication of cocaine
hypertension, arrythmia (tachycardia), and AMI
Oldest and most widely used
Can cause intense euphoria and “a sense of well-being”
Relaxing effect
Cannabinoids
Source of cannabinoids
Cannabis sativa
Metabolite of cannabinoids
Tetrahydrocannabinol (THC)
Half life cannabinoids
1 day if single use
3-5 days if chronic
Longest to be removed in the body
cannabinoids
Detection window of cannabinoids
5 days in a single use
4 weeks chronic
Crystal meth
Methamphetamine hydrochloride
party drug or tablet form of meth
3,4-methylenedioxymethamphetamine (MDMA or ecstasy)
Euphoria and Mental Alertnetss
Amphetamines
Half-life of Amphetamines
10 hours
Detection window of amphetamine
3 days
Effects of Amphetamines
CNS and Respiratory stimulation
Anorexia
Psychic stimulation and excitability
Temporary increase in mental and physical activity
Administered to ADHD to prolong attention span
Adderall
Commonly known as “angel dust” or “angel hair”
PCP - phencyclidine
Metabolite of PCP
1(1-Phenylcyclohexyl)-4-hydroxypiperidine (PCHP)
4-Phenyl-4-(1-piperidinyl) cyclohexanol (PPC)
5-(N-1-phenylcyclohexyl)amino]pentanoic acid (PCAA)
PCP acts as
Analgesic
anesthetic
stimulant
Adverse effect of PCP
Stupor and coma
Opiates are derived from
Opium poppy plant
Modified natural forms of opiates
Heroin
Hydromorphone (Dilaudid)
oxyxodone (percodan)
Syntheti/More addicitve opiates
Meperidine (Demerol)
Methadone (Dolophine)
Propoxyphene (Darvon)
Pentazocine (Talwin)
Fentanyl (Sublimaze)
Adverse effects of opiates
respiratory acidosis due to depression of respiratory centers
myoglobinuria
increase in serum indicators of cardiac damage
Sedative: Barbiturates (SePhenPen)
Secobarbital
Pentobarbital
Phenobarbital
Sedatives: Benzodiazepines (LoDiChlo) / (VaLibAt)
Diazepam (Valium)
Chlorodiazepoxide (librium)
Lorazepam (ativan)
Enhanced by alcohol consumption
Sedatives
Not allowed to collect specimen for drug analysis
employer of client
crime investigator
complainant
owner/administrator of establishment
Remote collection sites needs permit from
Bureau of Health Facilities and
Services BHFS/CHD
Types of collection:
Single: 1 container
Split: one time collection but two containers equal volume
Specimen container for urine
Urine: 30 or 60 ml, polyethylene bottle, wide mouth with screw cap
Specimen container for saliva
30 mL polyethylene bottle
Specimen container for blood
10 mL plain test tube
Specimen container for hair
Self-sealed transplant plastic bag
Specimen container for Sweat
BFAD approved sweat patch
Specimen container for tissue
screw capped plastic container
Minimum requirement for scalp hair
100 mg or equivalent
Minimum requirement for saliva
2mL single
1.5 and 0.5 split
Minimum requirement for Sweat
DOH cleared patch worn for 7 to 14 days
Minimum requirement for urine:
60 mL single
30 mL each spit sample
Minimum requirement for blood:
5 mL
procedure to account for the integrity of each specimen or aliquot by tracking and storage from point of specimen collection to final disposition of the specimen and its aliquot
Chain of custody
contain the following: all steps of collection, persons who handled the specimen, status and integrity of specimen, pertinent info
Custody and Control froms
Storage for urine
-20 deg C
Storage for hair
cool and dry place
Storage for saliva
deep frozen at leat -8 to -10 deg C
Storage for blood separated serum
immediate freeze at -20 deg C
Storage for tissue
macerated and frozen
Specimen retention: Negative
5 days
Specimen retention: Positive
Minimum of 15 days
Specimen retention judicial proceedings or upon request
up to a year
Test results are valid for
1 year from date of issue