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Clinical Toxicology > Introduction > Flashcards

Introduction Flashcards

1
Q

Deals with the undesirable effects of chemicals on living systems, from individual cells to complex ecosystems.

A

TOXICOLOGY

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2
Q

Predict outcomes of exposure in human and animal populations.

A

TOXICOLOGY

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3
Q

Study adverse effects of xenobiotics on living organisms.

A

TOXICOLOGY

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4
Q

Study of adverse effects of chemical, physical, or biological agents on humans, animals, and the environment.

A

TOXICOLOGY

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5
Q

These were very popular for hunting animals (and sometimes fellow humans).

A

Arrow and dart poisons

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6
Q

the term “toxicology” is derived from _______, a Greek word which when translated reads, “__________________”.

A

toxicon, poison into which arrowheads are dipped

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7
Q

Ordeal poison

A

Physostigmine (Physostigma venenosum) or “Calabar bean” & Amygdalin from peach pits.

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8
Q

Common arrow poison

A
  • Cardiotoxic plants: Strophanthin, aconitine, and Helleborus
  • Snake/Toad venom
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9
Q

40-80 AD
Greek Physician who classify poisons into 3 groups: Animal, vegetable and mineral (De Materia Medica)

A

DIOSCORIDES

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10
Q

204-135 BC
Greek Physician who began experimenting animal poison using condemned criminals

A

NICANDER

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11
Q

370-286 BC
Early treatise on plant poisons (De Historia Plantarum)

A

THEOPHRASTUS

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12
Q

1198
Treatise on Poisons and their Antidote (Insects, snakes and mad dogs.)

A

MAIMONIDES (Moses ben Maimon)

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13
Q

1493 – 1541
* Studied Dose-response relationship.
* First scientific approach in toxicology.
* “The dose makes the poison”

A

PARACELSUS

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14
Q

1787 – 1853
* Father of modern toxicology.
* Advocate practice of autopsy.
* Published “Traite des Poisons” – foundation of forensic toxicology

A

Mathieu Joseph Bonaventure Orfila

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15
Q

12th Century BC.
An Indian collection that contains religious, knowledge and praises. Some contents describe plant poisons.

A

RIG VEDA

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16
Q

470 – 399 BC
Executed by the administration of hemlock (Conium maculatum).

A

SOCRATES

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17
Q

The tale leads to the use of the word “Mithridates” as an antidote or protective mixture.

A

THE TALE OF KING MITHRIDATES VI

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18
Q

138 to 78 BC
Issued “Lex Cornelia” – law against poisoning. Became a regulatory statute directed at careless dispensers of drugs

A

SULLA

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19
Q

1480
Warned of the toxicity of Hg and Pb from goldsmithing

A

ELLENBOG

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20
Q

1556
Published short treatise on mining disease (Miner’s sickness) other were published by Paracelsus.

A

AGRICOLA

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21
Q

1770
Published “Discourse on the Diseases of Workers”– discussed occupation ranging from miners to potters.

A

RAMAZZINI

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22
Q

1775
Recognition of the role of soot in scrotal cancer among chimney sweeps.

A

POTT

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23
Q

1797 – 1882
Published a simplified English version of “A Treatise on Poisons”.

A

COSTILL

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24
Q

1848
First published work on clinical toxicology “Practical Treatise on Poisons”

A

CHRISTISON

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25
Q

1850-1929
Published early work on the toxicity of narcotics, mathanol, glycerol and chloroform

A

LEWIN

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26
Q

Focus of the Study

  1. Mechanism
  2. Symptoms
  3. Detection
  4. Treatment
A
  1. Mechanism: How toxicity occurs
  2. Symptoms: What are the clinical manifestations?
  3. Detection: Confirmatory test and identification
  4. Treatment: Antidote and management
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27
Q

The incidence of poisoning in ______ is among the highest in the world

A

India (50,000/yr)

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28
Q

CAUSES OF POISONING

A
  • industrial
  • accidental
  • deliberate
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29
Q

COMMON AGENTS THAT CAUSES TOXICITY

A
  1. Pesticides: organophosphates
  2. Sedatives: BZD, barbiturates
  3. Chemicals: corrosives (acids and bases)
  4. Alcohols: ethanol and methanol
  5. Plant toxins: datura, oleander, Strychnos, Castors
  6. Households: cleaning agents
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30
Q

PHYSIOLOGY AND PHARMACOLOGY

A

By using toxic agents to understand the medicinal and the physiologic phenomena.

IMPORTANCE AND CONTRIBUTION

Ex. Use of muscarine and nicotine (Cholinomimetic drugs)

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31
Q

IDENTIFICATION AND QUANTITATION

A

Hazards resulting from occupational exposure to chemicals and the public aspects of chemicals in air, water, food, drugs and other parts of the environment

IMPORTANCE AND CONTRIBUTION

Lead containing paints or gasoline fume inhalation

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32
Q

DISCOVERY AND DEVELOPMENT

A

Contribution in new formulation, development and innovation. Participation in the discovery of new drug and pesticides.

IMPORTANCE AND CONTRIBUTION

clinical trials

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33
Q

STANDARDIZATION AND REGULATION

A

Participate in developmental standard designed to protect human health and environment from adverse effects of chemicals.

IMPORTANCE AND CONTRIBUTION

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34
Q

AREAS IN TOXICOLOGY

A
  • mechanistic toxicology
  • regulatory toxicology
  • risk assessment
  • descriptive toxicology
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35
Q

Concerned with the mechanism by which chemicals exert their toxic effects on living organisms.

A

MECHANISTIC TOXICOLOGY

AREAS IN TOXICOLOGY

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36
Q

Often lead to the development of sensitive predictive test useful in risk assessment, design and production of safer alternative chemical and rational therapy for chemical poisoning and treatment of disease

A

MECHANISTIC TOXICOLOGY

AREAS IN TOXICOLOGY

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37
Q
  • Toxicity testing
  • Provides necessary information for safety evaluation and regulatory requirements.
A

DESCRIPTIVE TOXICOLOGY

AREAS IN TOXICOLOGY

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38
Q
  • Concerned with the responsibility of deciding on the basis of data provided by the descriptive toxicologist if a drug or other chemical posses a sufficiently low risk to be marketed for stated purpose
  • Concentration based standard of “safe” exposure
A

REGULATORY TOXICOLOGY

AREAS IN TOXICOLOGY

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39
Q

Concerned with the medico legal aspects of the harmful effects of chemicals on humans

A

FORENSIC TOXICOLOGY

SPECIALIZED AREAS OF TOXICOLOGY

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40
Q

Aids in establishing the cause of death and in criminal investigation.

A

FORENSIC TOXICOLOGY

SPECIALIZED AREAS OF TOXICOLOGY

41
Q

Within the realm of medical science concerned with disease caused by, or uniquely associated with toxic substances

A

CLINICAL TOXICOLOGY

SPECIALIZED AREAS OF TOXICOLOGY

42
Q

Involved in emergency medicine and poison management

A

CLINICAL TOXICOLOGY

SPECIALIZED AREAS OF TOXICOLOGY

43
Q

Develop treatment emergency poison antidotes regimens for ameliorating poisoning and xenobiotic injury.

A

CLINICAL TOXICOLOGY

SPECIALIZED AREAS OF TOXICOLOGY

44
Q

Focuses on the impacts of chemical pollutants found in the environment biological organisms

A

ENVIRONMENTAL TOXICOLOGY

SPECIALIZED AREAS OF TOXICOLOGY

45
Q

Studies chemicals that are contaminants of water, soil or air food

A

ENVIRONMENTAL TOXICOLOGY

SPECIALIZED AREAS OF TOXICOLOGY

46
Q

Also associated with the studies of chemical effects on animals

A

ENVIRONMENTAL TOXICOLOGY

SPECIALIZED AREAS OF TOXICOLOGY

47
Q

Deals with the chemicals found in the workplace

A

OCCUPATIONAL TOXICOLOGY

SPECIALIZED AREAS OF TOXICOLOGY

48
Q

Protects workers from toxic substances and makes their work environment safe

A

OCCUPATIONAL TOXICOLOGY

SPECIALIZED AREAS OF TOXICOLOGY

49
Q

Identify the agents of concern, define conditions leading to their use, and prevent the absorption of harmful amounts

A

OCCUPATIONAL TOXICOLOGY

SPECIALIZED AREAS OF TOXICOLOGY

50
Q

It is the application of new and modern methods of technologies for early detection of toxicants in the field setting or practice area.

A

APPLIED TOXICOLOGY

SPECIALIZED AREAS OF TOXICOLOGY

51
Q

Study of adverse effects on the developing organism

Ex. Teratology

A

DEVELOPMENTAL TOXICOLOGY

SPECIALIZED AREAS OF TOXICOLOGY

52
Q

Focuses on the study of the occurrence of adverse effects on the male and female reproductive system.

A

REPRODUCTIVE TOXICOLOGY

SPECIALIZED AREAS OF TOXICOLOGY

53
Q
  • Every known chemical has the potential to produce injury if it is present in sufficient amount.
  • For a given chemical, each of the various effects that may occur in a given organism will have their own dose-response relationship
A

LETHAL DOSE 50 (LD50)

GENERAL CHARACTERISTIC OF TOXIC RESPONSE

54
Q

Generally refers to toxic substances that are produced by biological system such as plants, animals or bacteria

A

Toxin

55
Q

Toxic substances produces by or a by-product of human activities.

A

Toxicant

56
Q

SPECTRUM OF UNDESIRED EFFECTS

A
  • Allergic reactions/Sensitization
  • Idiosyncratic reaction
  • Immediate vs. delayed toxicity
  • Reversible vs. irreversible effects
  • Local vs. systemic toxicity
  • Interaction of chemicals
57
Q

Occur in hypersensitive individuals or after sensitization in allergic or sensitized persons.

e.g. Reaction ranges from skin irritation to anaphylactic shock

A

ALLERGIC REACTION

58
Q

Occur in individuals who have genetic polymorphism that lead to structural changes in biomolecules, making them very sensitive to chemicals.

A

IDIOSYNCRACTIC REACTION

59
Q

Most chemicals exert their effects soon after exposure.

A

IMMEDIATE TOXICITY

60
Q

Others may be delayed for days to years (cancer)

A

DELAYED TOXICITY

61
Q

Depends on tissue’s ability to regenerate itself at a variety of levels: molecular, cellular and tissue

Liver vs. CNS

A

REVERSIBLE VS. IRREVERSIBLE

62
Q

Corrosives and irritants act locally, little goes systemic.

e.g. Eyes and skin

A

LOCAL

63
Q

Systemic effects in sensitive (not always highest concentration) tissues.

e.g. CNS, circulatory and blood, visceral organs

A

SYSTEMIC

64
Q

Combined effect is the same as the sum of effects when given alone

Ex. CNS depressants + Alcohol | Amphetamine + caffeine

A

ADDITIVE

CHEMICAL INTERACTION

65
Q

combined effects are much greater than the sum of effects when given alone

Ex. CCl4 and EtOH | Pyrethroids and piperonyl butoxide (PBO)

A

SYNERGISTIC

CHEMICAL INTERACTION

Note: Pyrethroids and piperonyl butoxide(PBO) - a pesticide synergist (knock-down effect)

66
Q

Exposure to a chemical with no toxicity increases the toxicity of another compound

Ex. CCl4 and isopropanol

A

POTENTIATION

CHEMICAL INTERACTION

67
Q

Co-administration of two chemicals interferes with the toxicity of both or one of them.

Ex. Antidotal therapies

A

ANTAGONISM

CHEMICAL INTERACTION

68
Q

Chemicals counterbalance each other by exerting opposite physiological function

Ex. Convulsions treated with benzodiazepines

A

FUNCTIONAL

TYPES OF ANTAGONISM

69
Q

Chemical reaction between two compounds leads to less of the toxic compound

Ex. Chelators and metals

A

CHEMICAL (or inactivation)

TYPES OF ANTAGONISM

70
Q

An antitoxin active against the venom of a snake, spider, or other venomous animal or insect.

ex. of chemical antagonism

A

Antivenins

71
Q

Disposition of toxic chemical is changed so that concentration and/or duration is diminished.

Ex. Ipecac, charcoal, pH alteration, metabolism, induction or inhibition

A

DISPOSITIONAL

TYPES OF ANTAGONISM

72
Q

Chemicals compete for the same receptor, decreasing effective binding of toxic compound.

Ex. Naloxone and morphine

A

RECEPTOR

TYPES OF ANTAGONISM

Tamoxifen and estradiol – antagonist of the estrogen receptor in breast tissue

73
Q

A state of decreased responsiveness due to a prior exposure to the same or a structurally similar chemical in an individual

A

TOLERANCE

74
Q

A decreased amount of chemical reaches the site where the effect is produced

A

DISPOSITIONAL TOLERANCE

TYPES OF TOLERANCE

75
Q

Same amount of chemical reaches the site, but target receptor response decreased

A

RECEPTOR TOLERANCE

TYPES OF TOLERANCE

76
Q

A selective process (evolution) by which sensitive individuals do not survive and only those with a genetic trait that accommodates the chemical survive.

A

RESISTANCE

77
Q

A prompt and marked disturbance of function or death within a short time.

A

ACUTE POISONING

TYPES OF POISONING

78
Q

that are caused by:
* Taking a strong poison
* Excessive single dose of a drug
* Several small doses but frequent administration of a drug

A

ACUTE POISONING

TYPES OF POISONING

79
Q

Marked by a gradual deterioration of function of tissues and may not result in death

A

CHRONIC POISONING

TYPES OF POISONING

80
Q

due to:
* Taking several small doses of drugs at long intervals
* Taking only toxic doses of the drug

A

CHRONIC POISONING

TYPES OF POISONING

81
Q

<24 hrs, generally a single dose

A

ACUTE

DURATION OF EXPOSURE

82
Q

Usually dietary

A

REPEATED

DURATION OF EXPOSURE

83
Q

Repeated exposure for a month or less

A

SUBACUTE

DURATION OF EXPOSURE

84
Q

Repeated exposure for 1-3 months

A

SUBCHRONIC

DURATION OF EXPOSURE

85
Q

Exposure > 3 months

A

CHRONIC

DURATION OF EXPOSURE

86
Q

Benzene:

Acute Exposure: ?
Chronic Exposure: ?

A

Acute Exposure: CNS Narcosis
Chronic Exposure: Bone marrow damage and leukemia

DIFFERENT OUTCOMES OF EXPOSURES

87
Q

Cigarette smoke

Acute Exposure: ?
Chronic Exposure: ?

A

Acute Exposure: CNS Stimulation
Chronic Exposure: Pharyngeal, laryngeal, mouth, lung, esophageal, pancreas, bladder cancer and emphysema

DIFFERENT OUTCOMES OF EXPOSURES

88
Q
  • Contributed by circumstances or deduced from occurrences and facts
  • Not strong evidence

Ex. various Motives for poisoning, purchasing the poison keeping the materials used, etc.

A

CIRCUMSTANTIAL OR MORAL EVIDENCE

EVIDENCE OF POISONING

89
Q
  • Includes symptoms observed during poisoning.
  • This is not conclusive though some disease may be present and similar symptoms may be observed as those of poisoning

Ex. Arsenic poisoning is like cholera, alcoholic coma may stimulate diabetic coma

A

SYMPTOMATIC EVIDENCE

EVIDENCE OF POISONING

90
Q
  • Obtained by chemical analysis of the suspected substance, or the vomitus or secretion of the body.
  • This alone is not reliable because the poison may be decomposed or changed or it may have been placed anywhere after death.
A

CHEMICAL EVIDENCE

EVIDENCE OF POISONING

91
Q

Evidence from examination of tissues and organs after death

A

POST – MORTEM EVIDENCE (AUTOPSY)

EVIDENCE OF POISONING

92
Q
  • Obtained by administering the suspected substance to some living animal and noting the effects or symptoms.
  • Not very conclusive procedure since tolerance may not be the same as in man.
A

EXPERIMENTAL EVIDENCE (PHYSIOLOGIC TEST)

EVIDENCE OF POISONING

93
Q

major route of entry of poison in the industrial settings

Atmospheric (Sulfur oxides, pollutants nitrogen
oxides, carbon monoxide and dioxides)

A

Inhalation

ROUTES OF EXPOSURE

94
Q

water and soil pollutants

A

Ingestion

ROUTES OF EXPOSURE

95
Q

Broad range effects can be found with many drugs or chemicals with sufficient exposure.

A

CHEMICAL EXPOSURE

96
Q

EFFECTS OF CHEMICAL EXPOSURE

A
  • neurotoxicity
  • blood and immunity
  • reproductive and genetic alterations
  • cardiovascular
  • respiratory
  • nephrotoxicity
97
Q
  • Describes the response of an individual organism to varying doses of chemical
  • Often referred to as “Graded” response because the measured effect is continuous over a range of doses
A

INDIVIDUAL DOSE-RESPONSE RELATIONSHIP

DOSE-RESPONSE RELATIONSHIP

98
Q
  • Characterizes the distribution of responses to different doses in population.
  • Population that responds at each dose vs. the log of the dose administered is obtained.

The effective dose (ED50), toxic dose (TD50), and lethal dose (LD50) are extracted from experiments carried out in this manner.

A

QUANTAL DOSE-RESPONSE RELATIONSHIP

DOSE-RESPONSE RELATIONSHIP

99
Q

VARIATION IN TOXIC RESPONSES

A
  • Selective toxicity
  • Species differences
  • Individual differences in response [Genetic polymorphism (aka idiosyncrasy)]

Clinical Toxicology (3 decks)

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