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Alcohol Flashcards

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1
Q

What do Drug Toxicologists do?

A

Detect and identify the presence of drugs and poisons in body fluids, tissues, and organs

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2
Q

Drugs can be either . . .

A

Illegal, legal, or pharmaceutical

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3
Q

Where do drug toxicologists work?

A

Health facilities such as hospitals and clinics as well as crime labs

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4
Q

The role of the toxicologist?

A

First attempt to narrow down type of toxic substance based on victim’s symptoms, postmortem pathological exam, exam of victim’s personal effects, nearby presence of empty drug containers or household chemicals

Next, they use general screening procedures

Test for small quantities that may be remaining

Must be aware that the body always processes substances so test for the metabolite

Must also assess for substance’s toxicity

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5
Q

What is the most frequently requested test?

A

Presence of alcohol

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6
Q

Why must drug toxicologists test for the metabolite?

A

Few substances enter and completely leave the body in the same chemical state since most are metabolized

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7
Q

What is the most widely abused drug in western countries?

A

Alcohol

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8
Q

Most of the worst effects of alcohol are not due to the alcohol, but from what?

A

psychomotor impairment

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9
Q

Due to the prevalence of abuse, laws have been instituted to regulate alcohol abuse, such as . . . ?

A

Driving while under the influence– intoxication

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10
Q

The degree of intoxication can be influenced by what factors?

A

Body weight

Rate of absorption through stomach and small intestines directly into the blood stream (influenced by presence/absence of food)

Total time taken to consume the alcohol

Type of alcohol consumed– diluted/undiluted

The longer total time required for complete absorption, the lower will be the peak alcohol concentration

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11
Q

Alcohol and the law

A

A BAC of .08% or .10% in most states in equivalent to intoxication for most drivers

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12
Q

What is the Federal standard for bus and truck operators?

A

.04%

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13
Q

When is BAC the highest?

A

An hour after consumption

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14
Q

What does “DUI” stand for?

A

Driving Under the Influence

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15
Q

Why are legislative limits for DUI different?

A

Depends on country and jurisdiction

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16
Q

What must be available to accurately determine BAC at time of arrest

A

Uniform testing

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17
Q

What happens when comparing testing vs. time of arrest?

A

Allowable level of analytical inaccuracy

  • Usually between 0.2g/L (g of alcohol per L of blood)
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18
Q

Generally, blood alcohol level drops how many mg/dL per hour?

A

15 to 20 mg/dL per hour

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19
Q

How many hours would a person with a BAL of 120 mg/dL (1.2 g/L) take to reach a negligible level?

A

6 to 8 hours

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20
Q

Driving laws

A

implied consent comes with obtaining a license to operate a motor vehicle

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21
Q

Driver has a choice:

A

Submit to test

Subject to loss of license for a given period of time

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22
Q

Legalizing alcohol

A

Methods had to be developed to assess levels of intoxication at the time of arrest

These had to be reliable to withstand court presentation

They also needed to be standardized throughout jurisdictions

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23
Q

Most commonly encountered in terms of DUI

A

Ethanol

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24
Q

Methanol

A

Highly toxic
Mainly wood grain alcohols
May cause blindness

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25
Which two drugs cause impairment but are not consumed regularly?
Isopropanol and ethylene glycol (antifreeze)
26
While alcohol is the most common source, ethanol is present in what?
Gasoline Industry solvents Household products Pharmaceuticals (hand sanitizers, mouthwash)
27
Sources of methanol
tends to be in methyl alcohol and wood alcohol
28
Methanol is mainly located in what?
Consumer products-- windshield wiping fluid, carburetor cleaners, copy machine toner Formaldehyde
29
Ethylene Glycol is found in which consumer products?
Antifreeze Hydraulic fluids Drying agents Ink
30
0.02 BAC
Relaxation, slight body warmth
31
0.05 BAC
Sedation, slowed reaction time
32
0.10 BAC
Slurred speech, poor coordination, slowed thinking
33
0.20 BAC
Trouble walking, double vision, nausea, vomiting
34
0.30 BAC
May pass out, tremors, memory loss, cool body temperature
35
0.40 BAC
Trouble breathing, coma, possible death
36
0.50 BAC and greater
Death
37
Female demographic difference in intoxication
Higher blood ethanol levels after ingesting equal doses More susceptible to alcohol-induced hepatitis and cirrhosis
38
Asians demographic difference in intoxication
50% have inactive ALDH, which increases the risk of esophageal, stomach, colon, lung, head and neck cancers
39
Effects of Ethanol on the brain
it depresses the Central Nervous System (CNS) Extent of depression is directly proportional to concentration of alcohol within the nerve cells
40
How ethanol effects the brain
Eventually alcohol will effect the central and rear portions of the brain
41
Which portions of the brain are the most resistant and last to fail due to ethanol?
In the medulla, which regulates respiration and heart activity
42
Most ethanol tests rely on what?
blood
43
The medium for distributing alcohol throughout the body
blood
44
Research confirms the direct proportional relationship of . . .
Blood alcohol concentration to brain alcohol concentration Maximum Blood Alcohol Content (BAC) may not be reached until 2-3 hours after time of consumption
45
Alcohol is readily absorbed through what?
stomach and small intestine
46
What percentage of an oral dose is uniformly absorbed?
100%
47
Ethanol transfers readily to what?
the bloodstream, portioning into all tissues, particularly those with a high water content
48
The most common, preventable cause of mental retardation in children?
Fetal Alcohol Syndrome
49
Diagnostic criteria for Fetal Alcohol Syndrome?
Heavy maternal alcohol consumption Pre and postnatal growth retardation Craniofacial malformations (e.g., microcephaly) Mental retardation
50
Because of the toxicity of ethanol, excessive alcohol consumption can damage major organs such as . . .
Liver and heart
51
Liver and Ethanol
results in cirrhosis or alcohol-induced hepatitis
52
Heart and Ethanol
Results in alcoholic cardiomyopathy
53
Ethanol also _______ the risk of stroke, hemorrhaging, as well as pancreatic problems
increases
54
Effects of methanol
Most commonly from ingestion Asymptomatic for 12 to 24 hours before: Formic acidemia (low blood pH from formic acid) Ocular toxicity Coma Death
55
Main target of methanol
retinas
56
Severe visual disturbances from ethanol develop between _____ to _____ hours after ingestion
18 to 48 hours Can range from photophobia (light sensitivity) to complete blindness
57
Effects of Ethylene Glycol
Mainly through ingestion or absorption (dermal)
58
Acute poisoning entails . . .
Inebriation (dose dependent) and neurotoxic symptoms 12-24 hours: cardiopulmonary stage Tachycardia to cardiac failure Tachypnea to pulmonary edema 24-72 hours: Renal toxicity stage Metabolic acidosis (low pH) can progress in all stages
59
Ethylene glycol is distributed through what?
Total body water
60
Ethylene glycol (EG) can cause _______ (calcium oxalate or hippuric acid) in the kidneys and brain
crystals
61
Limited chronic toxicity potential, no evidence of carcinogenicity and does not affect ______
Reproductive processes
62
** Alcohol's movement through the circulatory system
After alcohol is ingested, it moves down the esophagus into the stomach-- where about 20% of the alcohol is absorbed through the stomach lining into the portal vein Remaining 80% is absorbed into the blood through the lining of the small intestines Once in the blood, it is transported to the liver, heart, lungs, back to heart to be distributed to all parts of body During period of alcohol absorption, alcohol concentration within arterial (oxygenated) blood will be considerably higher than in venous (deoxygenated) blood This has ramifications for sampling for prosecution
63
Liver begins the elimination process of 95-98% of the alcohol by _________
oxidation
64
Enzymes involved in detoxification (biotransformation)
Alcohol dehydrogenase Aldehyde dehydrogenase Acetaldehyde and acetic acid
65
Detoxification via excretion
Remaining 2-5% is excreted unchanged in the breath, urine, and perspiration
66
Amount exhaled is in direct proportion to concentration of _______
Alcohol in the blood
67
Elimination or ______ rate can vary by 30% between individuals, but average is 0.017% w/v (weight/volume) per hour
"burn off"
68
Driving
complex process requiring psychomotor tasks, hand-eye coordination, muscle control, and cognitive tasks
69
What causes slowing of nerve conduction resulting in slower reaction times?
Alcohol
70
Identification methods for alcohol impairment
Smell Bloodshot eyes Unusual behavior Demeanor: flat, dull, excited Unusually large/small pupils Unusual eye movements Impaired motor skills Presence of alcohol containers or drug paraphernalia Clinical signs and symptoms will determine if the officer needs to do any tests for impairment
71
Who performs Field Sobriety Tests?
Police officers
72
Normally performed to ascertain the degree of the suspect's physical impairment and whether or not an evidential test is justified
Field Sobriety Test
73
These Field Sobriety Tests are psychophysical, which involves what?
The ability to think and do at the same time
74
Physiological Field Sobriety Test
Horizontal gaze nystagmus (HGN)
75
Divided attention Field Sobriety Test
One-Leg Stand Test (OLST) Walk and Turn Test (WATT)
76
Most accurate field sobriety test?
Horizontal gaze nystagmus 77% accuracy rating in detecting blood alcohol content levels of .10% or higher
77
What is nystagmus?
Involuntary jerking or bouncing of the eyeball
78
Why does HGN involve?
Moving an object (usually a finger or pen) horizontally in front of the suspect Usually about one foot away from the suspect's face at eye-level Jerking movements in the eye before the gaze reaches a 45-degree angle is indicative of a possible blood alcohol content level over .05%
79
One-Leg Stand Test
When properly administered, 65% accurate in determining if a driver has a blood alcohol content level above .10%
80
Proper stance for One-Leg Stand test?
Hands at side One leg about six inches above the ground Suspect to count upward starting at 1,000
81
Signs of intoxication for One-Leg Stand test?
Swaying while balancing Using the arms to keep balance Hopping on the anchor foot in order to maintain balance Resting the raised foot on the ground three or more times during the required thirty seconds
82
Walk and Turn Test
68% accurate in identifying blood alcohol content levels of .10% and above Putting one foot in front of the other in a straight line, toe touching the back of the last heel Suspect takes nine steps, turns around and comes back Hands must be at sides, watching the feet, and steps counted aloud
83
Walk and Turn Test signs of intoxication
Inability to stay balanced while receiving instructions Starting or stopping the test before indicated Failure to touch heel-to-toe Stepping off of the line Using arms to balance Improperly turning Using the incorrect number of steps
84
Breath tests
Roadside breath tests are done upon suspicion of toxicity Preliminary testing and later tests will be performed for confirmation
85
Most known roadside test
Breathalyzer
86
Breathalyzer
A device for collecting and measuring the alcohol content of alveolar breath
87
Breathalyzer test process
A subject blows into a mouthpiece Trapped alveolar breath can be analyzed Any alcohol present in the sample dissolves in a solution and is oxidized to acetic acid A spectrophotometer takes a reading of acetic acid content Indirectly determines the quantity of alcohol consumed (it is not quantitating alcohol but the amount of alcohol that has been oxidized)
88
Infrared
Designed to minimize operator error and free of chemical reagents Operates on infrared light absorption and/or fuel cells Infrared light absorption uses filters selected to a wavelength of infrared light at which alcohol will absorb
89
Gas Chromatography
Alcohol is separated from other volatiles in blood Compares resultant alcohol peak area to ones obtained with known blood-alcohol standards
90
Collection and preservation of blood
The collection of blood for analysis is done depending on certain factors
91
What factor of collection and preservation of blood matters most to us?
Whether the suspect is alive or deceased
92
Collection on a living suspect
Must be drawn by a qualified person (phlebotomy license) Must use a sterile needle Cleanse with a non-alcoholic disinfectant Seal blood sample in an airtight container with an anticoagulant (usually EDTA, or a "purple top tube" Place in refrigerated storage for delivery to toxicology
93
Collection of postmortem samples
Requires added precautions Must account for bacterial action so collect from several different body sites (each sample is kept in separate airtight containers with an anticoagulant and refrigerated; each must be labeled correctly) Collect urine and vitreous humor fluids (both usually do not suffer from postmortem ethyl alcohol production to any significant extent)
94

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