E3-Toxicology/HeavyMetals(Powerman5000)

Question 1

Defined as the range of response per dose

􏰂 An individual may require a higher/lower dose to produce the desired effect

Answer 1

Biological Variation

Question 2

Response of the patient to the drug is QUALITATIVELY different from the usual or expected response

Answer 2

drug idiocycracy

Question 3

Geriatrics- Give (lower/higher)? dose

Answer 3

lower

Question 4

A rapid development of tolerance…example?

Answer 4

TachYphylaxis-local anethesia

Question 5

Dose of a drug that kills 50% of the total numbers of mice that received it

Answer 5

Lethal Dose (LD)

Question 6

Dose of a drug that causes an effect in 50% of the total numbers of mice that received it

Answer 6

Effective Dose (ED)

Question 7

Margin of safety = ?/?….Acceptable margin of safety is _____ or more

Answer 7

LD50/ED50… 2000

Question 8

Also known as chronic toxicity studies
􏰂 Daily dosing to rats and dogs from 3 months
to 2 years
􏰂 Observe for toxicities, evaluate blood chemistries
􏰂 Sacrificed, then evaluate histopathology
􏰂 Many toxic effects appear only after repeated dosing over many months or years

Answer 8

long term toxicology

Question 9

Theraputic Index = ?/?

Answer 9

TD50 (toxic) /ED50 (effective)

Question 10

Study of the absorption, distribution, metabolism and excretion of toxic parent compounds and metabolic products
􏰂 Used to predict the concentration of toxin that reaches the site of injury and the resulting damage

Answer 10

Toxicokinetics

Question 11

There are 3 primary sites of absorption into the body:

Answer 11

– Gastrointestinal tract – Respiratory tract

– Skin

Question 12

Rate of distribution to a particular tissue is related to the amount of ______ to the tissue

Answer 12

blood flow

Question 13

Concentration of the toxin in each tissue is determined by the ______ of the toxin for the tissue

Answer 13

affinity

Question 14

Cross cell membranes
– _____ soluble cross directly
– ______ soluble = cross through channels/pores through receptor-mediated mechanisms

Answer 14

Lipid…… Water

Question 15

Toxins that are _____-soluble molecules (polar) have difficulty crossing the blood brain barrier

Answer 15

water

Question 16

Occurs primarily in the _____ Process is called = detoxication….Nontoxic materials may be converted into toxic metabolites after undergoing metabolism in the _____
􏰂 Process is called = toxication

Answer 16

liver…liver

Question 17

In summary, toxins can undergo 3 types of changes with metabolism (just like drugs):

Answer 17

(active to inactive)…(inactive to active)…(active to active)

Question 18

Renal excretion of _____-soluble molecules

Answer 18

water

Question 19

Lead = stored in _____ for decades following exposure

Answer 19

bones

Question 20

DDE = a metabolite of the pesticide DDT stored for years in ____

Answer 20

FAT

Question 21

Inhaled particulates = phagocytosed (engulfed) by macrophages, but may never be eliminated
– Found in _____ and _______ at autopsy

Answer 21

lung and lymph nodes

Question 22

Reactive Species - Example __________
– Solvent used in cleaning products and in
fire extinguishers
– Not hepatotoxic in itself
– When metabolized by the liver, reacts with oxygen to form toxic organic free radicals
– These free radicals cause toxicity (renal toxicity, hepatotoxicity, liver cancer)

Answer 22

􏰂 Carbon tetrachloride

Question 23

Nerve gases and pesticides are _________________

inhibitors

Answer 23

acetylcholinesterase

Question 24

______ binds to the heme iron in the active site of the enzyme cytochrome C oxidase; inhibition of this enzyme prevents the generation of ATP

Answer 24

CN-

Question 25

Receptor-Mediated – ________ binds strongly to the iron in the active site of hemoglobin, preventing oxygen binding and reducing oxygen carrying capacity

Answer 25

Carbon monoxide

Question 26

Carcinogen = a chemical, physical or biological substance that can cause _________

Answer 26

transformation

Question 27

Most teratogens are ________ or ________

Answer 27

reactive species or metabolic inhibitors

Question 28

What is ________ toxicity? 􏰂 Examples: – Targeting a protein that is unique to the pathogen’s survival

Answer 28

selective

Question 29

Antifungal drugs are not good at ________ targeting

Answer 29

selective

Question 30

Everyone has about ___ micrograms of arsenic in body daily, but can tolerate it well

Answer 30

3

Question 31

“garlic breath” = able to diagnose this poisoning due to smell

Answer 31

arsenic

Question 32

Used for semiconductor manufacturing, increases hardness of lead, batteries, soldering materials, matches.... Used for the treatment of protozoan infections

Answer 32

antimony

Question 33

Samsung places in washing machine for antibacterial effect on clothing...Kohler has _____ ions in new toilet seats....FDA approved endotracheal tube coated with ______ to prevent ventilator-associated pneumonia (VAP)

Answer 33

silver

Question 34

Bluish-grayish pigmentation of skin and mucous membranes (Smurf looking dude)

Answer 34

Argyria (silver tox)

Question 35

Pure gold is not _____

Answer 35

toxic

Question 36

Gold ____ are toxic to liver and kidneys

Answer 36

salts

Question 37

In 1800s, was in teething powders for infants and to treat toothaches

Answer 37

Merc

Question 38

With continuing exposure, a fine tremor develops and may escalate to violent muscular spasms. Tremor initially involves the hands and later spreads to the eyelids, lips, and tongue.

Answer 38

Merc

Question 39

________ mercury = corrosive to oral cavity and gut | – Used in dental amalgam – Kidney damage

Answer 39

INORGANIC

Question 40

Enzyme inhibitor in the production of heme | – Inhibits protoporphyrin IX; accumulation of aminolevulonic acid = diagnostic

Answer 40

Lead

Question 41

______ lines are visible in teeth in children – Dark line (gray) along gingiva

Answer 41

Lead

Question 42

Antidotes: combination calcium EDTA and dimercaprol..Combination better than either agent alone

Answer 42

Lead

Question 43

Historial uses: treatment of enlarged joints and glands | 􏰀 Known to cause cancer

Answer 43

Cadmium

Question 44

Similar to lead poisoning; inhibits same processes as lead

Answer 44

Cadmium

Question 45

Complexes with trivalent ions (Ferric ions) to form ferrioxamine, which is removed by the kidneys

Answer 45

deferoxamine

Question 46

“pots and pans” senility | 􏰀 Concern for association with Alzheimer’s disease (little to no evidence)

Answer 46

Aluminum

Question 47

Exposure from electronic, steel and mining industries | 􏰀 Symptoms: dermatitis, nasal and respiratory cancer

Answer 47

Nickel

Question 48

Really the only slide that matters: Antidote? | – Arsenic, antimony, gold, mercury

Answer 48

Dimercaprol

Question 49

Really the only slide that matters: Antidote? Lead, cadmium

Answer 49

Calcium disodium edetate (EDTA)

Question 50

Really the only slide that matters: Antidote? Gold, mercury

Answer 50

Penicillamine

Question 51

Really the only slide that matters: Antidote? Iron and aluminum

Answer 51

Deferoxamine

Question 52

Really the only slide that matters: metal(s)? Dimercaprol (4)

Answer 52

Arsenic, antimony, gold, mercury

Question 53

Really the only slide that matters: metal(s)? Calcium disodium edetate (EDTA) (2)

Answer 53

Lead, cadmium

Question 54

Really the only slide that matters: metal(s)? Penicillamine (@)

Answer 54

Gold, mercury

Question 55

Really the only slide that matters: metal(s)? (2)

Answer 55

Iron and aluminum