M7: TOXICOLOLGY Flashcards by pink popcorn

is an enzyme
which serves as a marker for alcohol abuse

Gamma-glutamyl transferase (GGT)

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ALCOHOLS
TARGET

BRAIN

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Disorientation, confusion, and euphoria
 unconsciousness, paralysis, and death

ALCOHOLS

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ALCOHOL AND METHANOL
TOXIC LEVEL:

> 50 mg/dL

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(nonhemodialysis patients)

 >400 mg/dL

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(hemodialysis
patients)

 >500 mg/dL

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Ethanol
Fetal dose:

300-400 mL

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other name ethanol

 “Grain alcohol”

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 accumulation of lactic acid and ketones from alcohol

ACIDOSIS
ethanol

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inhibition of the hormone ADH

DIURESIS
-ethanol

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methanol other name

wood alcohol

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 diuresis and acidosis
 Blurred vision
 Incoordination
 Slurred speech and coma
 Hangover symptoms

ethanol

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 Blindness
 Metabolic acidosis

methanol

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 Laboratory solvent

methanol

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 Contaminant in home-made liquors

methanol

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 used to check for chemical reactions

methanol

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 Isopropyl alcohol
 rubbing alcohol

ISOPROPANOL

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METHANOL
Fatal dose:

60-250 mL

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 CNS depression
 Hypertension
 Indication of toxicity: increased acetone

ISOPROPANOL

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ISOPROPANOL
Fatal dose:

250mL

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Found in hydraulic fluid and anti-freeze substances

ETHYLENE GLYCCOL

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has a characteristic sweet taste and smell.

ETHYLENE GLYCCOL

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 presence of calcium oxalate crystals

ETHYLENE GLYCCOL

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ETHYLENE GLYCCOL
FATAL DOSE:

Fatal dose: 100 g/mL

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 Increased ______can also be found in metabolic imbalances

OSMOLAR GAP

Difference between measured and calculated osmolarity

OSMOLAR GAP

 Freezing point depression:

Increased serum alcohol concentration, increased osmolarity (directly proportional)

Most common method  non-human form of alcohol dehydrogenase

ENZYMATIC METHOD P

GAS CHROMATOGRAPHY Internal standard:

n-propanol

- the space between the liquid

Headspace or volatiles

Simultaneously measures other alcohol species

GAS CHROMATOGRAPHY

Most common method : ALCOHOLS

ENZYMATIC METHOD

 Formed from incomplete combustion of carbon- containing substances

CARBON MONOXIDE

CO + cytochrome – inhibits transport of electrons

o CO + hemoglobin o CO + myoglobin

CARBON MONOXIDE ____higher affinity with hemoglobin and impairs oxygen transport

 200x

Major toxic effect: tissue hypoxia

CARBON MONOXIDE

CAUSTIC AGENTS

-CARBON MONOXIDE -CYANIDE -METALS -PESTICIDES

CYANIDE Toxic level:

>2ug/mL

 Indication of toxicity: “cherryred” color of the face

CARBON MONOXIDE

Indication of toxicity: “Odor of bitter almonds” breath - Hallmark

CYANIDE

CARBON MONOXIDE MEASUREMENTS:

-SPOT TEST FOR EXCESSIVE CARBON --MONOXIDE EXPOSURE -GAS CHROMATOGRAPHY -SPECTROPHOTOMETRY

SPOT TEST FOR EXCESSIVE CARBON MONOXIDE EXPOSURE PRINCIPLE

5mL of 40% NaOH + 5mL aqueous solution of whole blood

GAS CHROMATOGRAPHY PRINCIPLE:

Whole blood + potassium ferricyanide to release CO from hemoglobin

Components of insecticides and rodenticides  Inhibits cellular respiration, electron transport, and ATP formation  Has capability to bind with iron

CYANIDE

CYANIDE: SPECTROPHOTOMETRY PRINCIPLE

 Whole blood + Strong acid → Hydrocyanic acid  Hydrocyanic acid + Strong base → RED COMPLEX

capable of crossing the placenta

ARSENIC

ARSENIC  Inhibits ___throughout the body

sulfhydryl enzymes

Acute Fatal Dose:  ____ (arsenic trioxide)  ____ (arsenic gas)

-120 mg -30 ppm

 Indication of toxicity: o “Garlic odor” breath o Metallic Taste

ARSENIC

 Destruction of Type 1 epithelial cells in lungs

CADMIUM

Increased resistance to bacterial infection

CADMIUM

-can accumulate in the kidney and lead to renal tubular damage.

Indicator for ____ is positive GGT in the urine

cadmium

 Blocks the enzymes  Potent enzyme inhibitor

LEAD

-Delta aminolevulinic acid synthetase -Pyrimidine 5’-nucleotidase -Na-K ATPase

 Urinary aminolevulinic acid  Free RBC porphyrins  Presence of basophilic stippling in the RBC

-LEAD

MERCURY - Inhibits

COMT (catecholamine-Omethyltransferase

Has the ability to amalgamate (bind, merge)

MERCURY

 Two forms of mercury:

elemental and alkyl

Major Toxic Effect of Alkyl Mercury

 Congenital Minamata Disease  Severe mercury intoxication

Major Toxic Effect of Elemental Mercury:

 Acrodynia – pink foot  Erethism - mad hatter disease

Face deformity

Congenital Minamata Disease

mad hatter disease

Erethism

MERCURY TESTS

-REINSCH TETS -ATOMIC EMISSION SPECTROSCOPY -ATOMIC ABSORPTION SPECTROSCOPY -INDUCTIVELY COUPLE PLASMA MASS SPECTROMETRY

REINSCH TEST

Copper wire + Nitric acid solution + sample

Lead or mercury COLOR

GRAY

MERCURY Positive Result:

Black Plating of Copper wire

After one hour, the copper is cooled and rinsed

REINSCH TEST

 Mixture is heated for _____ and there is subsequent addition of HCl

1 HR

Aerosol is delivered to the source, where is receives energy to emit radiation

ATOMIC EMISSION SPECTROSCOPY

 Absorption = concentration of the analyte.  Follow Beer’s law

ATOMIC EMISSION SPECTROSCOPY

Substances that have been intentionally added to the environment to kill or harm an undesirable life form

-PESTICIDE

PESTICIDES Most common configuration:

Organophosphates

Organophosphates inhibit ____

acetylcholinesterase

PESTICIDE  Screening test:  Confirmatory test:

- SchE (Serum Cholinesterase) -Erythrocytic ChE (Erythrocytic Cholinesterase

Symptoms of Toxicity  Salivation  Lacrimation: tearing of the eyes  Involuntary urination and defecation

PESTICIDE

CHOLINESTERASE ASSAYS

-Michel Method/pH Change -Ellman -Method/Colorimetric

 When Choline ester is hydrolyzed, a proton is released

Michel Method/pH Change

Sensitive and rapid  Thiolcholine + dithiobis-nitrobenzoic acid (DNBA)  Colored product measured at 410 nm

Ellman Method/Colorimetric

 Cholinesterase + thiol ester →

Thiolcholine

 treatment of narcolepsy and attention-deficit disorder  Leads to “pleasant feeling”  block release of dopamine  Anti-histamine can cause false positive

AMPHETAMINES

Acute psychotic syndromes  Auditory and visual hallucinations  Suicidal tendencies  Paranoia

AMPHETAMINES

 Tetrahydrocannabinol or cannabis

CANNABINOIDS

 Local anesthetic for nasopharyngeal surgery and an active CNS stimulant

COCAINE

 Lipophilic substance, rapidly removed from the bloodstream

CANNABINOIDS

 Induces platelet aggregation, vasoconstriction, and synthesis of plasminogen activator inhibitor

COCAINE

 Capable of crossing placenta and mammary gland

COCAINE

OPIATES OURCE: OPIUM POPPY

 Naturally occurring opiates:

opium, morphine, codeine

major metabolite in the urine

 Morphine

 “Pin-point pupils” – constricted pupils

OPIATES

 Stimulant, depressant, hallucinogenic  Physiologic effect: analgesia, anesthesia

PHENCYCLIDINE

 therapeutic role and depressants  barbiturates and benzodiazepines

SEDATIVE-HYPNOTICS

enzyme labelled antigen, antibody, substrate, test antigen

Enzyme Multiplied Immunoassay Technique (EMIT)

labelled antigen is___ to the enzymatic activity

INVERSELY PROPORTIONAL

 Confirmatory Test  Separation of volatile mixture of drugs according to mass to charge ratio  Measured by a detector according to intensity of ion current

Gas Chromatography - Mass Spectroscopy

 Solvent migrates by capillary action, dissolving and carrying the drugs

Thin Layer Chromatography

tampering of the specimen for drug testing which makes the test results false-negative

Adulteration

Step-by-step documentation of the handling and testing legal specimens  Process provides this documentation of proper sample identification from the time of collection and receipt of laboratory results

CHAIN OF CUSTODY

Chemically-related to testosterone  Treatment for male hypogonadism  Increases muscle mass

ANABOLIC STEROIDS

High ratio is associated with ____ testosterone administration

exogenous

Normal T/E ratio:

1:1

Toxic effects:  Chronic hepatitis  Atherosclerosis  Abnormal Platelet Aggregation  Cardiomegaly

ANABOLIC STEROIDS

Toxic effects:  Palpitations  HTN  Cardiac arrhythmias  Convulsions  Pancytopenia  Mental impairment  Teeth grinding

AMPHETAMINES

Toxic effects:  Palpitations  HTN  Cardiac arrhythmias  Convulsions  Pancytopenia  Mental impairment  Teeth grinding

AMPHETAMINES

 Signs of acute intoxication: hyperpyrexia (very high fever)

AMPHETAMINES

M7: TOXICOLOLGY Flashcards

(106 cards)