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MT2 > TOXICOLOGY > Flashcards

TOXICOLOGY Flashcards

1
Q

is the study of the adverse effects of chemical agents on biological systems.

A

TOXICOLOGY

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2
Q

 Involved in the recognition,
identification, and quantitation of hazard
 Develops standards and regulations to
protect health and environment
 Involved in the safety assessment and
use of data as basis for regulatory
control of hazards
 Determines risk associated with the use
of chemicals

A

TOXICOLOGISTS

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3
Q

Risk Assessment

A

Hazard Identification
Dose Response Assessment
Exposure Assessment
Risk Characterization

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4
Q

Risk Assessment:

Whether Physical, Chemical, Biological

A

Hazard Identification

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5
Q

Risk Assessment:

Biological System

A

Dose Response Assessment

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6
Q

Risk Assessment:

Effect or Response

A

Exposure Assessment

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7
Q

Risk Assessment:

Exposure situation

A

Risk Characterization

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8
Q

Major Factors that influence toxicity

A

 Route of administration
 Duration and Frequency of Exposure
 Dose or concentration

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9
Q

Rapidly of Response with respect to
route of exposure:

A

 Intravenous
 Inhalation
 Intraperitoneally
 Subcutaneous
 Intramuscular
 Intradermal
 Topical

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10
Q

Some xenobiotics cause toxicity by
disrupting _______

A

normal cell functions

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11
Q

xenobiotics disrupt normal cell functions by:

A

 Bind and damage proteins (structural
enzymes)
 Bind and damage DNA (mutations)
 Bind and damage lipids
 React in the cell with oxygen to form
“free radicals” which damage lipid,
protein, and DNA.

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12
Q

Types of Toxic Effects:

Death

A

Arsenic, Cyanide

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13
Q

Types of Toxic Effects

Organ Damage

A

Ozone, Lead

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14
Q

Types of Toxic Effects

Mutagenesis

A

UV Light

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15
Q

Types of Toxic Effects

Carcinogenesis

A

Benzene, Asbestos

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16
Q

Types of Toxic Effects

Tetratogenesis

A

Thalidomide

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17
Q

Target Organ Toxicity: Central Nervous System

A

Lead

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18
Q

Target Organ Toxicity: Immune System

A

Isocyanates

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19
Q

Target Organ Toxicity: Liver

A

Ethanol, Acetaminophen

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20
Q

Target Organ Toxicity: Respiratory Tract

A

Tobacco Smoke, Asbestos, Ozone

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21
Q

Target Organ Toxicity: Eye

A

UV Light (sunlight)

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22
Q

Target Organ Toxicity: Kidney

A

Metals

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23
Q

Target Organ Toxicity: Skin

A

UV Light, Gold, Nickel

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24
Q

Target Organ Toxicity: Reproductive System

A

dibromochloropropane

25
Q

Spectrum of Undersided Effects

A

 Allergic reactions
 Chemical allergies
 Idiosyncratic reactions
 Immediate vs. delayed toxicity
 Reversible vs. irreversible toxicity
 Local vs. systemic toxicity

26
Q

Is the use of drug concentration
measurements in body fluids as an aid
to the management of drug therapy for
the cure, alleviation or prevention of
disease.

A

TDM

27
Q

The monitoring of therapeutic drugs involves measuring drug concentrations in ______, ______ or ______. This information is used to individualize dosage so that drug concentrations can
be maintained within a target range.

A

plasma, serum or blood

28
Q

Therapeutic drug monitoring is useful only for drugs that have a poor correlation between ______ and ________ (high pharmacokinetic variability).

A

dose and clinical effect

29
Q

TDM is not generally helpful in the ________ of patients. Examples of this are the measurement of blood pressure during antihypertensive therapy; glucose in patients treated with heparin or warfarin, and cholesterol in patients treated with cholesterollowering drugs.

A

routine monitoring

30
Q

The main reasons for measuring drugs

A

 To ensure that sufficient drug is reaching the drug receptor to produce the desired response (the onset of which may be delayed)
 To ensure that drug (or metabolite) concentrations are not so high as to produce symptoms or signs of toxicity
 To guide dosage adjustment in clinical situations in which the pharmacokinetics are changing rapidly (e.g., in neonates, children or patients in whom hepatic or renal function in changing)
 To define the pharmacokinetic parameters and concentration effect relationships of new drugs.

31
Q

Indicators for therapeutic drug
monitoring include:

A

Toxicity
Dosing
Monitoring

32
Q

diagnosing toxicity when the clinical syndrome is _______ (unexplained nausea in a patient taking digoxin)

A

(toxicity) ; undifferentiated

33
Q

Avoiding toxicity (_________, __________)

A

(toxicity) ; aminoglycoside, cyclosporine

34
Q
  • After dose adjustment (usually after reaching a steady state)
  • Assessment of adequate loading dose (after starting ______ treatment)
  • Dose forecasting to help predict a patient‟s
    dose requirements (__________)
A

(dosing) ; phenytoin ; aminoglycosides

35
Q

In monitoring, the information required to allow
interpretation of the result should include the ____________, _____________, __________ and _____________.

A

time of the sample collection, the time of the last dose, the dosage regimen, and the indication for drug monitoring.

36
Q

 Assessing compliance (anticonvulsant concentrations in patients having frequent seizures)
 Diagnosing under treatment (particularly important for prophylactic drugs such as anticonvulsants, immunosuppressants)
 Diagnosing failed therapy (therapeutic drug monitoring can help distinguish between ineffective drug treatment, noncompliance and adverse effects that mimic the underlying disease)

A

Monitoring

37
Q

may be defined as what that body does to drugs (the processes of absorption, distribution, metabolism and excretion)

A

Pharmacokinetics

38
Q

as what the drugs do to the body (mechanisms of drug
action and biochemical/pathophysiological effects
such as tissue responsiveness, presence of other drugs and disease states).

A

Pharmacodynamics

39
Q

is the fraction of the dose that reaches the blood

A

Bioavailable fraction

40
Q

the time required to reduce a drug level to half of its initial value

A

Half-life

41
Q

the ratio between the minimum toxic and maximum
therapeutic serum concentration

A

Therapeutic index

42
Q

the difference between highest and lowest effective dosage

A

Therapeutic range

43
Q

the lowest concentration of a drug obtained in the
dosing interval

A

Trough concentration

44
Q

Commonly Monitored Drugs - Cardioactive drugs

(normalize heart rhythm)

A

digoxin, procainamide

45
Q

Commonly Monitored Drugs - Antiepileptic

(treatment of seizures)

A

valproic acid,
phenobarbital,
phenytoin,
carbamazepine

46
Q

Commonly Monitored Drugs - Antibiotics

A

amikacin, gentamicin, vancomycin, tobramycin

47
Q

Commonly Monitored Drugs - Immunosuppressants:

(prevent or minimize the risk of organ transplantation)

A

cyclosporine, tacrolimus, sirolimus

48
Q

Commonly Monitored Drugs - Antidepressants

(increases the effect of neurotransmitters)

A

nortriptyline, desipramine, lithium

49
Q

Commonly Monitored Drugs - Bronchdilators

(CNS and cardiac stimulant, causes smooth muscle relaxation and diuresis)

A

theophylline

50
Q

Commonly Monitored Drugs - Antineoplastic

A

Methotrexate

51
Q

Commonly Monitored Drugs - Antipsychotic

(produce emotional calmness and mental
relaxation)

A

promethazine

52
Q

Requirements when making a request for
TDM

A

 Accurate information about the patient (name, identification number, age, gender and pathology)
 The drug therapy (dose, formulation and route of administration, length of therapy, date and time of last dose)
 The date and time of the sample are essential for proper interpretation
 Additional information such as the patient‟s weight, renal and hepatic function and other prescribed medication may also be required in many circumstances.

53
Q

SAMPLES..

_____ or _______ is commonly used for
drug assays.

A

Plasma or Serum

54
Q

SAMPLES..

_________: for Cyclosporine, tacrolimus, sirolimus, as there are large shifts of drug between red cells and
plasma with storage and temperature change.

A

Whole blood

55
Q

SAMPLES…

_______, which gives a measure of the unbound drug concentration, may be a useful alternative when blood samples are difficult to collect. Ex: Phenytoin, Lithium, Amitriptyline, Marijuana, Cocaine, Alcohol

A

Saliva

56
Q

SAMPLES..

OTHER. BODY FLUIDS:
 ______: Benzodiazepines
 ______: Cocaine & Heroin
 ______: Alcohol

A

Urine
Sweat
Breath

57
Q

____________ is also important. Ensure complete absorption and distribution

A

Timing of sample-taking

58
Q

For TDM to be meaningful, the patient Should be in _______ on the present dose of the drug. However, when suspected toxicity is being investigated, waiting to attain steady state is clearly contraindicated. The time taken to reach steady state is determined by the elimination half-like of the drug. In practice, samples are taken after drug dosing has continued for at least _______.

A

steady state ; four half-lives

MT2 (45 decks)

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