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Toxicology Flashcards

(90 cards)

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1
Q

What is the highest incidence of toxic exposure in the US?

A

young kids younger than 5 > teens > adults

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2
Q

Definition of toxicology

A

Study of adverse effects of xenobiotics in humans

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3
Q

Xenobiotics

A

Chemicals and drugs that are not normally found in or produced by the body. Describe the environmental exposure to chemicals or drugs.

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4
Q

What are the 3 major disciples of toxicology?

A

Mechanistic, Descriptive, and Regulatory

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5
Q

What is mechanistic toxicology?

A

Explain the cellular, molecular, and biochemical effects of xenobiotics within the context of a dose-response relationship between the xenobiotic and its adverse effects​

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6
Q

What is descriptive toxicology?

A

Uses the results from animal experiments to predict what level of exposure will cause harm to humans (risk assessment)

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7
Q

What is regulatory toxicology?

A

Combines data from mechanistic and descriptive studies to establish standards that define the level of exposure that will not pose a risk to public health or safety​

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8
Q

What are the three toxicology specialties?

A

Forensic, clinical, environmental

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9
Q

What is the purpose of forensic tox?

A

Primarily concerned with the medical and legal consequences of exposure​

Major focus is establishing and validating the analytic performance of test methods used to generate evidence in legal situations—including cause of death​

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10
Q

What is the purpose of clinical tox?

A

Focuses on relationships between xenobiotics and disease states​

Emphasis on diagnostic testing and therapeutic intervention​

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11
Q

What is the purpose of environmental tox?

A

The evaluation of environmental chemical pollutants and their impacts on human health​

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12
Q

Which of the following is an exogenous substance?

Xenobiotics

Poisons

Toxins

A

Xenobiotics and Poisons

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13
Q

Poisons

A

Describe substances from an animal, plant, mineral, or gas

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14
Q

Toxins

A

Endogenous substance biologically synthesized either in living cells or in microorganisms. Toxicant and toxic refers to substances that are not produced within a living cell or microorganism and are more commonly used to describe environmental chemicals

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15
Q

Populations in which we see majority of poisoning cases

A

50% Suicide (highest mortality)
30% Accidental (most frequent in children)
20% Homicide/Occupational (industry or agriculture)

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16
Q

What are the most common routes of exposure/

A

Ingestion, inhalation, transdermal absorption

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17
Q

T/F:

Ionized substances can undergo passive diffusion

A

FALSE

Ionized CANNOT
Hydrophobic CAN

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18
Q

List some factors that can influence absorption

A

rate of dissolution, GI motility, resistance to degradation in GI tract, other substances

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19
Q

What is the central theme to toxicology?

A

The concept that all substances have the potential to cause harm

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20
Q

What is the purpose of the toxicity rating? (dose-response relationship of oral dose)

A

Useful system to compare relative toxicities of substances as the predicted endpoint is death​. It evaluates data from a frequency histogram to toxic responses over a range of doses and will evaluate the responses over that wide range of concentration

5mg/kg can be lethal

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21
Q

What is TD50?

A

The toxic dose

the dose that would produce a toxic response in 50% of the population

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22
Q

What is LD50?

A

The lethal dose

the dose that would produce a lethal response in 50% of the population

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23
Q

What is ED50?

A

The effective dose

the dose that would produce a therapeutic/beneficial/effective response in 50% of the population

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24
Q

What is the therapeutic index?

A

Ratio of TD50 OR LD50 to the ED50

TD50:ED50

OR

LD50:ED50

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25
What does it mean when you have a large therapeutic index?
That there are fewer toxic/adverse effects when the dose is in the TR
26
Does the following statement refer to Acute or Chronic toxicity: Generally associated with repeated and frequent exposure for extended time periods at doses that are insufficient to cause an immediate acute response​
Chronic Acute refers to a single, short term exposure to a substance in which the dose can cause immediate toxic effects
27
T/F: Signs and symptoms are often non-specific and relies on lab testing​
TRUE
28
What are common specimen types for tox testing?
Urine and blood Forensics often use serum, plasma, nails, hair, oral fluid
29
Define toxicokinetics
Toxic agents exhibit unique absorption, distribution, metabolism and elimination
30
Analysis of toxic agents is typically a two step process consisting of __1__ and __2__
1) screening (qualitative) 2) confirmatory (quantitative)
31
What are the methods used in toxic agent analysis?
Immunoassays (most common), GC, LC-MS, Inorganic compounds, NMR
32
State the most significant metabolism pathway for alcohols:
1) Alcohol 2) ADH (alcohol dehydrogenase) 3) Aldehyde 4) ALDH (hepatic aldehyde dehydrogenase) 5) Acid
33
What tubes are preferred for blood for toxic analysis?
Royal Blue trace free unless lead testing then we want a tan top These are known to be free of certain chemicals
34
____ are known to have a common depressant effect on the CNS, mediated by changes in membrane properties
Alcohols
35
___ is in the top 10 causes of hospital admissions
ETOH (ethanol- most common)
36
What is fetal alcohol syndrome caused by and what is the result?
Ethanol consumption during pregnancy. It can result in delayed motor and mental capabilities
37
Chronic consumption of ___ affects the liver the most. What is the mechanism?
Ethanol It causes an accumulation of lipids in hepatocytes and 20% develop toxic hepatitis. Cirrhosis is common
38
What is the mechanism that is used to mediate the pathological effects of long term ethanol use?
Adduct formation with the aide of acetaldehyde. The adducts can change the structure and function of various proteins 1) Ethanol 2) Acetaldehyde 3) Acetate 4) Acetaldehyde adducts
39
Methanol
Is a common lab solvent found in household cleaners Accident consumption occurs from homemade alcohol (moonshine) Neuropathy and blindness Formic acid = severe metabolic acidosis
40
Isopropanol
Rubbing alcohol CNS depressant similar to ethanol but can have severe acute phase symptoms
41
Ethylene glycol
Common component of hydraulic fluid and antifreeze. It has a sweet taste so you can see ingestion in kids and animals. Severe metabolic acidosis
42
Alcohol determination for BAC can be performed on serum, whole blood, and plasma. Which of these is the most preferred specimen and why?
Serum is the preferred specimen of choice as it has a higher body water than whole blood and the ethanol is uniformly dispersed in total body water.
43
How is serum osmolality effected with serum ethanol?
Serum osmo increases 10 mOsm/kg per 60mg/dL increase in serum ethanol (freezing point lowers with more alcohol)
44
How is carbon monoxide produced?
By the incomplete combustion of carbon-containing substances
45
CO and __ compete for the same binding sites
O2
46
What are the greatest hazards for CO poisoning?
Aspiration and ingestion
47
T/F: CO is odorless but has a taste
FALSE CO is odorless and tasteless
48
Cyanide
Very toxic substance in solid, liquid, or gas form. Binds to heme iron Can be poisoned via inhalation, ingestion, transdermal. Used in industrial processes, insecticides, and rodenticides
49
High lactic levels are commonly found in ___ poisoning
Cyanide
50
Arsenic
Both natural and manmade substances and the toxicity depends on the valent state, solubility, rate of absorption and elimination.
51
What are the three major groups of arsenic?
Arsine gas, inorganic forms, organic forms (foods)
52
Cadmium
Used in electroplating and galvanizing. It is a significant environmental pollutant. SLOW half like of 30yr
53
What diseases/conditions are associated with Cadmium poisoning
- concomitant parathyroid dysfunction - Vit D deficiency - Itai-Itai disease
54
Lead
Component of byproduct of many industrial processes. Distributed in the body and mostly in the bone and soft tissues with a much longer half time in the bones.
55
T/F: Children are more sensitive to lead than adults
TRUE
56
____ is a potent inhibitor of many enzymes
Lead
57
What are the 3 forms of mercury?
- Elemental (liquid at RT) - Inorganic salts - Component of organic compounds
58
Give an example for each form of mercury with its toxicity level
Elemental mercury (Hg0): no significant effects Cationic mercury (Hg2+): moderately toxic Organic mercury (methyl mercury CH3Hg+): extremely toxic
59
What is the most common route for mercury into the human body that is the primary factor that determines mercury toxicity in the human body?
GI absorbance
60
T/F: The inorganic form of mercury is rapidly and efficiently absorbed
FALSE the ORGANIC forms are
61
_____ binds with proteins and inhibits many enzymes
Mercury
62
Function of pesticides
Intentionally added to harm or kill something.
63
What is the primary concern with pesticides?
High level exposure. Those most at risk are people handling exposures without appropriate PPE​
64
Salicylates
Acetylsalicylic (ASPIRIN) Interference with PLT aggregation and GI function Reye's syndrome in viral infection in kids Acute ingestion of high doses causes metabolic acidosis, hyperventilation, excess ketone formation, mixed acid-base disturbance
65
Acetaminophen
TYLENOL - common analgesic Overdose associated with severe hepatotoxicity Concern with MFO: more susceptible in alcoholics
66
MFO
Mixed-function oxidase Hepatic system can become overwhelmed
67
T/F: DOA POSITIVE can tell us whether the patient has used the drug a single time or if they are a chronic user
FALSE, a positive result cannot tell us if this was a single use or a chronic substance abuse.
68
What is the typical method for a drugs of abuse screening
A urine screen to detect recent drug abuse
69
What are substances of abuse
OTC, prescription, illicit drugs
70
T/F: DOA testing is a 2 tiered approach
TRUE: Screening and confirmation
71
What are things that can cause detection alteration
Urine tamp, pH, SG, and creatinine
72
The following statements describe which part of the DOA testing process: - Simple, rapid, inexpensive - "Spot tests: - Lateral flow assays Detects classes of drugs based on similarities in chemical configurations
SCREEN
73
What is a drawback of DOA test screening
May also detect chemical related substances with little to no abuse potential
74
Confirmation testing must use methods with high __a__ and __b__
Sensitivity and specificty
75
What is the reference method used the most for DOA confirmation?
GC-MS
76
T/F: DOA confirmation can provide quantitative or qualitative information
TRUE
77
Amphetamines/Methamphetamines
Therapeutic drugs used for narcolepsy and ADD. These are stimulants with high abuse potential. Chronic use can lead to develop tolerance and physiological dependency
78
Sedatives-hypnotics
CNS depressants with a wide range of roles and abuse potential. Serious toxic effect with respiratory depression and hypotension Toxicity potentiated with ethanol use Overdose symptoms include lethargy, slurred speech, and possible coma
79
Barbiturates
A sedative that has a high abuse potential Originally a sleep inducer Used as a "downer" after a cocaine or amphetamine "high" Long half life
80
Benzodiazepines
A sedative that is more commonly found at a greater availability compared to barbiturates. Metabolized quickly and long acting. Has a high efficacy, safety, and low addiction potential with minimal side effects. Used as a sedative and for anti-anxiety uses
81
Tetrahydrocannabinol (THC)
Cannabinoid: psychoactive component of marijuana Abundant and potent that causes a sense of well-being or euphoria Lipophilic substance that is rapidly removed from circulation by passive diffusion into hydrophobic compartments (brain and fat) Slow elimination
82
Cocaine
Low concentrations = local anesthetic Higher concentration = potent CNS stimulator with a sense fo excitement and euphoria Alkaloid salt that is administered directly or inhaled as a vapor (crack)
83
The primary factor that determines toxicity of cocaine is the __a__ and the __b__
a) dose b) route of administration
84
What route of administration is the greatest hazard regarding cocaine use?
IV is the greatest hazard followed by smoking
85
Opioids
Capable of analgesia, sedation, and anesthesia Derived from opium poppy Naturally occurring, chemically modified, synthetic High abuse potential that can cause physical and psychological dependence. Acute overdose results in respiratory acidosis due to depression of respiratory centers, myoglobinuria, possibly including some cardiac markers
86
Opium, morphine, and codeine are collectively known as what?
Opiates (naturally occurring)
87
Tricyclic Antidepressants (TCA)
Used to treat depression and mood disorders Commonly used in suicide attempts Blocks the reabsorption and serotonin and norepinephrine, increasing the levels of those neurotransmitters in the brain 3 ring chemical structure
88
Methylenedioxymethamphetamine (MDMA)
Amphetamine derivative "ecstasy" Administered orally but can be admin from inhalation, injection, and smoking 20% eliminated in the urine unchanged Hallucination, euphoria, empathic and emotional responses, increased visual and tactile sensistivity
89
Phencyclidine (PCP)
"angel dust" Illicit drug with stimulant, depressant, anesthetic, and hallucinogenic properties Overdose cases stupor and coma Ingested/inhaled by smoking PCP-laced tobacco or marjuana LIPOPHILIC = dist into fat and brain Slow elimination
90
Anabolic Steroid
Chemically related to testosterone Used to increase muscle mass and improve athletic performance Chronic use is associated with toxic hepatitis and accelerated atherosclerosis = abn aggregation of plts MALE: testicular atrophy, sterility, impotence FEMALES: development of masculine traits, breast reduction, sterility

Chem I (14 decks)

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