CC2 lab cards

Toxicology, pancreatic, elisa, thyroid gland cards gonadal and drug testing in PH TBF

Toxicos

Toxicos

Greek word which means poisonous

Logos

Greek word which means study

Mechanistic Toxicology

• Elucidates the cellular and biochemical effects of toxins.

• Provides a basis for rational therapy design and development of tests to assess the degree of exposure of poisoned individuals.

Clinical Toxicology

• The study of interrelationships between toxin exposure and disease states.

• Emphasizes not only in diagnostic testing, but also therapeutic intervention

Risk assessment

Descriptive Toxicology is also known as?

Forensic Toxicology

Toxicology that is primarily concerned with the medico legal consequences of toxin exposure

Suicide

It has the highest mortality rate among individuals exposed to toxins

Ingestion

Most common route of toxin exposure

Homicide or Occupational Exposure

Type of toxin exposure in the workplace or industry

Transdermal absorption

The exposure to toxin via the skin

ED 50

Dose that would be predicted to be effective or have a therapeutic benefit in 50% of the population

TD 50

Dose in which 50% of individuals will experience toxic adverse effects

LD 50

Dose in which 50% of individuals will result in death

>0.05% w/v or >50 mg/dL

Symptoms of alcohol intoxication begin when the concentration is?

Ethanol

Also known as Grain alcohol

It is the most commonly abused drug

Methanol

Also known as Wood alcohol

It is a commonly used solvent and a contaminant of homemade liquors

Isopropanol

Also known as Rubbing alcohol

It is metabolized to hepatic ADH to acetone

Ethylene glycol

It is a common constituent of hydraulic fluid and antifreeze

It is converted to oxalic acid and glycolic acid

Carbon monoxide

It is a colorless, odorless, and tasteless gas

Cherry-red color of face

Indicator of carbon monoxide poisoning

CO-oximetry

The method of testing used for carbon monoxide

Arsenic

Component of ant poisons, rodenticides, paint and metal alloys

• It is a common homicide or suicide agent

• It is a common agent of heavy metal poisoning

Cadmium

Utilized in electroplating and galvanizing

• It is a significant environmental pollutant

• It is the pigment in paints and plastics

Lead

Component of household paints and is a potent enzyme inhibitor

• It combines with the matrix of bone and can persist in this area for a long time

Zinc protoporphyrin

Which test is useful to assess blood concentration of lead?

Mercury

It has the ability to “amalgamate”, which means to mix or merge with other substances

Reinsch test

It is the method of testing for Mercury

Amphetamines

Therapeutically used for treating narcolepsy and ADHD

• Structurally related to dopamine and catecholamines

Hyperpyrexia

It is a sign of acute amphetamine intoxication

Anabolic steroids

It improves athletic performance by increasing muscle mass

Tetrahydrocannabinol (THC)

It is the most potent competent or the psychoactive substance of marijuana

Prozac

It is used to inhibit the action of cocaine

Opiates

They are capable of analgesia, sedation and anesthesia

• Derived chemically from opium poppy

Methadone

It is a non-bicyclic drug that binds with morphine in the brain

Naloxone (narcan)

It is the antagonist for opiate overdose

Mixed Function Oxidase (MFO) system

It is the biochemical pathway responsible for the greatest portion of drug metabolism

100% bioavailability

Intravenous route of administration is associated with:

0.7 bioavailability fraction

Orally administered drugs should achieve:

Intravenous

It is the most immediate route of administration

Whole blood EDTA

Which sample is required for cyclosporine and tacrolimus tests?

Timing of specimen collection

It is the single most important factor in TDM

Only after steady state has been achieved

Measurement of serum concentrations should be done:

Trinder assay

Which test is for salicylate using ferric nitrate forming a (+) colored complex?

Thin Layer Chromatography

• This method uses serum, urine or gastric fluid for analysis

• It qualitatively identifies drugs by means of their Rf values

HPLC

It is a highly quantitative procedure.

Measurement depends on the type of column used, the solvent and detector systems

GC-MS

It is used for the quantitation of many drugs

Discontinuously

Most common way of therapeutic drug administration

First order kinetics

The half life of a drug is independent of its concentration because several drugs are excreted according to the so-called?

Cytochrome P450

The metabolic system utilizes oxidative enzymes that in turn utilize a special system called?

Digoxin

Used for the treatment of congestive heart failure and atrial fibrillation-flutter.

It causes release of calcium ions in the T-system of myocardium.

Procainamide

For the treatment of supraventricular or ventricular arrhythmias.

Toxic effect includes reversible lupus erythematosus-like syndrome

Respiratory depression

It may be caused by rapid intravenous administration

Phenobarbital

To stabilize damaged membranes and raise the threshold for neuronal membrane depolarization

Phenytoin

It appears to block sodium and calcium ion influxes into repeatedly depolarizing CNS neurons

Carbamazepine (Tegretol)

It appears to decrease sodium and calcium ion influxes into repeatedly depolarizing CNS neurons

Reduces excitatory synaptic transmission in the spinal trigeminal nucleus

Aspirin

A nonsteroidal anti-inflammatory compound that is used as an analgesic, an antipyretic and anti-inflammatory agent

Acute aspirin toxication

It is a common cause of fatal drug poisoning in children

Acetaminophen (Tylenol)

a.k.a Paracetamol

It is used as an analgesic and antipyretic to treat fever, headache, myalgia and arthralgia.

There is cyanosis of the skin

Tacrolimus (FK-506)

It is a macrolide lactone antibiotic, more potent than CsA

It is utilized in transplant surgery to prevent organ rejection

CYP3A4 system 

Rapamycin is metabolized predominantly in the liver by the?

Lithium

It is a monovalent cation, a member of the group of alkali metals and is available commercially as citrate and carbonate salts

• It is an antimanic agent used in the prophylaxis and treatment of bipolar disorder

• It is used as an adjunct to antidepressant therapy in melancholic depression.

• It is the drug of choice for the prevention of chronic cluster headache.

Antidepressants

Used in the treatment of clinical depression.

• It blocks the uptake of norepinephrine

Methotrexate

Used in the treatment of childhood acute lymphatic leukemia and Hodgkin’s lymphoma

For treatment of choriocarcinoma, and used as immunosuppressive agent.

Busulfan

It is an alkylating agent used to treat leukemias and lymphomas before bone marrow transplantation

Drug

Refers to any product used to modify/explore the physiologic system/pathologic states for the benefit of the patient

Receptor

It is a component of the cell that interacts with drug, initiating a chain of biochemical events leading to drugs’ observed effects

Pharmacology

Thee science concerned with history, sources, physical & chemical properties of drugs & the way in which drug affects living system

Pharmacodynamics

It is the study of the biochemical & physiological effects of drugs & mechanisms of action

Pharmacokinetics

It deals with the absorption, distribution, biotransformation & excretion of drugs 

Pharmacotherapeutics

It is the study of drugs used in the diagnosis, prevention, suppression, & treatment of diseases, deals with beneficial effects of the drugs (medicines)

Pharmacognosy

It is the study of drugs in their original unaltered state; origin of drugs ; source of drugs (penicillin from penicillium

Toxicology

It is the study of poison & its effects deals with deleterious effects of physical & chemical agents in humans.

Pharmacoeconomics

It is the study of relationship of drugs & economics

Pharmacovigilance

It is the science of collecting, researching, analyzing, & evaluating a set of information about adverse drug effects.

Circulatory system

It is a convenient route that can effectively deliver most drugs to its site of action.

• Changes in intestinal movement

• pH

• Inflammation

• Presence of food or other drugs

Factors affecting absorption:

• Liberation

• Absorption

• Distribution

• Metabolism

• Excretion

Pharmacological parameters determining serum drug concentration:

Excretion

The rate at which a particular drug is cleared from the circulation

• Elevated concentration of free drugs.

• Abnormal response to drugs after administration.

• The presence of active drug metabolites

Causes of drug toxicity:

Erythroxylon

Give the name of the coca plant in which cocaine was derived from

Thyroid Gland

A butterfly-shaped gland located in the lower anterior neck responsible for producing thyroid hormone and calcitonin.

Thyroglobulin

A glycoprotein stored in the follicular colloid of the thyroid gland, acting as a preformed matrix containing tyrosyl group.

T3 and T4

Thyroid hormones that require iodine for their synthesis.

TRUE

True or False

T3 is more abundant in circulation than T4.

98%

Approx. ___ of Circulating T3 and T4 is bound to protein.

“Shut off” the release of TSH from the Pituitary gland

What will happen when there is high serum levels of free T3 and T4?

Inverse relationship

TSH have a ___________ to free T3 and Free T4

Calcitonin

A hormone produced by the thyroid gland that helps regulate calcium levels in the blood and maintain calcium homeostasis.

Monoiodotyrosine (MIT) and diiodotyrosine (DIT)

Iodination of tyrosine residues in thyroglobulin results in formation of ?

Metabolically inactive / physiologically active

Protein bound hormones are ______________________.

Free Hormones (FT3 and FT4) are the ___________________ portions of the thyroid hormones.

50ug/day

Iodine intake below _______ is an indication of the deficiency of hormone secretion.

Laboratory Evaluation and Imaging Studies of Thyroid Function

• Serum T4

• Serum T3

• TSH

• Anti-thyroid antibodies

• Thyroid stimulating Immunoglobulins

• Thyroid uptake and scan

• Thyroid Ultra sound

Hypothyroidism

Underproduction of thyroid hormones

leading to conditions like myxedema, cretinism, and thyroiditis.

Hyperthyroidism

Overproduction of thyroid hormones

resulting in conditions like Graves' disease, thyrotoxicosis, and goiter.

Thyrotropin-releasing hormone (TRH)

Hormone released by the hypothalamus to stimulate the production of thyroid-stimulating hormone (TSH) from the pituitary gland.

Free Hormones (FT3 and FT4)

Metabolically active portions of thyroid hormones that are not bound to proteins.

Hashimoto's Disease

Chronic autoimmune thyroiditis, the most common cause of primary hypothyroidism, characterized by high TSH and positive TPO antibodies.

Myxedema

Non-pitting swelling of the skin associated with hypothyroidism, leading to symptoms like weight gain and a puffy face.

Thyrotoxicosis

A condition where there is an excess of thyroid hormone in the body, leading to symptoms such as weight loss, rapid heartbeat, and sweating.

Plummer's Disease

Another term for thyrotoxicosis characterized by an increase in FT3 levels while FT4 levels remain normal with low TSH.