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Glossary of 18. Toxicology

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What is Toxicology?
The science of poisons and their effects on people.
What are 3 factors that make a toxin worth testing for?
-Whether antidoe is available
-If detection can exclude a medical condition
-If quantifying toxin will affect management of overdose
What are 6 toxic drugs that have antidote available?
1. Acetaminophen
2. Ethanol
3. Lithium
4. Opiates
5. Propoxyphene
6. Salicylates
Which 5 toxins are important to quantify for management?
1. Acetominophen
2. Salicylates
3. Amphetamines
4. Lithium
5. Tricyclic Antidepressants
What are 9 classes of toxic agents?
1. Analgesics
2. Cardiacs
3. Stimulants
4. Depressants
5. Volatiles
6. Metals
7. Noxious gases
8. Pesticides
9. Drugs of abuse
What are the analgesics?
-Acetaminophen
-Salicylate
What cardiac drug is toxic?
Digoxin
What stimulant is toxic?
-Tricyclic Antidepressants
What depressant is toxic?
-Lithium
What are the 5 volatiles?
1. Ethanol
2. Methanol
3. Isopropanol
4. Acetone
5. Ethylene Glycol
What are 8 toxic metals?
1. Chromium
2. Manganese
3. Colbalt
4. Cadmium
5. Mercury
6. Aluminum
7. Lead
8. Arsenic
What noxious gas are we mainly concerned with?
Carbon monoxide
How is acetaminophen toxic?
Causes glutathione depletion resulting in hepatic toxicity
How are salicylates toxic?
-Dpress the respiratory centers in the medulla
-Can cause respiratory alkalosis resulting in metabolic acidosis.
What is the treatment for SSA toxicity?
-Hemodialysis
-Charcoal
How is Digoxin toxic?
Can cause cardiac, gastrointestinal and visual abnormalities
What are the most common life-threatening drugs?
Tricyclic antidepressants.
What methods are used to measure TCAs?
TLC, HPLC, and Immunoassays
What is the antidote for TCA overdose?
Flumenazil
What are the general symptoms of TCA overdose? (3)
Seizures
Cardiac changes
Respiratory changes
How is iron toxic when overdosed? (4 changes)
-Damages GI mucosa
-Decreases cardiac output
-Hemoconcentration causes cardiac overload
-Alters Kreb's cycle
What is the treatment for iron overload?
-Ipecac
-Saline levage
-Bicarbenate
-Polyethylene Glycol
How is lithium toxic?
-Renal toxicity because it undergoes renal clearance.
-Dehydration - is a diuretic
What is the therapy for lithium overdose?
-Volume replacement
-Hemodialysis
How are the Volatiles measured?
Via Gas chromatography
How is Ethanol toxic?
Causes intoxication - by drinking too much; common.
How is Methanol toxic?
It metabolizes to formic acid, resulting in:
-metabolic acidosis
-optic nerve damage
What is the treatment for Methanol overdose?
-Lavage
-Ethanol to 100 mg/dl
-Hemodialysis
-Folate
What is the metabolite of isopropanol?
Acetone
What is ethylene glycol in that makes it toxic?
Antifreeze
What makes ethylene glycol toxic?
-Causes metabolic acidosis
-Renal damage by forming oxalate crystals
Can ethylene glycol be analysed by GC?
No; it is not volatile
Which alters serum osmolality the most; EtOH, Isopropanol, or Methanol?
Isopropanol > MetOH > EtOH
What is the toxic mechanism of LEAD?
-Inhibits amino levulinic acid dehydratase
-Result: altered heme synthesis
What does lead toxicity manifest in?
Anemia
Protoporphyrin buildup
How is lead toxicity treated?
Chelation
What are toxic lead levels in
-Children
-Adults
Children <10 mg/dl

Adults <30 mg/dl
When should chelation take place (for what levels)?
at >60 mg/dl
What samples are used for lead analysis?
-Whole blood
-Urine
-Hair
-Bone
What type of assay is done for lead?
Atomic absorption spec
Why is Carbon Monoxide toxic?
-Binds heme and decreases its O2 capacity
-Increases the remaining O2's affinity for Hb too.
What is the toxic effect of CO poisoning?
Hypoxia
What 2 methods are used for CO detection?
-GC
-Spectrophotometry

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