Exam 1 Study Guide PDF

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JS 667 Exam 1 Study online at quizlet.com/_4ajjj8 1.

Who said "everything isa poison at the right dose"?

Paracelsus

2.

Who is Paracelsus?

The father of toxicology

3.

What did Paracelsus discover? (5)

1. Dose-response 2. Effect varies with exposure 3. Small amount = no effect 4. Large amount = fatal 5. Basis for toxicology

4.

What are the two subunits of pharmacology?

1. Pharmacokinetics 2. Pharmacodynamics

5.

What is pharmacokinetics?

What the body does to the drug

6.

What is pharmacodynamics?

What the drug does to the body

7.

What is pharmacy?

Health profession tasked with ensuring safe and effective use of pharmaceutical drugs

17.

What is agonist? (2)

1. Drug binds to and activates a target 2. Maximal response when used at high enough concentrations 3. Key fits the lock and is able to open it (activate it )

18.

What is partial agonist?

Drug produces less than maximal response even at high enough concentrations to cause maximal response

19.

As ____ drug is administered, the higher the effect but there is a max effect

More

20.

Describe antagonist: (2)

1. Inhibit the ability of targets to be activated by physiologic or pharmacologic agonists 2. Key fits the lock but can't get the lock open

21.

Describe competitive antagonist: (4)

1. Bind to active site; usually reversible 2. Blocks the effect of the biological agonist 3. Inhibitory effect can be overcome when ligand concentration is raised 4. Key that fits in lock, does not open door

22.

Describe noncompetitive antagonist: (3)

1. Bind to a different site than the ligand; irreversible 2. Inhibitory effect cannot be overcome by increasing the ligand concentration 3. Dead-bolt lock; door will never open, even if key is put into lock

8.

What is toxicology?

Pharmacology gone bad

9.

What is the dose response effect? (3)

1. Dose 2. Blood concentration 3. Effect

10.

What does pharmacokinetics consist of? (4)

1. Absorption 2. Distribution 3. Metabolism 4. Elimination

11.

What does pharmacodynamics consist of? (2)

1. Diuretic effect 2. Euphoria

12.

What is pharmacokinetics? (2)

1. Movement of a drug over time thought the body 2. What the body does to the drug

23.

What is the most rapid onset for drugs? (2)

1. Intravenous (IV) 2. Inhalation

What is efficacy (Emax)?

Maximal effect a drug can produce

24.

What is potency (EC50)?

What is the most easiest way to take drugs?

Oral

Measure of how much drug is required to produce a given effect (affinity for a receptor)

25.

What is first pass metabolism?

Phenomenon of drug metabolism where the concentration of a drug is greatly reduced before it reaches the systemic circulation

What are the subfields of forensic toxicology? (3)

1. Forensic drug testing 2. Postmortem forensic toxicology 3. Human performance toxicology

26.

What does forensic drug testing consist of? (2)

1. Workplace testing 2. Performance enhancement testing

What are the main drug receptor interactions? (5)

1. Agonist 2. Partial agonist 3. Antagonist 4. Competitive Antagonist 5. Non-competetitve antagonist

27.

What does postmortem forensic toxicology consist of?

Death investigation

13.

14.

15.

16.

28.

What does human performance toxicology consist of?

DUI/DUID

41.

What are the metabolites of ethanol? (2)

1. Alcohol dehydrogenase (ADH) 2. Aldehyde dehydrogenase (ALDH)

29.

What are the main groups of forensic drug testing and monitoring? (2)

1. Workplace and military urine drug testing 2. Doping control

42.

What is the elimination rate range of alcohol?

0.01 - 0.02 g/100 mL/hr

30.

Describe workplace and military urine drug testing: (3)

1. Safety and economic (Drug Free Workplace Act 1988) 2. SAMHSA (Substance Abuse and Mental Health Services Administration) Regulated 3. National Institute on Drug Abuse (NIDA-5)

43.

What is the Per Se limit?

0.08%

44.

What was the conclusion of the Grand Rapids study?

The probability of accident involvement increases rapidly at BACs over 0.08% and exponentially increases after 0.15%

What does workplace and military urine drug testing test for? (5)

1. Cannabinoids (marijuana) 2. Cocaine 3. Amphetamines 4. Opiates (heroin, codeine, morphine) 5. Phencyclidine (PCP)

45.

Describe impairment: (4)

1. Deterioration of judgement, attention, loss of fine motor skills 2. Increased reaction time 3. Diminished of sensory perception 4. Gross physical signs may be absent

46.

Describe intoxication: (3)

1. Advanced state of impairment 2. Gross physical signs 3. Impairment becomes intoxication is unique to the subject and it depends on tolerance

47.

Can someone be impaired without any physical signs?

Yes

48.

Describe tolerance: (4)

1. Reduction of effectiveness of a drug after a period of continuous or largedose administration 2. A person taking drugs chronically as prescribed may have minimal side effects due to tolerance 3. May mask impairment but does not eliminate it 4. Tolerance will be evident based on the individual's behavior and performance on SFSTs

49.

What does DRE stand for?

Drug recognition expert

50.

What is the 12 step process for DRE? (12)

1. Breath alcohol test 2. Interview of arresting officer 3. Preliminary examination 4. Eye examination 5. Divided attention tests 6. Vital signs 7. Dark room checks 8. Check for muscle tone 9. Check for injection sites 10. Interrogation of subject 11. Opinion of evaluator 12. Toxicological sample

31.

32.

33.

Describe doping control: (3)

What does doping control test for? (3)

1. Competitive sports (humans/horses) 2. International Olympic Committee (IOC) 3. World Anti-Doping Agency (WADA) 1. Stimulants 2. Anabolic steroids 3. Diuretics (weight loss, masks other substances)

34.

Describe what postmortem toxicology studies: (2)

1. Cause of death 2. Manner of death

35.

What are the manners of death? (5)

1. Homicide 2. Suicide 3. Accident 4. Natural 5. Undetermined

36.

Describe the main goals of human performance: (2)

1. Behavioral toxicology 2. Drugs can enhance or impair performance

37.

Describe behavioral toxicology:

Identify and quantify the relationships between drugs and behavioral changes

38.

Describe how drugs can enhance or impair performance: (2)

1. Anabolic steroids, stimulants (sports) 2. Ethanol, ambient (driving, workplace accidents)

39.

What happens to the plateau if more alcohol is consumed?

The plateau widens

40.

What are the pharmacokinetics stages?

ADME

51.

What is the memorization guide for the 12 steps for DRE?

BIPED-VD-MISOT

52.

What does DSHDNIC stand for?

Dissociative anesthetic narcotic inhalant cannabis

53.

What does DID drugs stand for?

HGN drugs

54.

What does DIDC stand for?

Drugs that cause lack of conversion

55.

What does CASH stand for?

Drugs that cause pupil dilation

56.

What does ANTs standard for?

Drugs that cause a slow pupil reaction to light

57.

What are general indicators of CNS depressants? (7)

1. Disoriented droopy eyes 2. Drowsiness 3. Drunk-like behavior 4. Gait ataxia 5. Slow, sluggish reactions 6. Thick, slurred speech 7. Uncoordinated

58.

What are the general indications of CNS stimulants? (9)

1. Anxiety 2. Body tremors 3. Dry mouth 4. Euphoria 5. Exaggerated reflexes 6. Excited 7. Eyelid tremors 8. Grinding teeth 9. Hallucinations

59.

What are the general indicators for hallucinogens? (12)

1. Body tremors 2. Dazed appearance 3. Difficulty with speech 4. Disoriented 5. Flashbacks 6. Hallucinations 7. Memory loss 8. Nausea 9. Paranoia 10. Perspiring 11. Poor perception of time and distance 12. Synesthesia

60.

What are the general indicators of dissociative anesthetic? (12)

1. Blank stare 2. Confused 3. Chemical odor 4. Cyclic behavior 5. Difficulty with speech 6. Disoriented 7. Early HGN onset 8. Hallucinations 9. Incomplete verbal responses 10. Increased pain threshold 11. Moon walking 12. Muscle rigidity

61.

What are the general indicators of narcotic analgesic? (12)

1. Constricted pupils 2. Depressed reflexes 3. Droopy eyelids 4. Drowsiness 5. Dry mouth 6. Euphoria 7. Itching 8. Nausea 9. On the nod 10. Puncture marks 11. Slow, low raspy speech 12. Slowed breathing

62.

What are the general indicators of inhalants? (12)

1. Bloodshot eyes 2. Confusion 3. Disoriented 4. Flushed face 5. Intense headaches 6. Lack of muscle control 7. Noncommunicative 8. Odor of substance 9. Possible nausea 10. Residue of substance 11. Slow, thick, slurred speech 12. Watery eyes

63.

64.

What are the general indicators of cannabis? (13)

What are some examples of CNS depressants? (6)

1. Altered perception of time/distance 2. Alterations in thought formation 3. Body tremors 4. Bloodshot eyes 5. Debris in mouth 6. Disoriented 7. Drowsiness 8. Eyelid tremors 9. Impaired memory 10. Increased appetite 11. Lack of concentration 12. Odor of marijuana 13. Possible paranoia

70.

What are some examples of cannabis? (3)

1. Marijuana 2. Hash 3. Hash oil

71.

What does toxicology assist with?

Establishing manner and cause of death

72.

What is the cause of death?

What actually caused the death (gunshot)

73.

What is the manner of death?

What actually happened (homicide)

74.

What is postmortem redistribution (PMR)?

Movement of drugs from one area to another by diffusion after death

75.

What is simple diffusion?

Movement from area of high concentration to area of low concentration

1. Benzodiazepines 2. Alprazolam (Xanax) 3. Opioids 4. Barbiturates 5. General anesthetics 6. Alcohol (ethanol)

76.

What is important in studying postmortem redistribution (PMR)?

Are the drug concentrations in blood collected at autopsy representative of the concentrations at the time of death?

77.

What are the factors that influence postmortem blood tests?

1. Site sampling (central blood, peripheral blood) 2. Decomposition 3. Manner of death (trauma) 4. Handling of body (CPR) 5. Conditions of death (aspiration, sea water, IV) 6. Method of blood sampling (blind thoracic stick) 7. Time since death 8. Sample storage (temperature, preservatives) 9. Type of blood (serum, plasma, whole blood) 10. Volume of distribution 11. Lipohilicity 12. pKa of drug

78.

Why do lipophilic drugs stay in the body longer than hydrophilic drugs?

Because they are stored in fat and cannot be released easily through water

79.

What is lipophilicity?

Drugs stored in fat

80.

Where can blood be drawn for site sampling?

1. Central 2. Peripheral blood (preferred)

81.

Describe central site sampling: (2)

1. Heart blood 2. Contributions from heart, liver, lung tissue

65.

What are some examples of CNS stimulants? (5)

1. Amphetamines 2. Cocaine 3. Methamphetamine 4. Caffeine 5. Nicotine

66.

What are some examples of hallucinogens? (5)

1. LSD (lysergic acid diethylamide) 2. PCP (phencyclidine) 3. Magic mushrooms (psilocybin) 4. Ketamine 5. Mescaline (peyote cactus)

67.

What are some examples of dissociative anesthetics? (4)

1. Nitrous oxide 2. Ketamine 3. Dextromethorphan 4. PCP

What are some examples of narcotic analgesics? (7)

1. Codeine 2. Hydrocodone 3. Oxycodone 4. Methadone 5. Hydromorphone 6. Morphine 7. Fentanyl

68.

69.

What are some examples of inhalants? (5)

1. Nitrites 2. Poppers 3. Snappers 4. Whippets 5. Aerosols

82.

Describe peripheral blood site sampling: (3)

1. Preferred 2. Femoral 3. Vessel should be ligated proximally, such that back flow from inferior vena cava or more central compartments does not occur

What type of syringe should be used for site sampling?

A clean/new hypodermic syringe

What are the psychological effects of marijuana? (3)

1. CNS depressant + stimulant (at low doses) 2. CNS depressant (at high doses) 3. Sedatin, euphoria, hallucinations, confusion, dizziness

85.

What are the physiological effects of marijuana?

Red eye, increased heart rate, dry mouth, increased appetite, vasodilation, eyelid tremors

86.

What are the duration of effects for marijuana? (4)

1. Peak: 10-30 minutes 2. Average duration (euphoria): 2 to 3 hours 3 Baseline return (behavior, physiological): 3 to 5 hours 4. Residual effets: 24 hours

87.

What is the LOQ after one joint? (2)

1. 0.5 ng/mL 2. Deetection times dependent highly on cut-off

88.

What are the detection times for plasma for one joint? (2)

1. THC: 3 to 27 hours 2. THC-COOH: 2 to 7 days

89.

Describe the amount of THC in plasma after 2-3 hours:

5 ng/mL

90.

Describe the amount of THC in blood after 2-3 hours:

2.5 ng/mL

91.

What is the parent drug (active drug) in marijuana?

THC

92.

What are the metabolites in marijuana? (2)

1. THC-COOH 2. THC-OH

93.

Describe the levels of THC and metabolites of a chronic user after 12 hours: (3)

1. THC: 0.86 ng/mL (plasma); 0.43 ng/mL (WB) 2. 11-OH-THC: 0.46 ng/mL 3. THC-COOH: 46 +/- 12 ng/mL

94.

Do chronic users have more THC and metabolites in their system than acute users?

Yes

83.

84.

95.

What is the Heustis model?

Chronic use studies, gives tool to estimate off of parent drug and metabolite and estimates time since last use

96.

What is Model I of the Huestis model?

THC

97.

What is Model II of the Huestis model?

THC + THC-COOH

98.

What is the first step for the estimation of last consumption?

Convert whole blood to plasma

99.

What are the key points for the Heustis model? (6)

1. 99.1% accurate with combined models 2. n = 717 3. No underestimates 4. Overestimates (4 minutes) 5. Applies to single and multiple doses 6. Validated for low cannabinoid concentrations

100.

When is the Huestis model 100% accurate?

With THC concentrations between 0.5 and 2.0 ng/mL and THCCOOH concentrations > ng/mL

101.

What are the limitations of the Huestis model? (2)

1. Postmortem 2. Ultra-chronic users

102.

Does marijuana increase traffic accidents?

Yes

103.

What did the Heustis simulation do?

Monitored how people drove while on a known amount of marijuanas

104.

What are the main two types of drug facilitated sexual assault (DFSA)? (2)

1. Opportunistic 2. Surreptitiously

105.

What is opportunistic sexual assault? (2)

1. Prey on intoxicated subject 2. Mos date rape cases

106.

What is surreptitiously sexual assault? (2)

1. Places intoxicating substance into beverage without victim's knowledge 2. Relatively rare

107.

What are the commonalities of DFSA drugs? (7)

1. Fast onset 2. Amnesia 3. Potentiated by alcohol 4. Sedative-hypnotic 5. Relaxing effects 6. Rapidly dissipated from body 7. Attempt to elude drug testing

108.

109.

110.

What are the most common symptoms of drug facilitated sexual assault? (5)

1. Fragmented memory 2. Blackout 3. Vomiting 4. Drowsiness 5. Loss of muscle control

What are the most common victims for DFSA assaults? (5)

1. All female 2. Average 23 years old 3. Range (12-54) 4. 80% caucasian 5. 19% African American

What are the most common suspects for DFSA assaults? (5)

1. 95% male 2. Average 29 years old 3. Range: 13-59 4. 60% caucasian 5. 36% African American

111.

In 87% of the DFSA cases the victim reported ______ ingesting a drug or alcohol

Voluntarily

112.

What are the most frequent drugs voluntarily used in DFSA cases? (3)

1. Ethanol 2. Marijuana 3. Alprazolam

113.

What does the media report that are the most common date rape drugs? (2)

1. GHB 2. Rohpnol

114.

What is the number one date rape drug?

Ethanol

115.

What is excited delirium (ExD)? (4)

1. An altered mental state usually triggered by mental illness or chronic abuse of illicit drugs which often results in sudden death 2. Common with cocaine (sometimes meth) 3. Can happen when the drug isn't at a toxic level 4. Often happens during stressful situations (arrest)

116.

117.

What are common symptoms of ExD? (7)

What is zolpidem? (3)

1. Disorientation 2. Aggressive/combative behavior 3. Hyperthermia/sweating 4. Hallucinations/paranoia 5. Exceptional strength 6. Apparent endurance without fatigue 7. Bizarre behavior 1. Ambien 2. Sleep aid 3. Sedative hypnotic

118.

What is the average treatment time for zolpidem?

Short term treatment of insomnia (4 weak)

119.

What is the half life for zolpidem? (2)

1. t^1/2 = 2 hours 2. Cmax = 2 hours

120.

What is the therapeutic range for zolpidem?

80 to 200 ng/mL

121.

For zolp...