Exam 4 Chemistry Review/Study Questions Part 8

Which therapeutic drug has an OD that leads to severe liver necrosis due to accumulation of free radicals?
Acetaminophen
Treatment for Acetaminophen OD is effective in the first how many hours?
48 hours
Acetaminophen – _____ can predict liver toxicity based on serum levels
Nomogram
True or False:
Alcohol ingestion increases toxic effects of Acetaminophen
True
Acetaminophen OD – Samples should be drawn how many hours post ingestion and monitored over a 24 period?
4 hours
What else should be monitored when an Acetaminophen OD occurs?
Liver enzymes, bilirubin and PT
What are the side effects of Salicylate (Aspirin)?
GI irritation, disturbed platelet aggregation, tinnitus
What are 2 Other OTC NSAIDs?
Ibuprofen
Naproxen
____ is a possibility for any patient who is unconscious for unexplained reasons
OD
True or False:
Because most drugs clear quickly, screening tests can only detect recent abuse
True
Name 7 Drugs with a High Potential for Abuse
Tranquilizers
Amphetamine/Methamphetamine
Cannabinoids
Cocaine
Opiates
Hallucinogens
Anabolic Steroids
What are the following consistent with:
CNS depressants/ anti-anxiety drugs
Barbiturates (Pentobarb, phenobarb)
Benzodiazepines (Valium, Librium, Ativan, Prozac)
Tranquilizers (Sedative-Hypnotics)
What does OD of Tranquilizers (Sedative-Hypnotics) cause?
lethargy, slurred speech, stupor, respiratory arrest, coma
What are the following consistent with:
CNS stimulants (bennies, uppers, speed)
Used to treat narcolepsy and ADD
Causes talkativeness, restlessness, tremors, psychosis
Amphetamine/Methamphetamine
What are the following consistent with:
Psychoactive compounds (primarily THC) in marijuana and hashish
Lipophilic = accumulation in brain/fat cells; slower elimination
Detected up to 5 days after single use; one month+ in chronic use
Alters mood, perception, psychomotor skills, short-term memory; paranoia
Cannabinoids
What are the following consistent with:
Local anesthetic
CNS stimulator: elicits a sense of excitement and euphoria
Cocaine
What are the following consistent with:
Used as analgesics, sedatives and anesthesia
Derived from opium poppy
Opiates
Amphetamine/Methamphetamine – A
llergy meds contained the chemically related _____ & _______
ephedrine & pseudoephedrine
___________ – amphetamine designer derivative
MDMA (Ecstasy)
Cannabinoids – what does the current method distinguish between?
Direct Use and Passive Exposure
Marinol and medical marijuana are used to treat what?
anorexia, glaucoma, pain, and nausea associated with chemo
OD of Cocaine is associated with what?
Seizures and heart attacks
What are the following consistent with:
LSD, PCP (Phencyclidine), Mescaline
May cause both stimulant and depressant effects
Hostility, paranoia, flashbacks
Hallucinogens
What are the following consistent with:
Related to testosterone; originally developed to treat male hypogonadism
Increases muscle mass and athletic performance
Hepatitis, atherosclerosis, stroke, MI, sterility, impotence
Potency of black market drugs is variable
Anabolic Steroids
List 3 Natural Opiates
morphine, codeine, opium
List 3-4 Natural Modified Opiates
Heroin, Oxycodone/Dilaudid, Percodan
List 2 Synthetic Opiates
Demerol, Darvon
What is an OD of Opiates tied to?
Respiratory acidosis and heart failure (myoglobin, CKMB and TnI)
Which Drug with a high potential for abuse was originally developed to treat male hypogonadism?
Anabolic Steroids
Which Metal is consistent with the following:
Naturally occurring and man

made:
insecticides, herbicides, and treated lumber
Disrupts many proteins
GI bleeding, shock and convulsions
Arsenic
Which Metal is consistent with the following:
Commercial and art paints; in pipes and on highways from car emissions
Most toxicity is from ingestion of contaminated foods
Inhibits heme and Vit D synthesis
Causes anemia (hypoxia), liver and kidney injury, bone disorders,brain dysfunction, birth defects, porphyria
Lead
Which Metal is consistent with the following:
Most toxicity is from contaminated foods (fish/seafood) or industrial
Binds / alters proteins
Bloody diarrhea, behavioral changes, loss of balance
If patient survives initial poisoning, renal failure often follows
Mercury
Tests to determine adulteration. General rules for urine sample validity:
Temperature
91-97 degrees F
Tests to determine adulteration. General rules for urine sample validity:
Creatinine
Positive
Tests to determine adulteration. General rules for urine sample validity:
SG
1.003-1.035
Tests to determine adulteration. General rules for urine sample validity:
pH
4-10
Tests to determine adulteration. General rules for urine sample validity:
Nitrite
Negative
Tests to determine adulteration. General rules for urine sample validity:
Glutaraldehyde
Negative
What does lead inhibit?
Heme and Vitamin D Synthesis
What does Lead Poisoning cause?
Anemia (hypoxia), liver and kidney injury, bone disorders,brain dysfunction, birth defects, porphyria
Most Mercury Toxicity is from where?
Contaminated foods (fish/seafood) or industrial
What does Mercury do?
Binds/Alters Proteins
If patient survives initial Mercury Poisoning, what often follows?
Renal Failure
Which Misc. Toxic Agent is associated with the following:
Incomplete combustions of fuels
Binds to hemoglobin (replaces O2) to form carboxyhemoglobin
Severe hypoxia, primarily affecting heart and brain (lactic acidosis)
Carbon Monoxide
Which Misc. Toxic Agent is associated with the following:
Gas or solid: insecticides, rat poison, burning insulation
Binds to heme iron and disrupts production of cellular ATP
Respiratory arrest, seizures, coma, death
Cyanide
Which Misc. Toxic Agent is associated with the following:
Pesticides (contaminated food/ industrial exposure)
Affects nerve synapses, causing salivation, involuntary urination and
defecation, muscle cramps, respiratory failure
Organophosphates
What does Carbon Monoxide bind to?
Hemoglobin
When Carbon Monoxide binds to hemoglobin what does it replace?
O2
When Carbon Monoxide binds to hemoglobin what does it form?
Carboxyhemoglobin
What does Cyanide bind to?
Heme Iron
When Cyanide binds to Heme Iron, what does it disrupt?
Production of cellular ATP
What do Organophosphates affect?
Nerve Synapses
When Organophosphates affect nerve synapses, what does this cause?
Salivation, involuntary urination and
defecation, muscle cramps, respiratory failure
Hair can detect alcohol and drugs for how long after exposure?
Months
True or False:
Hair AND Saliva are Impossible to adulterate
True
What is considered the best specimen for alcohol testing?
Blood
Other than alcohol, what else can Saliva detect?
Drugs of abuse