Chem 6A Toxicology & Newborn Chemistry

Front 1

List the antidote used in overdose of Acetaminophen.

Back 1

Acetaminophen antidote.
N-acetylcysteine
(NAC, Mucomyst)

Front 2

List the antidote used in overdose of Salicylate.

Back 2

Salicylate antidote.
forced alkaline diuresis

Front 3

Llist the antidote for overdose of Lead.

Back 3

Lead antidote.
EDTA or other lead chelators, Dimercaprol (BAL = British antilervisite)

Front 4

List the antidote used in overdose of Carbon monoxide.

Back 4

Carbon monoxide antidote.
remove from source of CO; administer oxygen

Front 5

List the antidote used in overdose of Wood alcohol (methanol).

Back 5

Wood alcohol (methanol) antidote.
ethanol (block alcohol dehydrogenase & block formation of metabolites); 4-Methylpyrazole (fomepizole); Sodium bicarbonate (treat resulting acidosis)

Front 6

Drigs; Class: Stimulants; Metabolites

Back 6

Drug; Class: Stimulants: Metabolites
Cocaine: Benzoylecgonine
Amphetamine: Benzoic acid, etc.
Methamphetamine: Norephidrine, D-methamphetamine, etc.

Front 7

Drug; Class: Narcotics; Metabolites

Back 7

Drug; Class: Narcotics: Metabolites
Heroin: Morphine
Methadone: Methadol, 3-diphenylpyrroline, etc.
Codeine: Mrophine, norcodeine
Meperidine (Demerol): normeperidine, meperidinic acid, etc.
Morphine: Morphine sulfate, morphine conjugates

Front 8

Drug; Class: Depressant; Metabolites

Back 8

Drug; Class: Depressant; Metabolites
Diazepam: glucoronide conjugates, nordiazepam, oxazepam, etc
Ethanol: Acetaldehyde, acetate

Front 9

Define LD50.

Back 9

LD50: the amount of a substance that will cause death in half the test animal population;
Lethal dose for 50% of the population.

Front 10

Define compartment (TDM).

Back 10

Compartment (TDM): specific place in the body where a drug is present (plasma, tissue).

Front 11

Define first order kinetics.

Back 11

First order kinetics: describes absorption, distribution & elimination of drugs. The rate of change in a drug's concentration change is dependent on the drug concentration. (The rate of metabolism is dependent on the substrate concentration.) A constant % of drug is eliminated per unit of time.

Front 12

Define peak concentration (TDM):

Back 12

Peak concentration (TDM): drug concentration at its highest.

Front 13

Define therapeutic range (TDM).

Back 13

Therapeutic range (TDM): concentration of a drug between the minimum effective concentration & minimum toxic concentration.

Front 14

Define trough concentration (TDM).

Back 14

Trough concentration (TDM): drug plasma concentration at its lowest.

Front 15

What is the metabolite of epinephrine?

Back 15

Epinephrine metabolite. VMA (vanillylmandelic acid) & metanephrine.

Front 16

What is therapeutic drug monitoring? Define half-life.

Back 16

TDM: process of determining the quantity of a therapeutic drug required to produce a predetermined desirable effect.

Half-life of a drug is the time required for the drug concentration to be decreased by 1/2.

Front 17

Name & define the 4 processes that take place when a therapeutic agent is administered to a patient.

Back 17

4 processes:
Absorption: drug enters blood
Distribution: transferred via blood to its site of action
Metabolism: aka biotransformation. Occurs mainly in the liver; metabolites are formed with increase, decrease, or have no effect on the activity of the drug.
Excretion: elimination for the body (usually in urine if water soluble).

Front 18

What plant is digoxin derived from?

Back 18

Digoxin is derived from the foxgtlove plant (digitalis lanata or purpurea)

Front 19

What are the toxic effects of digoxin?

Back 19

Toxic effects of digoxin: affect cellular K transport, resulting in bradycardia (rapid heart rate), followed by arrhythmia, coma & death

Front 20

Why do we test Procainamide and NAPA durg levels on a patient? How do we dilute a high specimen?

Back 20

NAPA is a metabolite of procainamide & has similar anti-arrhythmic activity. NAPA has a longer 1/2 life than procainamide.
Dilute with like amount of purified water.

Front 21

What is the principle of the salicylate procedure? What is the toxic level of salicylates?

Back 21

Salicylate: procedure, toxic level.
Toxic of >100 ug/mL 6 hrs after ingestion --> gastric intolerance, affects platelet function & therefore hemostasis

Trinder method: salicylate + Fe3+ --> violet complex measured at 540 nm. Not specific, but no false negative reactions (ie. it is sensitive method)

Trough level <100 ug/mL; anti-inflammatory=150-300 ug/mL; intoxication >500 ug/mL

Front 22

Why is the procedure for drawing a blood alcohol so exact?

Back 22

May be used in court as evidence for DUI charges; do not use alcohol or volatiles to clean the venipuncture site.

Front 23

Would you expect to see a higher or lower K value on a newborn than a child?

Back 23

K value newborn vs. child.
Higher K values with newborns; More K is released because RBCs with hemoglobin F cells denature quicker than Hgb A RBCs. Also, newborn kidneys may not be functioning as well as older child (kidneys immature).

Front 24

When an acute care panel is collected by heelstick, which value is not reported?

Back 24

Heelstick value not reported.
CO2

Front 25

Define neonate.

Back 25

Neonate: newborn <28 days.

Front 26

List tests that are common for neonates.

Back 26

Common tests for neonates:

bilirubin, glucose, hemoglobin/hematocrit, PKU, electrolytes