Neurology Unit - Toxicology of Substance Abuse
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| Comatose/unresponsive patients should be tested for | alcohol. Always assume other drugs may be involved
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| Which is higher in EtOH, serum or whole blood? | Serum by 12%.
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| EtOH levels are usually measured using which specimen? | whole blood
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| alcohol detection in blood lasts how long? | depends on peak blood level, generally 1.5-12 hours in blood.
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| alcohol detection in urine | Detection window depends on peak level, but generally 1-2 hours longer than in the blood (which is 1.5-12 hours)
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| Urine assay | Urine assays are not as reliable as blood due to differences in renal function & clearance
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| Legally drunk BAC | .08%
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| Impaired balance and coordination BAC | .15%
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| Being in the cold and not recognizing it in an alcoholic may suggest BAC of | .20%
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| Loss of Consciousness BAC | .40%
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| Isopropanol is | rubbing alcohol
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| Methanol is | wood alcohol
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| Ethylene glycol is | antifreeze
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| Enzyme that metabolizes alcohol | alcohol dehydrogenase
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| _________ applies to the handling of evidence and its integrity | Chain of Custody
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| What is not used in a blood draw for a BAC? | alcohol prep
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| Lab abnormalities associated with chronic alcohol use | macrocytosis, anemia (appears later than macrocytosis), elevations in liver enzymes
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| ________ distinguishes between methanol and ethanol | Gas Liquid Chromatography
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| If you are at Duke and you want a substance abuse test stat, when should you expect to receive it? | In one hour. (routine is 4 hours at Duke)
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| Clinical sx of cocaine and amphetamines | hyperthermia, agitation, altered mental status
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| Urine screening of cannabinoids | are unreliable. False positives on screening is high. NSAIDs, passive smoking and 5% of unknown reasons cause false positives
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| Which drugs are lipophilic? | Cannabinoids and PCPs(hallucinogens).
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| Which drug is used as a horse tranquilizer? | PCP
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| Acetominophen, Salicylate, Tricyclics and Ethanol can be detected in a | serum drug screen (green tube top, no alcohol prep)
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| Meconium is used when? | In newborns to test for maternal drug use
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| Common toxicology specimens | breath, blood, urine, gastric aspirate, hair, meconium
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| How long are marijuana metabolites in the urine? | 1-7 days with light use, up to a month with moderate to heavy use.
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Created by:
ltm12