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Toxicity & poisoning


When does Pharmacology intersects with toxicology? When the physiological response to a drug is an adverse effect
What is Toxicology? The science of poisons and poisoning
What is a poison? Any substance that has the capacity to harm a living organism
What is the quantal dose-response curve used for? To determine the median lethal dose (LD50), and the therapeutic effectiveness [Effective dose(ED50)]
What do you use the slopes for in the quantal response curve The comparison of drugs A & B
Define Therapeutic index and what does it explain? It equals LD50/ED50 .. The larger the ratio the safer the drug
TRUE/FALSE: Median doses are considered slopes. FALSE
What is used as slopes in the quantal dose response curve? Margin of safety
What is Margin of safety equal to? LD1/ED99
When do you observe U shaped response ccurve? When Heavy metals and minerals are present
What are the 4 principles of Pharmacokinetics? Absorption, distribution, metabolism, and excretion
What is Toxicokinetics? refer the pharmacokinetics of a drug under circumstances that produce toxicity or excessive exposure - and may differ significantly
What does ingesting large amounts of pharmaceuticals cause? -1- Prolong its absorption -2- Alter its Protein binding -3- Alter the apparent volume of distribution -4- Alter its metabolic fate
What is the leading cause of overdose morbidity and mortality? Aspirin poisoning
What may aspiring overdose cause? spasm in the pyloric valve, delaying the entry of drug to the small intestines
Approximately how much is the elimination half life of valproic acid? about 14 Hours
The incidence and seriousness of toxicity is proportional to what? the concentration and duration of exposure to the drug
TRUE/FALSE: drug overdoes is an example of dose-dependent toxicities? TRUE
Pharmacologic toxicity is caused by 3 things what are they and an example of each? 1- Dose dependent = CNS depression produced by barbiturates, and degree of hypotension caused by nifedipine 2- Duration dependent = Tardive dyskinesia caused by antipsychotics 3- Correct dose = Phototoxicity associated with exposure to sunlight in patients treated with sulfonamides, tetracyclines, chlorpromazine
What causes Genotoxic effects? - Ionization radiation and many environmental chemicals - Many cancer chemotherapeutic drugs
Define an Allergy? An adverse reaction that results from previous sensitization to a particular chemical or one that is structurally similar
What is Anaphylaxia mediated by? IgE antibodies
What are the main targets of Anaphylactic reaction? 1. GIT 2. Skin 3. Respiratory system 4. Vasculature
What are cytolytic reactions mediated by? IgG and IgM and involve the complement system
What are the major target of cytolytic reaction? cells of the circulatory system
What are Arthrus reactions mediated by? IgG antibody - They are deposited in the vascular endothelium resulting in a destructive inflammatory response
What are Delayed Hypersensitivity reactions mediated by? Sensitized T lymphocytes and macrophages - when sensitized cells come in contact with an antigen, the inflammatory reaction is generated by production of lymphokines and influx of neutrophils and macrophages
What is Idiosyncratic reaction? Abnormal reactivity to a chemical that is peculiar to a particular individual and can result from gentic polymorphisms
What are the 2 main principles underlie all descriptive toxicity? 1. The effects of the chemicals on animals apply to human toxicity 2. Exposure of experimental animals to toxic agents in high doses is a necessary method to discover possible hazards to humans
On the basis of surface area and body weight, what is the difference between animal and human toxic effects? surface area- humans and animals encounter same range of toxicity ..... Body weight- humans are more vulnerable
How is toxicity testing in animals performed? 1. LD50 in 2 species by 2 different routs of administration 2. Repeat exposure for 90 days-by route intended to use 3. Long term studies are carried out the same time clinical trials are carried out 4. other tests are made to measure teragenicity
What does an IND (investigational New drug) include? 1. info on the composition and source of the drug 2. chemical and manufacture info 3. all data on animal studies 4. proposed clinical plans 5. names and credentials of physicians doing clinical trials 6. all key data relevant to study the drug
What are the 2 signals that the FDA rely on to detect rare adverse drug reactions 1. required post marketing surveillance of drugs 2. Voluntary reporting system available for health professionals and consumers
Top 5 agents involved in drug related deaths cocaine, opioids, Benzodiazepines, alcohols, antidepressants.
Reduce medication administration error - short term 1. maintain unit-dose distribution systems 2. have pharmacies prepare IV solutions 3. remove inherently dangerous meds from patient care areas 4. develop special procedures for high risk drugs ................. many more
Reduce medication administration error - long term 1. Technology based safeguards, computerized order entry 2. computerized dose and allergy checking 3. computerized medication tracking 4. use of bar codes for medication preparation and administration
What are the major goals of treatment of poisoning 1. maintain vita physiological functions from impairment 2. keep concentration of poison in the tissue as low as possible preventing absorption and enhancing elemination 3. combat the toxicological effects of the poison at the effector site
What are the steps for decontamination of poisoned patient 1. stop exposure 2. Wash Eye and Skin 3. GI decontamination --> gastric emptying 4. Gastric emptying may be attempted by induce vomitting .. like using syrup ipecac 5. gastric lavage involve removing stomach content using a tube
What is the most common adsorbent used in the treatment of acute drug overdose? Activated charcoal
What is whole bowel irrigation and what is the goal of it involves enternal administration of large amounts of high molecular weight, iso-osmotic polyethylene glycol electrolyte solution. The goal is to pass the poison by the rectum before ir can be absorbed
How can you alkalinize urine? administering sodium bicarbonate
Created by: amiqnais



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