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63 Cards in this Set

  • Front
  • Back
what is toxicity
ability of an agent to cause injury
what is risk
expected frequency o foccurrence of an undesirable effect
what is hazard
likelihood that injury will occur in any given situation
what is LD50
dose which causes death in 50 percent of exposed animals
what is a graded dose response relation ship
increase in magintude of dose increases magnitude of response
what is a quantal dose response relationship
the percentage of the population affected increases as the dose is raised
what is ED50
dose where 50 percent of subjects show a response
what is the formula for therapeudic index
LD50/ED50
what are the three types of toxic reactions
- pharmacological
- pathological
- genotoxic
what is local toxicity
toxcicity effect at the site where the toxin first encounters the body with rapid onset and short duration
what is systemic toxicity
involves one or more systems in the body
what is chemical allergy
adverse reaction that results from previous sensitization to a compound or to one that is structurally similar
what are the rule when evaluating patients
treat the patient not the poison
what is the goal of termination of exposure
decrease the dose the patient recieves
what are the three methods of emeiss
- mechanical
- ipecac
- apomorphine
what are the 5 methods of prevention of absorption
- emesis
- gastric lavage
- chemical absorption
- chemical inactivation
- purgation
what is used for prevention of absorption by chemical absorption
activated charcoal
what are three ways to increase elimination
- alter metabolism
- modify urinary excretion
- dialysis
what are the two methods to change urinary excretion
diuretics
modify urine pH
what drug can cause acifification of the urine
amphetamine
what two drugs can cause alkalinization of urine
phenobarbital
salicylates
how do you counter opiod intoxication
naloxone
how do you counter heavy metal poisoning
chelating agents
what is the antidote for acetaminophen OD
acetylcystein
what is the antidotes for anticholinesterase OD
atropine
what is the antidote for antimuscarinic agent OD
physostigmine
what is the antidote for ethylene glycol OD
Ethanol
what is the antidote for arsenic OD
dimercaprol (BAL
what is the antidote for copper OD
penicillamine
what is the antidote for gold OD
BAL or penicillamine
What is the antidote for lead OD
calcium disodium edetate (CaEDTA) or penicillamine
what is the treatment for mercury OD
nacetylpenicillamine or BAL
what is the treatment for iron OD
eferoxamine
what is the treatment for methanolol OD
ethanol
what is the treatment for organophosphate OD
atropine + pralidozime (2-PAM
where are the four places that heavy metals are absorbed
- Mainly Gi
- respiratory
- mucosal surfaces
- skin
where is the distribution of heavy metal in heavy metal toxicity (5)
soft tissue
- CNS
- Liver
- Kidney
- skeleton (lead only)
where does metabolism of heavy metals occur
liver
where does exretion of heavy metals occur (4)
- kidneys
- sweat
- GI
- Breast Milk
what is the pharmacodynamics for lead
displace cation, espeically calcium in bone
what is the pharmacodynamics for lead and mercury
- alter membrane structure
what does lead toxicity in children lead to (7)
- Developmental delay
- decrease neurocognitive function
- hyperkinesis
- aggressive behavior
- convulsions
- peripheral neuropathies
- metabolic disorders
what are the hallmark signs for lead poisoning
muscle weakness
wrist or foot drop
what are teh CNS effects of lead
encephalopathy in all ages
what are the effects of lead poisioning in adults (5)
- GI disturbances
- Milky vomit
- abdominal pain
- metallic taste
- black stools
how does lead OD affect blood
hypochromic microcytic anemia due to decreased lifespane
what does mercury toxicity cause (4)
-behavioral problems
- peripheral neuropathy
-acture renal tubular necrosis
- gastroenteritis
what does arsenic cause (5)
- shock
- arrhythmias
- peripheral neuropathy
encephalopathy
- cancer
what is the michaelis menton formula
V = (Vmax* [S]) / Km+ [S]
what are first order reactions according to michaelis menten model
- KM is very large relative to substrate con
- drug is elimitated exponentially
- conc never reaches zero
- non saturable
what does a change in dose in 1st order kinetics cause
a change in dose will lead to a proporinonate change in the steady state plasma level achieved
what is saturation kinetics in micealis menton model
- [S] is very large relative to Km
- velocity is capacity limited by VBmax
- only a fixed amount of drug can transverse the pathway per unit time
what occurs in saturation kinetics if plasma drug conc exceed vmax
further dose increase will result in disproportionate and unexpectedly high plasma drug conc
what are the three main objects in human drug testing
- determine whether the pharmacologic effects seen in humans confirm predictions derived from animal data
- to show that pharmacological actions lead to therapeutically useful effects
- to determine safety in humans
what trials must be completed before a drug can be approved
phase III
who monitors adverse reactions of drugs following marketing
Committee on safety of medicines
what is the application called to start testing new drugs in humans
investigational new drug application
what 5 things are included in the IND
- information on the compositon and source of drug
- manufacturing information
- all data from animal studies
- clinical plans and protocols
- names and creditial of physicians who will conduct the clinical trials
what must be approved before human clinical trials began
- IND
why do most drugs not reach phase 3 human studies
because of toxicity occuring or because the pharmaceutical therapeutic benefit did not occur in humans
what is the most rigorus and most widley used control clinical trial
- concurrent control
what is a concurrent control study
- concurrent control group receivdes the placebo and is observed simultaneously with the group given the experimental drug
- most are double blind, randomized and cross-over design
what occurs in cross over designs
- patients act as their own control in that they recieve either the test drug, the standard control drug and the placebo for a certain period