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TDM/Toxicology
68K 12-01 Chem 201 Unit 4
83
Chemistry
Undergraduate 2
12/12/2011

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Term
Pharmacology
Definition
study of how drugs interact with living organisms and how the body affects the drugs.
Term
Pharmaceuticals
Definition
substances that have medicinal properties.
Term
Pharmacokinetics (PK)
Definition
the study of the body's effects on the drug, to include; absorption, distribution, metabolism, and excretion
Term
Pharmacodynamics (PD)
Definition
the study of the physiological effects of the drugs on the body.
Term
Therapeutic Range
Definition
range of serum drug concentrations associated with therapeutic effect.
Term
Trough
Definition
lowest drug concentration during a dosing interval, occurs immediately before the next dose.
Term
Peak
Definition
highest serum concetration of a drug. Exact peak cannot be determined without frequen serial blood sampling.
Term
Half-Life
Definition
time required for serum drug concentration to decrease by 50%
Term
Steady State
Definition
equilibrium when the drug input equals drug excretion.
Term
Minimum Effective Concentration (MEC)
Definition
minimum serum drug concentration needed to produce desired therapeutic effect.
Term
Minimum Toxic Concentration (MTC)
Definition
minimum serum drug concentration needed to produce a toxic effect on the body.
Term
Describe an optimal dosing cycle
Definition
trough blood concentration does not fall below MEC, Peak does not rise above MTC.
administered once every half life
Acheives steady state
Term
Blood concentrations greater than MTC
Definition
place the patient at risk for the toxic effects of the drug
Term
Blood concentrations lower than MEC
Definition
place the patient at risk for the disorder the drug was intended to treat.
Term
Bioavailability
Definition
fraction of the drug that is absorbed into systemic circulation.

oral drugs most have greater tahn 70% of the administered use availble to the body.
Term
First PAss Effect & Liver Biontrasformation
Definition
drugs pass through the stomach into the small intestine and directly to the liver where it is extensively metabolized before reaching the systemic circulation. Drugs are generally convered to polar, water soluble molecules through oxidation reduction or hydrolysis making them more readily excreted.
Term
LIVER
Definition
Principal organ for drug metabolism.
Term
Rate of absorption
Definition
usually much greater than rate of elimation. ORal drugs are formulated with larger doses because of First Pass. IV drugs MUCH smaller doses because 100% enters the blood stream.
Term
Conditions that Influence rate of drug absorbtion
Definition
Abnormal GI motility, disease or infection of the GI tract, Food (presence or absence) and co-administered drugs.
Term
Synergistic
Definition
drug that enhances the therapeutic effect of another drug, beneficial or harmful.
Term
Antagonistic
Definition
drug that diminishes the action of another drug, may be beneficial ro harmful
Term
free faction of a drug
Definition
the form capable of generating a therapeutic effect.
Term
Liphilic drugs
Definition
cross the cellular membrane
Term
warer-soluble drugs
Definition
interact withd rug receptors to elicit a biological response.
Term
REnal pathway
Definition
major exretion route for water soulble drugs or drug metabolites. disease or injury of the kidnesy may geratly reduce excretion rate and half life of a drug.
Term
Cardioactive Drugs
Definition
used to treat heart conditions, some require TDM because of a small therapeutic range.
Term
Digoxin
Definition
cardiac glycoside used to treat cardiac arrhythmia.
Cardioactive drug.
Term
Lidocaine, Quinidine, PRocainamide
Definition
used to correct ventricular arrhythmia and prevent ventricular fibrillation.
Cardioactive drug.
Term
Antibiotics
Definition
effective against a wide range of bacteria.
Term
Aminoglycosides
Definition
used for the treatment of infections with gram-negative bacter, resustant to less toxic antibiotic. I.E. gentamicin, tobramycin, amikacin, and kanamycin.
Term
Vancomycin
Definition
glycopeptide antibiotic, effective against select gram-positive bacteriai. adminsiterd by IV infusion.
Term
Antiepileptic
Definition
effective against epilepsy
Term
phenobarbital
Definition
slow acting barbituate controls several types of seizures, abosprion is very slow. Antiepileptic.
Term
Phenytoin (dilantin)
Definition
treats a variety of seizure disorders, short term prophylactic agent to produce loss of function tissue. amdin oral. Antiepileptic.
Term
Valproic Acid
Definition
anticonvulsant and mood-stabilizing antiepileptic. USed to treat epeilepsy and bipolar disorder.
Term
Psychoactive
Definition
drugs effective at affecting the mind or behavior.
Term
Lithium
Definition
Orally administered psychoactive drug, used to treat manic-depressive illness, absorption is complete and rapid.
Term
Tricyclic Antidepressants
Definition
used to treat dpression, insomina, and extreme apathy. Psychoactive drugs.
Term
Bronchodilators
Definition
effective at dilating or expanding the air passages of the lung.
Term
Theophylline
Definition
aersol administered bronchodilator used in the treatment of asthma or other COPDs
Term
Advantages of having a TDM program
Definition
Detection of non-comliance, detects patients undergoing changes in drug disposition characteristics, can be used to adjust therapeutic regimens, establishes a dosage baseline.
Term
Collection Procedure for legal toxicology exams.
Definition
Must have a Chain of Custody. Collection and preservation IAW local SOP, PRoperly label and seal container, sign and date appropriate chain of custody form.
Term
Transportation and Storage of Legal Toxicology samples
Definition
specimens and other evidence must remain in custody of appropriate personnel or in a locked container to avoid legal obligations, decomentation includes detailed descreption of collection contatiner and signatures of transporting and receiving individuals.
Term
Chemical Analysis of a Legal Toxicology sample
Definition
ran in duplicate alongside known controls, annoted with testing individual's signature, stored in locked freezer per local SOP.
Term
Reporting Results for legal Toxicology samples
Definition
Legal toxicology results are NEVER give over the phone, the only individual authorized to receive toxicology results is the registrar from patient admin.
Term
Toxicology
Definition
science of poisons and their effects on the body
Term
Posion
Definition
chemical agent that when ingested, injected, inhaled, or absorbed can cause tissue injury or death.
Term
Dose
Definition
the amount of chemical agent introduced into the body.
Term
Lethal Dose 50
Definition
Quantity of a substance required to cause death in 50% of the sample group.
Term
Therapeutic Dose
Definition
amount of a substance that will produce a desired pharmacological effect.
Term
Drug of Abuse
Definition
drug used in excess or for non therapeutic reasons. high abuse potential and users can become addicted.
Term
Drug Addiction
Definition
physiological degree of drug dependence. USers are compulsively seeking, regardless of the potentiall negative consequences.
Term
Mechanisms of Toxicity
Definition
intereferecne with critical enzyme actions, blockage of O2, interferes with cell function, hypersensitivity reactions.
Term
Factors of Toxicity
Definition
Nature of toxicant, route of exposure, dosage, drug interactions, biological variables.
Term
Clinical Toxicology
Definition
Analysis of drugs, heavy metals and other chemical agents to support patient care.
Term
Forensic Toxicology
Definition
effects of potentially toxic substances as a determination of a cause of death to aid in medico-legal investigations.
Term
Examples of Psychostimulants
Definition
cocaine, amphetamines, methamphetamine, MDMA
Term
Examples of Cannabinoids
Definition
Marijuana, hasish
Term
CNS depressants
Definition
barbituarates alcohol, benzodiazepines
Term
Exampels of Opioids
Definition
morphine, codeine, oxycodone, oxymorpone, heroid, opium
Term
Psychedelics
Definition
LSD, designer amphetamines, peyote, [silocybin, PCP
Term
Examples of Sports enhancing drugs
Definition
anabolic steroids, hGH
Term
Examples of General Stimulants
Definition
nicotine, tobacco, caffeine
Term
Examples of inahalants and anestehtics
Definition
volatile nitrites, organic solvents.
Term
Medico-legal cases
Definition
possibility of criminal poisoning exists, legal action may be taken to determine liability.
Term
Chain of Custody
Definition
unbroken documentation trail of accountability, guarantees a samples security, inclusdes whi came in contact with a sample, why, and where it occurred.
Term
Ethanol
Definition
the most common drug of abuse seen in the emergency room.
Term
SOurces of ethanol
Definition
fermentation, distillation
Term
Major uses of alcohol
Definition
alcoholic beverages, solvents, antidote for methanol poisoning.
Term
Legal issues resulting from Alcohol
Definition
BAC of greater that .08% legal evidence for a criminal conviction for intoxicated driving.
any detectable ethanol present whil on duty is grounds for UCMJ
Term
Metabolism of Ethanol
Definition
rapidly absorbed from the GI tract, 20% is absorbed from stomach, 80% from the samll intestitime. 90-98% is oxidized to acetaldehyde by alcohol dehydrogenaze.
Term
Effects of alcohol on the musclar system
Definition
coordination is impaired.
Term
Efects on the circulatory system of alcohol
Definition
blood vessels dialate causing heat loss.
Term
effects on the respiratory system of alcohol
Definition
small doses stimulate respiration
Term
effects of the nervous system of alchol
Definition
low doses causes lowered social inhibition, followed by mental confusion and uncontrolled mood swings, excessive doses cause loss of consciousness or coma.
Term
effects of alcohol on the digestive system
Definition
increase in secretions cause stomach irritation, chronic use causes hepatatis and cirrhosis.
Term
effects of alcohol on the reprodcutive system
Definition
women : misscarriage, infant death, Fetal Alcohol Syndrome.
Males : impotence and decreased testoterone.
Term
Treatment for alcoholism.
Definition
Withrdol from alcohol is more severe and more likely to cause death than ANY OTHER DRUG.
Detoxification, clear stomach and treat DT with denzodiazepine.
Term
Acetiminophen
Definition
over the counter anagelisc, large amoutn of cytochrome p450 causes liver damage. REnal damage less frequently. alcoholics more prone to posisonig.
Term
Carbon Monoxide
Definition
most commonly encountered tpoxic cause. toxicity is consequence of cellular hypoxia.
Term
LEad
Definition
toxic to multiple oragn systems, inactivation of enzymes and other macromolecules.
Term
MErcury
Definition
itoxic to the CNS ptoent tertogen, mecuric salts are corrosive to skin eyes and GI tract, nephrotoxic.
Term
ORganophosphates
Definition
inhibit the critical enzyme acetlchoinestrase. found in insectisides and chemical warfare agents.
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