Pharmacology and Toxicology Quiz
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Questions and Answers

What does toxicity refer to in pharmacology?

  • The measure of a substance's benefits to health.
  • The ability of a substance to enhance biological processes.
  • The process of absorption, distribution, and excretion of drugs.
  • The ability of a substance to cause harm to a biological system. (correct)

    • Which branch of toxicology focuses on investigating the legal implications of toxic substances?

  • Regulatory Toxicology
  • Forensic Toxicology (correct)
  • Mechanistic Toxicology
  • Environmental Toxicology

    • What type of toxicologist would be most interested in the effects of pollutants on ecosystems?

  • Descriptive Toxicologist
  • Clinical Toxicologist
  • Environmental Toxicologist (correct)
  • Occupational Toxicologist

    • Which of the following is an application of clinical toxicology?

    <p>Treating poisonings and injuries from xenobiotics.</p> Signup and view all the answers

    How does tetrodotoxin affect the human body?

    <p>Blocks voltage-gated sodium channels, leading to numbness and respiratory failure.</p> Signup and view all the answers

    What does mechanistic toxicology primarily study?

    <p>How chemicals are absorbed and excreted.</p> Signup and view all the answers

    Which toxicology branch evaluates the safety of drugs and other products?

    <p>Descriptive Toxicology</p> Signup and view all the answers

    Who is considered the 'father' of toxicology?

    <p>Paracelsus</p> Signup and view all the answers

    Which of the following drugs can cause bradycardia and atrioventricular node block?

    <p>Barbiturates</p> Signup and view all the answers

    What type of toxicological analysis is primarily used for detecting acetaminophen poisoning?

    <p>Thin layer chromatography</p> Signup and view all the answers

    Which of the following is NOT a principle of poisoning management?

    <p>Immediate surgery</p> Signup and view all the answers

    Which drug is associated with QRS prolongation due to poisoning?

    <p>Amantidine</p> Signup and view all the answers

    What method is used for detecting benzodiazepines (BZD) in toxicological analysis?

    <p>Gas liquid chromatography</p> Signup and view all the answers

    Which of the following is a potential cause of ventricular tachyarrhythmias in cases of poisoning?

    <p>Cardiac glycosides</p> Signup and view all the answers

    Which bioassay is NOT typically used for confirming drug poisoning?

    <p>Acetone</p> Signup and view all the answers

    What is the primary goal of preventing future poison absorption during poisoning management?

    <p>To induce vomiting</p> Signup and view all the answers

    What is the intended urine pH range achieved by alkalinization with sodium bicarbonate?

    <p>7.5 - 8.0</p> Signup and view all the answers

    Which of the following is a contraindication for alkalinization therapy?

    <p>Congestive heart failure</p> Signup and view all the answers

    Which substance is primarily eliminated by acidification of urine?

    <p>Phencyclidine</p> Signup and view all the answers

    Which of the following statements about hemodialysis is true?

    <p>It can help remove toxins absorbed by the gut.</p> Signup and view all the answers

    What is the main purpose of chelation therapy?

    <p>To bind and excrete heavy metals</p> Signup and view all the answers

    Which of the following agents is commonly used as a chelating agent?

    <p>Dimercaprol</p> Signup and view all the answers

    Which of the following toxins is NOT typically managed with hemodialysis?

    <p>Aspirin</p> Signup and view all the answers

    What are the potential side effects of urine acidification?

    <p>Metabolic acidosis</p> Signup and view all the answers

    What is the average decrease in ingestant absorption when gastric lavage is performed within 5 minutes of ingestion?

    <p>52 %</p> Signup and view all the answers

    Which scenario is a contraindication for the use of ipecac syrup?

    <p>CNS depression or seizures</p> Signup and view all the answers

    Which of the following is NOT a common complication associated with gastric lavage?

    <p>Hypotension</p> Signup and view all the answers

    What is the recommended dose of activated charcoal per kilogram of body weight?

    <p>1 g/kg</p> Signup and view all the answers

    What is a potential side effect of administering ipecac syrup?

    <p>Protracted vomiting</p> Signup and view all the answers

    Which of the following is a contraindication for gastric lavage?

    <p>Unprotected airway</p> Signup and view all the answers

    Which of the following statements about activated charcoal is false?

    <p>It decreases absorption by 70 %.</p> Signup and view all the answers

    What fundamental principle of toxicology is illustrated by the phrase 'the dose makes the poison'?

    <p>The right dose differentiates a poison from a remedy.</p> Signup and view all the answers

    When can gastric lavage achieve only a 16% decrease in absorption?

    <p>If performed at 60 minutes</p> Signup and view all the answers

    Which of the following factors does NOT influence toxicity?

    <p>Color of the substance</p> Signup and view all the answers

    What differentiates acute effects from chronic effects in toxicology?

    <p>Acute effects occur immediately; chronic effects appear over time.</p> Signup and view all the answers

    Which substance is likely to have local effects at the point of contact?

    <p>Sulphuric acid causing burns on skin</p> Signup and view all the answers

    Which statement correctly describes carcinogenic and teratogenic effects?

    <p>They are typically irreversible.</p> Signup and view all the answers

    What is a major complication in linking cause and effect in toxicology?

    <p>Effects may manifest long after exposure, complicating attribution.</p> Signup and view all the answers

    What characteristic of a chemical determines if its toxic effects are reversible or irreversible?

    <p>The ability of the affected tissue to repair itself</p> Signup and view all the answers

    Why is detailed toxicological information often lacking for many substances?

    <p>Research on substances is limited and sometimes non-existent.</p> Signup and view all the answers

    What is one of the main advantages of extracorporeal blood rewarming?

    <p>It allows for rapid rewarming by directly warming the blood.</p> Signup and view all the answers

    In which scenarios should more invasive methods of active rewarming be considered?

    <p>Severe and refractory cases including hypothermic cardiac arrest.</p> Signup and view all the answers

    What are common complications associated with internal cooling techniques?

    <p>Difficulty in managing the procedures.</p> Signup and view all the answers

    Which medication can be used to treat pulmonary edema by reducing pressure caused by excess fluid?

    <p>Furosemide (Lasix)</p> Signup and view all the answers

    What is the role of vasodilators like Nitroglycerin in managing pulmonary edema?

    <p>To decrease pressure in the heart and lungs.</p> Signup and view all the answers

    Which of the following is NOT an internal cooling technique?

    <p>External immersion in iced saline bath</p> Signup and view all the answers

    What is a key characteristic of cavity lavage used in active rewarming?

    <p>It involves the use of warm fluids.</p> Signup and view all the answers

    Why is active rewarming using more invasive methods reserved for specific cases?

    <p>They are complex and carry higher risks.</p> Signup and view all the answers

    Study Notes

    Introduction to Toxicology

    • Toxicology is the study of the potential for a substance to produce adverse health effects on living organisms and the likelihood of those effects under specific conditions.
    • Toxicity is the ability of a substance to cause harm to a biological system.

    Branches of Toxicology

    • Mechanistic: Investigates how chemicals cause toxic effects by examining absorption, distribution, excretion, and biochemical/molecular mechanisms.
    • Forensic: Applies toxicology to legal aspects, including investigating cause of death.
    • Clinical: Physicians or veterinarians focus on treating poisonings and injuries from xenobiotics.
    • Environmental: Studies the effects of pollutants on organisms, populations, ecosystems, and the biosphere.
    • Descriptive: Evaluates the toxicity of drugs, foods, and other products.
    • Regulatory: Uses scientific data to protect humans and animals from excessive risk, often employed in government bureaus.
    • Occupational: Applies toxicology to chemical hazards in the workplace.

    Examples of Toxicological Cases

    • Eva Braun, in 1945, committed suicide using a cyanide capsule, an inhibitor of cytochrome c oxidase, hindering ATP production, leading to brain death and heart cessation.
    • Bando Mitsugoro, in 1975, a famous Japanese actor, died after eating pufferfish containing tetrodotoxin. Tetrodotoxin blocks voltage-gated sodium channels, suppressing neurotransmission and eventually leading to respiratory failure and death.

    History of Toxicology

    • Paracelsus (1493-1541), considered the "father of toxicology", determined that specific chemicals were the source of plant/animal toxicity. The right dose differentiates a poison and a remedy.
    • The dose makes the poison is fundamental to understanding the principles of toxicology and is important when trying to protect workers.

    Problems Linking Cause and Effect

    • The effect of exposure may not be immediate.
    • Individual susceptibility varies based on factors like age, gender, and health status.
    • The combined effect of multiple substances can be complex and difficult to predict.
    • Toxicological information is often not readily available for many substances.
    • The major factors influencing toxicity include mode of administration, exposure duration/frequency, and dose/concentration.

    Basic Toxicological Terms

    • Acute effects: Occur immediately after exposure, usually from a high dose, short-term, and generally reversible.
    • Chronic effects: Develop over time, often from repeated low doses, typically irreversible.
    • Reversible effects: Pathological injury to tissue; the extent of repair determines reversibility. Examples include rapid liver regeneration but less so the CNS.
    • Irreversible effects: Permanent effects on tissues and/or organs, such as carcinogenic and teratogenic effects.

    Basic Toxicological Terms - Local and Systemic Effects

    • Local effects: Occur at the site of contact with the substance. Examples include skin irritation/burns, de-fatting (Xylene), and pulmonary inflammation (Chlorine).
    • Systemic effects: Occur at target organs remote from the point of contact. Examples include dizziness/unconsciousness, liver and CNS damage (Xylene), and kidney/bone marrow damage (Cadmium/Lead).
    • Xenobiotic: a substance not originally found or produced in a person's body.

    Basic Toxicological Terms - Risk and Tolerance

    • Risk: The probability of harm under specific conditions.
    • Safety: The probability of harm not occurring under specified conditions.
    • Tolerance: A state of decreased responsiveness to a toxic effect, occurring after repeated exposure. There are two primary types: dispositional (decreased drug reaching the site), and cellular (reduced responsiveness of a tissue).

    Main Types of Combined Effects

    • Additive: The combined effect equals the sum of the individual effects (e.g., toluene + xylene).
    • Independent: The combined effect equals the sum of the individual effects (e.g., lead + xylene).
    • Synergistic: The combined effect is greater than the sum of the individual effects (e.g., carbon tetrachloride + ethanol).
    • Potentiation: One substance has no toxic effect, but when combined with another, substantially increases the effect of the other substance (e.g., zero toxicity substance + another toxic substance).
    • Antagonism: Two substances administered together interfere with each other's action or one interferes with the other. (e.g., (2+2=2) or(4+0=2)).

    Diagnosis of Poisoning - History Taking

    • Gather information from the patient (if conscious) or bystanders/witnesses
    • Note the substance, route, time of ingestion, dose, duration, symptoms, progression, previous medical issues.
    • Evaluate any medications patient is taking.

    Diagnosis of Poisoning - Physical Examination

    • General appearance (conscious/unconscious, behaviour)
    • Neurological status (level of consciousness, neurological signs)
    • Pupils (size, shape, responsiveness)
    • Vital signs (heart rate, blood pressure, respiratory rate, body temperature)
    • Identify any specific signs or symptoms associated with a particular poison.

    Diagnosis of Poisoning - Methods for Diagnosis

    • Physical Examination: include evaluation of odour, urine colour, and ECG abnormalities.
    • Toxicological analysis of samples: Urine, blood, and gastric contents. Methods include thin-layer chromatography, gas-liquid chromatography, high-performance liquid chromatography (HPLC), and mass spectrometry.
    • Enzyme assays: Assess blood cholinesterase levels to identify organophosphate poisoning.
    • Biochemical investigations: look for abnormalities like ECG, etc,
    • Radiological studies: Occasionally helpful, particularly when visualising suspected ingested material.

    Fundamentals of Poisoning Management

    • Fundamentals of poisoning management:
      • Initial resuscitation and stabilization
      • Removal of toxin from the body
      • Prevention of further poison absorption
      • Enhancement of poison elimination
      • Administration of antidote
      • Supportive treatment (hemodynamic support, management of hypothermia/hyperthermia)
      • Prevention of re-exposure

    Prevention of Poison Re-exposure

    • Adult education: Provide instructions on safe medication/chemical use.
    • Notification of regulatory agencies: Inform authorities in case of environmental/workplace exposures.
    • Psychiatric referral: Consider referrals for depressed/psychotic individuals.
    • Child proofing: Secure medications and other potentially hazardous substances out of reach of children.

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    Description

    Test your knowledge on key concepts in pharmacology and toxicology. This quiz covers various aspects including toxicity definitions, the branches of toxicology, and real-world applications. Challenge yourself with questions about drug effects, poisoning management, and notable figures in the field.

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