Toxicology Methods PDF
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San Lorenzo Ruiz College of Ormoc, Inc.
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This document describes various methods in toxicology, including immunoassay and chromatographic techniques. It also details substances involved in acute poisoning such as cyanide, carbon monoxide, alcohols, heavy metals, iron, salicylates, organophosphates, acetaminophen, and others. The methods and substances are part of a larger medical context that could potentially involve multiple medical specialties.
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124 2. Premature labor or premature rupture Toxicology of membranes (PROM) METHODS a. Premature Delivery - Fetal fibronectin (ffN) 1. Immunoassa...
124 2. Premature labor or premature rupture Toxicology of membranes (PROM) METHODS a. Premature Delivery - Fetal fibronectin (ffN) 1. Immunoassay ❖ Vagi.nal swab specimen ❖ Protein secreted at boundary of 2. Chromatographic Techniques amniotic sac and uterus a. Thin-Layer Chromatography (TLC) ❖ Negative test indicates preterm ❖ Separates drugs for identification delivery will not occur thus ❖ Urine best specimen for detecting sparing preventative measures drugs (MgSO4) with side effects ❖ Limited sensitivity b. Premature rupture of membranes ❖ Results should be confirmed with (PROM) another method ❖ Vaginal swab specimen b. Mass Spectrophotemtry (MS) as ❖ AmniSure TM detects amniotic fluid detector ❖ After separation & quantitation of PAMG-1 present in cen rico- vagi.nal secretions after rupture of drugs & metabolites by high fetal membranes performance liq. chrom. (HPLC or LC) or Gas Chrumatog. (GC) 3. Fetal newborn screening c. Gas Chromatography-Mass a. Dried blood spot specimen Spectrophotometry ( GC-MS) ❖ 11 b. Tandem mass spectrometry used to Gold-standard 11 technique for screen for >25 genetic diseases (ex. confirmation of SCI'eening methods PKU, congenital hypothyroidism, ❖ Highly sensitive and reliable cystic fibrosis, sickle cell disease. ACUTE POISONING other metabolic diseases) - 1. Substances a. Cyanide REMEMBER! h. Carbon monoxide- forms carhoxyhemoglohin ( affinity for ~ Hgb is 200 times the affinity for 0 2) c , Alcohols - Ethanol most common, Hemolytic Disease. of enzymatic - alcohol dehydrogenase d. Heavy meta]s (arsenic, mercury and the Newborn ( HDN). lead) Sin 60 ml/min IMMUNOSUPPRESSANTS 6. Urine Albumin 1. Generic names a. Use with eGFR to stage and monitor a. Cyclosporine chronic Kidney disease ( CKD) b. Tacrolirrms c. Sirolimus CREATININE d. Mycophenolic Acid (MPA) 1. From cr e atine in muscle 2. Suppress rejection after organ 2. Can also be measured to evaluate renal transplants function; NOT as sen sitive as GFR 3. Often u sed in combination 3. Classic meth od is the Jaffe reaction a. Creatinine reacts with picric acid in 4. Whole blood specimen of choice except alkaline solution to form a red- for MPA (serum or plasma) orange complex that absorbs light at 5. May need multiple samples instead of 490-540 nm trough collection- area under b. Interferents (non-creatinine time/concentration curve r eflects drug chrom agens) include glucose, exposure acetoacetate and ascorbic acid BLOOD UREA NITROGEN (BUN) Renal Function 1. ,+. in impaired renal function GENERAL INFORMATION 2. ,+. in high protein diet 1. All non-protein nitrogens (urea, creatinine, uric acid and ammonia) are ,+. 3. Rises more r apidly than serum creatinine in plasma in r enal impairment; 4. Methods: referred to a s azotemia a. Colorimetric method: urea reacts 2. Best laboratory evaluation when renal with diacetyl monoxime to form a impairment is suspected is glomerular colored complex filtration rate ( GFR) b. Enzymatic method: Urease hydr olyzes urea into ammonia which 3. Creatinine clearance evaluates GFR is mea sured spectrophotometically (more sensitive than BUN or creatinine) or ·with an I SE ❖ Inhibited by the anticoagulant, sodium fluoride
