Clinical_and_Forensic_Toxicology

Clinical_and_Forensi - Clinical and Forensic Toxicology Roger L Bertholf Ph.D Associate Professor of Pathology Chief of Clinical Chemistry

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Clinical and Forensic Toxicology Roger L. Bertholf, Ph.D. Associate Professor of Pathology Chief of Clinical Chemistry & Toxicology
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Toxicology Disciplines Industrial Toxicology Toxic exposures in the workplace Product testing Molecular Toxicology Veterinary Toxicology Environmental Toxicology Clinical Toxicology Forensic Toxicology
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Clinical Toxicology The branch of toxicology that is concerned with human poisoning Drug overdoses Pharmaceuticals Drugs of abuse Toxic exposures Environmental Occupational Accidental
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The Top Ten Poisoning. . . 1. Cleaning Products 2. Analgesics 3. Cosmetics 4. Plants 5. Cough/Cold Preparations 6. Hydrocarbons 7. Bites 8. Topicals 9. Foreign Bodies 10. Chemicals 1. Antidepressants 2. Analgesics 3. Sedative/Hypnotics 4. Street Drugs 5. Cardiovascular Drugs 6. Alcohols 7. Fumes 8. Chemicals 9. Asthma Medications 10. Cleaning Products Exposures Deaths
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Pharmacokinetics Plasma drug concentration Time α t 1/2 Peak plasma concentration β kt t e C C - = 0
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Pharmacokinetics Summary t 0.693 = k 0.693 = kt = (2) = C 0.5 C kt = C C -kt = C C e C = C 1/2 1/2 0 0 t 0 0 t -kt 0 t ln ln ln ln
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Pharmacokinetics Summary - = 2 1 693 . 0 0 t t t e C C C
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Pharmacokinetics Summary C V t 0.693 = V k = Clearance d 1/2 d
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The Autonomic Nervous System Sympathetic (Thoracocolumbar) Norepinephrine Parasympathetic (Craniosacral) Acetylcholine α β β 2 β 1 Cardiovascular Smooth muscle Insulin release Gluconeogenesis GI Vascular smooth muscle Muscarinic Nicotinic
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Cholinergic Poisoning Organophosphates, some mushrooms (Group III, clytocybe and inocybe species), betel nuts, pilocarpine, carbachol, acetylcholine Miosis, vasodilatation, bronchial secretions, bradycardia, increased bowel motility, urination, sweating Mnemonic: DUMB BELS (Diarrhea, Urination, Miosis, Bradycardia, Bronchorrhea, Emesis, Lacrimation, Salivation) Atropine + pralidoxamine is antidote Laboratory monitors AChE activity
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Anticholinergic Poisoning Belladonna, Jimsonweed, antihistamines, phenothiazines, certain mushrooms (Group V), scopolamine, tricylics, OTC sleeping pills Mnemonic: Red as a beet, dry as a bone, mad as a hatter, hot as a stone, bowel and bladder lose their tone, and the heart runs alone. Physostigmine is antidote
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Sympathetic Poisoning 2200 α : vasoconstriction, pupillary dilitation, coronary artery dilitation, decreased bowel motility, bladdar contraction 2200 β 1 : tachycardia 2200 β 2 : smooth muscle dilatation, insulin release, lipolysis, renin release, gluconeogenesis (miosis, vasodilatation, bronchodilatation, hyperglycemia, decreased bowel motility, bladder relaxation)
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Nicotinic Poisoning Insecticides, tobacco, black widow spider venom Tachycardia, hypertension, muscle fasciculations, weakness, paralysis d-turbocurarine is antidote
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This note was uploaded on 09/18/2011 for the course MED 6566 taught by Professor Staff during the Summer '11 term at University of Florida.

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Clinical_and_Forensi - Clinical and Forensic Toxicology Roger L Bertholf Ph.D Associate Professor of Pathology Chief of Clinical Chemistry

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