Unit 10 ToxicologyStudents will develop an understanding of the

adverse effects of drugs and be acquainted with the laboratory investigation of the most

common poisonings.

Cardiovascular system

Heart Artery Capillary Arteriole Venuole Vein Lungs Kidney Bladder Urethra

Ureter BAC Acetaldehyde Gas

Chromatography

Breath test Stimulant Depressant Narcotic 5 drug

schedules

Poison Toxicity Toxin Bacterial

toxins

Vocabulary

1.The cardiovascular system, sometimes known as a part of the circulatory system, is composed of the heart and a closed system of blood vessels through which blood is circulated.

2. The primary function is circulation. Critical transportation needs include the movement of oxygen and carbon dioxide, heat, nutrients, hormones, waste products, enzymes, electrolytes, and other substances on a continuing basis.

Obj. 1 Circulatory System

Heart: Pumps blood throughout the body. Arteries: A blood vessel which transports blood away

from the heart. Capillaries: A small vessel which carries blood from the

arterioles to the venuoles. It is the site nutrients and wastes are exchanged between the blood and the body cells.

Veins: A blood vessel which transports blood towards the heart.

All of the veins except the pulmonary veins transport deoxygenated blood.

Obj. 1 Circulatory System

Brings oxygenated air to the alveoli within the lungs and removes air containing carbon dioxide through the process of exhalation.

1. Lungs: Large spongy structures each found within their own pleural cavity within the thoracic cavity.

Obj. 1 Respiratory System

Regulate the composition and volume of the blood by removing and restore selected amounts of water and solutes. Excretes water, nitrogenous wastes from protein catabolism, inorganic salts, and assists in eliminating heat and carbon dioxide.

1. Kidneys: A pair of organs that are kidney bean shaped structures found against the posterior abdominal wall behind the peritoneum.

The kidneys contain the functional units, the nephrons, which actually filter the blood and form urine.

2. Bladder: A sac-like structure found in the pelvic cavity. Connected to the ureters and the urethra. The function is to hold urine until urination occurs.

3. Urethra: A small tube (approximately 2 inches in females and 8 inches in males) that transports urine from the bladder to the outside of the body.

Obj. 1 Urinary System

A. Blood alcohol content (BAC) 1. Measures the amount of ethyl alcohol in blood.

a. Expressed as a percent of weight per volume. b. The legal limit is 0.08% (which means that 0.08

grams of pure alcohol is present for every 100 ml of blood in the body).

c. Blood needs to be preserved with an anticoagulant and sodium fluoride. It must also be kept cold until analyzed by gas chromatography.

Obj. 2 MEASURING ALCOHOL IN THE BLOODSTREAM

B. Gas Chromatography Separates and analyzes compounds that can

be vaporized- like alcohol. C. Breath Test

1. According to Henry’s law the concentration of alcohol in the breath is proportional to that in the blood.

2. There are two types of breath tests.

Obj. 2 MEASURING ALCOHOL IN THE BLOODSTREAM

a. Infrared (IR) Spectrophotometry (1). Narrow beam of IR light is passed through a

breath sample chamber. The IR light is absorbed by the alcohol.

The relationship between the concentration and light absorption determines the alcohol content.

b. Electrochemical Fuel Cell Technology (1). Breaks down the oxygen in the alcohol and

creates a charge which causes an imbalance in electricity as it crosses over a conductor medium.

Obj. 2 MEASURING ALCOHOL IN THE BLOODSTREAM

A substance that, when ingested, inhaled, absorbed, injected into, or developed within the body in relatively small amounts, will cause damage to structures of the body and impair or destroy their function.

Any substance that impairs health or destroys life when ingested, inhaled, or absorbed by the body in relatively small amounts. Some toxicologists suggest that, depending on the dose, all substances are poisons.

Clinically all poisons are divided into those that respond to specific treatments or antidotes and those for which there is no specific treatment. Maintaining respiration and circulation is the most important aspect of treatment.

Poisons:

DEA calls the different categories “schedules” 1. Schedule I – Substances that have no accepted medical

use in the U.S. a. High abuse potential b. Are not prescribed

2. Schedule II – Substances that have a high abuse potential with severe psychic or physical dependence. a. Consists of certain narcotics, stimulants and depressant

drugs. b. Prescription must be written in ink or typewritten and

signed by the practitioner. c. No renewals.

Obj. 3 FIVE schedules OF DRUG TYPES

3. Schedule III – Substances that have an abuse potential less that those in Schedule I and II. a. Consists of limited quantities and certain

narcotics and non-narcotic drugs. b. Prescriptions may be oral or written. c. Up to 5 renewals are permitted within 6

months.

Obj. 3 FIVE schedules OF DRUG TYPES

4. Schedule IV- Substances that have an abuse potential less than those in Schedule III. a. Consists of limited quantities and certain

narcotics and non-narcotic drugs. b. Prescriptions may be oral or written. c. Up to 5 renewals are permitted within 6

months.

Obj. 3 FIVE schedules OF DRUG TYPES

5. Schedule V- Substances that have an abuse potential less than those in Schedule IV. Consists of preparations containing limited

quantities of a certain narcotic drug generally for anti diarrheal purposes.

Subject to state and local regulations and a prescription may not be required.

Obj. 3 FIVE schedules OF DRUG TYPES

1. Stimulants – Act on the CNS to make the user feel better and increase energy and alertness while suppressing appetite and fatigue. Causes restlessness, anxiety, and depression. Examples: caffeine, amphetamines,

methamphetamines, and cocaine.

Obj. 3 CLASSIFICATION OF DRUGS

2. Narcotics- Analgesics that act on the CNS to relieve pain. a. Examples: Aspirin, Tylenol, Motrin, Morphine,

Heroin, Codeine, Darvon, and Percocet. 3. Depressants- Act on the CNS to slow

response and feelings. a. Examples: Alcohol, Barbiturates,

Benzodiazepines (Valium).

Obj. 3 CLASSIFICATION OF DRUGS

Drug Symptoms

MDMA (ecstasy) heart rate and blood pressure increase, muscle cramps, anxiety, panic attacks, seizures, unconsciousness, stroke, kidney failure, death

Mescaline hallucinations, euphoria, dizziness, vomiting, increased heart rate, dilated pupils, diarrhea, headaches, anxiety, irrationality of thoughts

Obj. 4 Overdose symptoms: Hallucinogens

Drug Symptoms

LSD dilated pupils, loss of appetite, sleeplessness, increase in body temperature, increased heart rate and blood pressure, sweating, dry mouth, tremors, confusion, distortions of reality, and hallucinations

PCP increased heart rate and blood pressure, convulsions, sweating, dizziness, numbness, and possible death from heart failure, drowsiness, psychosis that can last for weeks.

Obj. 4 Overdose symptoms: Hallucinogens

Drug Symptoms

Opium difficulty breathing, low blood pressure, weakness, dizziness, confusion, loss of consciousness, coma, cold & clammy skin, constricted pupils

Heroin, Codeine, Morphine difficulty breathing, low blood pressure, coma, spasms of the stomach or intestines, constipation, nausea, vomiting, sleepiness, blue fingernails and lips, death

Obj. 4 Overdose symptoms: Narcotics

Drug Symptoms

Methadone difficulty breathing, drowsiness, coma, low blood pressure, muscle twitches, blue fingernails and lips

Oxycodone slow, difficult breathing, seizures, dizziness, weakness, loss of consciousness, coma, confusion, tiredness, cold clammy skin, constricted pupils

Obj. 4 Overdose symptoms: Narcotics

Drug Symptoms

Amphetamines high blood pressure, rapid heart rate, agitation, irregular heartbeats, stroke, seizures, coma, death

Cocaine, Crack dangerous rise in body temperature, sweating, tremors, seizures, irregular heartbeats, stroke, confusion, heart attack, bleeding in the brain, death

Methamphetamines dangerous rise in body temperature, rapid breathing, increased heart rate, dilated pupils, high blood pressure, kidney failure, bleeding in the brain, death

Obj. 4 Overdose symptoms: Stimulants

Effects: acne, increased body hair, baldness, high blood pressure, high cholesterol, impaired fertility in males, blood clotting, kidney and liver cancers, heart attacks

Obj. 4 Overdose symptoms: Anabolic Steroids

Effects: slow heart rate, drowsiness, slowed brain activity, slurred speech, loss of coordination, slow breathing, coma, death

Obj. 4 Overdose symptoms: Depressants

Toxin Symptoms

Botulism most poisonous biological substance known to humans. It is a neurotoxin, paralyzing muscles. Damage is irreversible. Painful spasms before death. “Botox” is a purified form of Clostridium botulinum.

Tetanus can cause muscle spasms so severe they can tear muscles and break bones. It is sometimes called “lockjaw” because spasms often begin in the jaw. Responsible for about 1 million deaths per year worldwide. Only 5 deaths per year in the U.S.

Obj. 4 Overdose symptoms: Bacterial Toxins

Drug Symptoms

Pesticides interferes with the movement of nerve impulses and muscular contractions, anxiety, seizures, twitching, rapid heartbeat, muscle weakness, sweating, salivation, diarrhea, tearing, coma, death

Lead nausea, abdominal pain, insomnia, headache, weight loss, constipation, anemia, kidney problem, vomiting, seizure, coma, death, blue discoloration along the gumline in the mouth.

Obj. 4 Overdose/Exposure: Heavy metals & pesticides

Drug Symptoms

Mercury “Mad-hatter’s disease”, inhalation causes flu0like symptoms. Chronic poisoning causes irritability, personality changes, headache, memory and balance problems, abdominal pain, nausea, vomiting, excessive salivation, damage to gums, mouth , teeth, death.

Arsenic (within 30 minutes of ingestion) abdominal pain, severe nausea, vomiting and diarrhea, dryness of the throat, difficulty speaking, muscle cramps, convulsions, kidney failure, delirium, death. Chronic exposure produces skin lesions and changes in pigment, headache, personality changes, nausea, vomiting, diarrhea, convulsions, coma.

Obj. 4 Overdose/Exposure: Heavy metals & pesticides

Drug Symptoms

Cyanide can be fatal 6-8 minutes after ingestion, weakness, confusion, coma, pink skin from high blood oxygen saturation, almond-like odor.

Strychnine body spasms, temperature rises, violent convulsions, rigor mortis occurs within minutes after death.

Obj. 4 Overdose/Exposure: Heavy metals & pesticides

Obj. 5 Bioterrorism Chemical AgentsRICIN: made from castor beans,

lethal in minute doses (head of a pin)

Method of contact symptoms

Inhalation within eight hours of exposure, difficulty breathing, within a few hours, fever, cough, nausea, sweating, tightness in the chest, low blood pressure, excess fluid in the lungs, death.

Ingestion within six hours, vomiting, diarrhea, bloody urine, dehydration, low blood pressure, hallucinations, seizures, death.

Skin & eye exposure Redness & pain

Obj. 5 Bioterrorism Chemical AgentsANTHRAX: from Bacillus anthracis

Method of contact Symptoms

Inhalation initially produces flu-like symptoms, like sore throat, cough, fever, muscle aches. Progressively worsens to include breathing problems and usually results in death.

Ingestion nausea, vomiting, fever, abdominal pain, severe diarrhea. Fatal in 25-60% of cases.

Skin absorption raised, itchy bumps that resemble an insect bite develop into a painless sore with a black area in the center. About 20% of untreated cases result in death.

One of the greatest difficulties with preventing OTC drug use is that few teens and adults realize the danger. Unlike the risks associated with illegal street drugs like cocaine and heroin, the risks associated with OTC drug abuse are given little thought and attention. Teens and young adults who learn about the risks of drugs at home are up to 50% less likely to abuse drugs.

OTC Drug Abuse

A. Packaging evidence 1. Handle evidence as little as possible. 2. Use appropriate size containers and an inner

packaging like zipper bags and sample bottles. 3. Place exhibit number, initials, date and seal

on the inner and outer packaging. Place date and initials on seal as well.

4. Use tamper resistant tape as the seal.

Obj. 6 COLLECT AND PRESERVE DRUG EVIDENCE

B. Collection of evidence 1. Plant substances (marijuana, mushrooms, )

a. Plant must be dried thoroughly. b. Do not include the roots and dirt. c. Leaves and stems are stripped from large

stalks. d. Packaged in paper bags and boxes to allow for

continued drying. e. Large amounts of evidence collected should be

sub-divided into thirty pounds or less.

Obj. 6 COLLECT AND PRESERVE DRUG EVIDENCE

2. Liquids a. All liquids are placed in sturdy plastic or

glass bottles and are sealed with a plastic lid. Metal cannot be used to seal bottles.

Label bottles clearly. Prop bottles upright and place in plastic zipper

evidence bags.

Obj. 6 COLLECT AND PRESERVE DRUG EVIDENCE

3. Biohazard evidence (syringes, body fluids, razors, broken glass) a. Use Universal Bloodborne Pathogen Precautions

and Personal Protective Equipment (PPE). b. Leave all liquid contents in syringe. c. Place syringes in approved safety containers. d. Mark all layers of packaging with biohazard

labels. e. Package in a puncture resistance packaging.

Obj. 6 BIOHAZARD EVIDENCE