clinical toxicology
Terms
undefined, object
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- sample types to submit for overdosed patient
-
1. Blood: whole or serum;quantitative
2. Urine: broad spectrum screen; qualitative
3. Gastric fluid: direct search, identify parent drug
4. anything found with patient and clinical hx -
drug screen:
Immunoassay -
sensitive
specific
quick,cheap,automated -
drug screen:
thin layer chromatography -
broad spectrum
not sensitive
slow, unautomated
need expertise -
drug screen:
negative report - need to search for other cause
- general treatment of overdose
-
comatose: ABCDrugs
supportive: lavage,fluids.charcoal,pressor.cardiac monitor
antidote
rare:hemodialysis if Vd decreased(central compartment) - zer order:
- constant AMOUNT eliminated in time
- first order
-
Constant PERCENT
most drugs
\half life - steady state
-
repeated dosing
reached at 4 half lives(94%)
first order only - factors that change pharmacokinetics
-
renal fxn
liver fxn
saturation: no more half life;excretion becomes zero order/2dary routes form oxic metabolites - cfh
- dfh
- ethanol
-
-thought processes affected first
-disulfiram blocks ALDH causing buidup of acetaldehyde causing unpleasant effects
-zer order
-.01to.02% w/v/hr;induced to .03%
-ALDH incytosol
-microsomal(inducible)
-ethanoltoADH to acetaldehyde to ALDH to acetate