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Toxicology: Poisons and Alcohol “If all those buried in our cemeteries who were poisoned could raise their hands, we would probably be shocked by the numbers.” —John Harris Trestrail, Criminal Poisoning Toxicology: Poisons and Alcohol Toxicology Toxicology—the study of the adverse effects of chemicals or physical agents on living organisms Types of Toxicology: Environmental—air, water, soil Consumer—foods, cosmetics, drugs Medical – ER, poisonings, drugs Forensic – Postmortem—medical examiner or coroner Criminal—motor vehicle accidents (MVA) Workplace—drug testing Sports—human and animal Environment—industrial, catastrophic, terrorism Chapter 8 Kendall/Hunt Publishing Company 2 2 Toxicology: Poisons and Alcohol Toxicology • Acute: immediate effects of toxins (i.e. death) • Chronic: long-term effects of toxins (i.e. cancer) • Synergism: The combination of drugs can have magnified effects. For example: a person takes barbiturates and drinks alcohol and then dies. By themselves, the drugs wouldn’t have killed the person, but taken together they have a lethal effect. • Antagonism: Combined effect of substances that decreases their individual effects (opposite of synergism) Chapter 8 Kendall/Hunt Publishing Company 3 3 Toxicology: Poisons and Alcohol Symptoms of Various Types of Poisoning Type of Poison Symptom/Evidence Caustic poison (lye) Carbon monoxide Sulfuric acid Hydrochloric acid Nitric acid Phosphorus Cyanide Arsenic, mercury Isopropyl (rubbing) alcohol Burns around the lips and mouth Red/pink patches on the chest & thigh Black vomit Greenish-brown vomit Yellow vomit Coffee-brown vomit, onion or garlic odor Burnt almond odor Extreme diarrhea Nausea, vomiting, unconsciousness, blindness Chapter 8 Kendall/Hunt Publishing Company 4 4 Toxicology: Poisons and Alcohol Drug Intake and Absorption Drug Intake: swallowing powders, tablets, capsules; inhaling vapors; injection with a syringe Absorption: Once a drug has entered the body, it is absorbed into the bloodstream and circulated throughout the body. Some drugs tend to concentrate in certain areas: Pesticides in fatty tissue Heavy metals: teeth, gums, hair LSD and marijuana: brain Chapter 8 5 Toxicology: Poisons and Alcohol Addiction vs. Dependence Tolerance: Occurs when increasing doses are required to keep the same level of effects on the person. If a person tries to quit a drug, withdrawal symptoms can sometimes be fatal because the body has become dependent on the drug. Drug addiction: physical process. Biochemical changes occur in the body to help tolerate the drug. The body may then require the drug on a regular basis. If the drug is not used, withdrawal symptoms may occur: sleeplessness, restlessness, nausea, hallucinations, headaches Dependence: psychological craving for the drug. Withdrawal symptoms do not occur if drug use is stopped. Chapter 8 6 Toxicology: Poisons and Alcohol Lethal Dose LD50 refers to the dose of a substance that kills half the test population, usually within four hours Expressed in milligrams of substance per kilogram of body weight Chapter 8 Kendall/Hunt Publishing Company 7 7 Toxicology: Poisons and Alcohol Elimination of Drug From Body Half-life: time it takes for the concentration of a drug to drop to half of its concentration Cocaine’s half-life: 60-90 minutes Heroin’s half-life: 3 minutes Liver: can change a drug into a different substance, forming a metabolite. For example, the metabolite of heroin is morphine. Toxicologists often look for metabolites when trying to detect drugs Elimination of Drugs From Body: Exhaled in breath Sweat Urine Chapter 8 8 Toxicology: Poisons and Alcohol Alcohol—Ethyl Alcohol (C2H5OH) Most abused drug in America About 40% of all traffic deaths are alcohol-related Depressant Alcohol appears in blood within minutes of consumption; 30–90 minutes for full absorption Detoxification—about 90% in the liver About 5% is excreted in breath, perspiration, & urine Neurotoxin: kills nerve cells (one ounce of ethanol can kill about 10,000 nerve cells) Chapter 8 Kendall/Hunt Publishing Company 9 9 Toxicology: Poisons and Alcohol BAC: Blood Alcohol Content Expressed as percent weight per volume of blood (grams of alcohol present in 100mL of blood) Legal limit in all states is 0.08% Parameters influencing BAC: • Body weight/physiology of consumer • Alcohol content of beverage • Number of beverages consumed • Time alcohol is consumed within • Quantity & type of food consumed • Time since consumption Chapter 8 Kendall/Hunt Publishing Company 10 10 Toxicology: Poisons and Alcohol Blood Alcohol Concentration (BAC) BAC and effects: 0.04: feeling of relaxation 0.06: less able to make rational decisions 0.08: impairment in motor coordination skills (driver intoxication) 0.12: vomiting 0.40: loss of consciousness 0.45: death Chapter 8 11 Toxicology: Poisons and Alcohol Drunk Driving Laws Implied Consent: when you sign your driver’s license you are giving consent that you will submit to a blood or breath test if you are stopped for drunk driving. Refusal to submit can result in the loss of your license for 90-180 days. Field Sobriety Testing: walk and turn, stand on one foot, horizontal gaze nystagmus (eyes watch a pencil as it moves) Chapter 8 12