TOXICOLOGY WHAT IS A DRUG?

- A chemical substance that brings about

Study of substances introduced exogenously
into the body.
The techniques involved in detecting the
presence and the level of particular drugs,
whether they are drugs abuse or therapeutic
drugs.
ALL MEDICINE ARE DRUGS BUT NOT ALL DRUGS ARE
MEDICINE DRUG
THERE ARE TWO BASIC TECHNIQUES:
1. Immunochemical technique:
This is term homogenous immunoassay
This technology has revolutionized
toxicology because it allows performance of
rapid stat analyses of blood and urine
constituents.
A. The ENZYME MEDIATED (OR MULTIPLE)
IMMUNOLOGIC TECHNIQUE (EMIT),
- The drug itself is covalently attached to
an enzyme such as alkaline
phosphatase.
- When the drug enzyme complex is
incubated with an antibody (usually
monoclonal) to the drug, the enzyme
activity is markedly decreased as to the
blocking of the site of the enzyme by
the antibody.
B. FLUORESCENCE POLARIZATION
IMMUNOASSAY (FPIA)
- This is the second type of homogeneous
drug assay.
- This method is particularly sensitive and
elegant.
- The drug is covalently attached to a
fluorescent microscope probe
molecule.
physical, emotional, behavioral and/or
psychological change in a person taking it.
DRUGS
- A chemical substance other food which is
intended to affect the structure or function of
the body of man or animal
DRUG ABUSE
- Abuse usually refers to illegal to drugs but may
also be applicable to drugs that are available
legally, such as prescribed medications and
certain over-the-counter medication.
When are drugs harmful?
Any drug may be harmful when taken in excess.
Some drugs can also be harmful if taken in
dangerous combinations or by hypersensitive
(allergic) person or even small amounts.
Are Products other than drugs ever abuse?
Yes, substances like glue, paint thinners,
gasoline and other volatile (breathable) solvents
contain a variety of dangerous chemicals. They
should be sold and used with caution.
DRUG DEPENDENCE
- The bodys physical need or addiction to a
specific agent
- Over long term, this dependence results in
physical harm and behaviour problems which
causes tolerance and cross tolerance

2. Chromatographic Techniques
This is a qualitative detection of drugs abuse
and toxins and less to the determination of
the level of therapeutic drugs.

A. Thin-layer chromatography
B. High-performance liquid chromatography
C. Gas chromatography-mass spectroscopy.
CLASSIFICATION OF DRUGS Opiates depress the central nervous system and
are used therapeutically as analgesics
1. According to Origin:
(painkillers), as cough suppressants and against
a. Natural Drugs
diarrhea; in non medical usage as euphoriants
Ram opium
and as a means of reducing anxiety, boredom,
Coca bush
physical or emotional pain.
b. Synthetic Drugs
Methamphetamine
Naturally occurring:
Barbiturates
Opium
Morphine- powerful analgesic; binds to mu-
2. According to Legal Classification:
receptor in the limbic system
a. RA 9165 (Comprehensive Act of 2002)
Codeine- anti-tussive
b. PD 1619 (Volatile Substances)
Chemically modified forms:
Heroin- highly addictive
3. According to International Classification :
Hydromorphone (Dilaudid)
a. Narcotics substances
Oxycodone (Percodan)
b. Psychotropic substances
Common synthetic opiates:
c. Designer drugs
Meperidine (Demerol)
Methadone (Dolophine)
4. According to Pharmacological Classification
Propoxyphene ( Darvon)
(Effects):
Pentazocinine (Talwin)
a. Stimulants
Fentanyl ( Sublimaze)
b. Hallucinogens
c. Narcotics
d. Sedatives/Depressants
HEROIN (Diamorphine)
Is often the opiate preferred by consumers
It is relatively potent, easily dissolved in water
for injecting and penetrates the blood-brain
NARCOTICS barrier more quickly than morphine.
Effects may last from 4-6 hours.
- Any drug that produces sleep or stupor and also
Heroin can also be snorted, smoked or inhaled
relieves pain (e.g. Opium and its derivatives
by the method known as "chasing the dragon"
such as Morphine, Codeine, Heroin.).
whereby it is heated on foil and the fumes
- Depress the central nervous system to produce
inhaled.
a marked reduction in sensitivity to pain, create
drowsiness and reduce physical activity
- A drug which therapeutic dose diminishes
NARCOTICS
awareness of sensory impulses, especially pain,
by the brain, in large doses, it causes stupor, Opiates
coma or convulsions. o Heroin
(Blanco,brown,sugar,Kabayo,Kengkoy,
OPIATES gamot,matsakao,pulbos,sapsap,tinik)
Derived from opium poppy o Morphine (M,dreamer,emma,emsel,pulbos)
(Papaver somniferum) - was named after Morpheus, the
Major metabolite: Greek god of dreams
o N-acetylmorphine (heroin) o Codeine (Schoolboy)
o Morphine
Antagonist for opiate overdose: NALOXONE
(Narcan)
TOXIC EFFECTS (OPIATES):
Respiratory acidosis
Myoglobinuria
Cardiopulmonary failure

STIMULANTS
- Psychostimulants (psychoactive drugs)
- Induce temporary improvements in (mental or
physical functions)
- Enhanced alertness, wakefulness, and
locomotion ( e.g. Amphetamine, Cocaine,
Caffeine, Nicotine)
- Having an "up" quality to user, stimulants are
also referred to as "uppers".
- Include naturally occurring plants such as COCA
(Erythroxylum coca), khat and betel nuts (which
are not under international control), products
extracted from the leaf of the coca bush - coca
paste, cocaine hydrochloride and crack cocaine
- and wholly synthetic substances in the form of
AMPHETAMINE AND AMPHETAMINE-TYPE
COMPOUNDS.
AMPHETAMINE
Amphetamine was first synthesized in 1887, but
because there was very little interest in it, the
substance went unnoticed until it became the
alternative to ephedrine
While researching the effects, it was discovered
that amphetamines could awaken dogs that
were under anesthesia.
This discovery led to the use of amphetamines,
in pill form, to treat narcolepsy
By the 1980s, amphetamine use dropped
because of increased control of its legal
manufacture, which, however, led to an
increase in the illegal manufacture of
METHAMPHETAMINE.
There are different types of methamphetamine:
Crank- refers to methamphetamine
sulfate
Crystal- refers to methamphetamine
hydrochloride
Ice - is a color-less and odorless
concentration of methamphetamine.
Methamphetamine Hydrochloride
(C.N. SHABU, ice, meth, shabs, ubas, siopao, sha,
poor mans coccaine, uppers, speed)
White colorless crystal powder with a bitter
numbing taste
Being taken by ingestion, injection, smoking,
sniffing, or inhalation (chasing the dragon)
Therapeutically used for treating narcolepsy
and attentional deficit disorder
Increases mental alertness and physical capacity
Structurally related to dopamine &
cathecolamine
Amphetamine like compound: Ephedrine,
pseudoephedrine, phenylpropanolamine
TOXIC EFFECTS:
Hypertension
Cardiac arrhythmias
Convulsions
Pancytopenia
MDMA (3,4- Methylenedioxymethaphetamine)
Also known as Ecstasy or Molly
Derivative of methamphetamine
MDMA is taken orally, usually as a capsule or
tablet. The popular term Molly (slang for
molecular) refers to the pure crystalline
powder form of MDMA, usually sold in
capsules.
It produces feelings of increased energy,
euphoria, emotional warmth and empathy
toward others, and distortions in sensory and
time perception.
ECSTASY (MDMA)
German pharmaceutical company first
synthesized MDMA in an attempt to create an
appetite suppressant
Ecstasy is most often available in tablet form
and is usually ingested orally, although some
users have reported taking it anally (known as
plugging or shafting).
MDMA affects levels of serotonin, a
neurotransmitter in the brain that is related to
mood (and pleasure), sleep, and heart rate
When ingested in the body, MDMA causes the
brain to flood itself with serotonin, causing the
body to have heightened sensitivity and the
individual to be intensely emotional and
empathetic.
When the effects of ecstasy wear off, the brain
is depleted of much of its supply of serotonin.
Because of this substantial loss, DEPRESSION is
a common after-effect of MDMA use.
 Cocaine first appeared in American society in
Short-Term Effects the 1880s as a surgical anesthetic, and soon
Muscle tension Severe dehydration became a common household drug, as well as
Heightened senses (especially when mixed an ingredient in Coca-Cola and in several types
Hallucinations with alcohol) of wines.
Euphoria Heat exhaustion The most common method of using powder
Empathy for Increased body
cocaine is snorting sniffing the powder into
others/emotional temperature up to 108
warmth (especially when
the nasal passages. It can also be injected
Anxiety or paranoia dancing) intravenously, ingested orally, or even rubbed
Involuntary teeth or jaw Increased blood on the users gums.
clenching pressure, breathing rate, Smoking crack or freebase creates an intense
Nausea and heart rate and immediate high (in about 10 to 15
Faintness Blurred vision or seconds), making the drug even more addictive
Chills or sweating nystagmus rapid
Extreme relaxation quivering of the pupils
(while the user is feeling Short Term Effects Long Term Effects
peak effects) 1. Dilated pupils 1. Psychosis
2. Increase in BP 2. Restlessness
Long-Term Effects 3. Increase in heart rate 3. Irritability & anxiety
Confusion 4. Sense of well-being 4. Sleeplessness
Depression 5. Lessened appetite 5. Stuffy/runny
Sleep problems nose 6. Slurred speech
Drug craving 6. Slurred speech
Severe anxiety
Possible depletion of serotonin
and memory Laboratory Analysis:
Death
1. Immunoassays
2. Thin-Layer Chromatography = Urine specimen

Cocaine (Benzoylmethylecgonine)
(C.N. coke, crack, gold dust, heavens dust,
stardust, white girl, speedballs)

Derived from the leaves of coca plant

(Erythroxylon coca)
Odorless and bitter
Stimulant of the CNS (acts on Dopamine)

Easily pass the placenta and mammary glands

Cause sudden death: Cardiac toxicity
Overdosage: Violent behaviour; high abuse
potential
PROZAC is used to inhibit the action
Detected in urine for up to 3 days; for chronic
user up to 20 days

TOXIC EFFECT:
Hypertension
Arrhythmias
Seizures and
Myocardial infarction

URINE METABOLITE: Benzoylecgonine

 Short Term Effects Long Term Effects
HALLUCINOGEN
1. Faster heart beat & 1. Chest pains
pulse rate 2. Irregular menstrual cycle
- Also called (psychedelics) drugs which affect
2. Bloodshot eyes 3. Temporary loss of fertility
sensation, thinking, self awareness and emotion 3. Altered sense of for both sexes
- Refers to a substance that produces strong time 4. Premature babies
mood-changing with unpredictable 4. Forgetfulness or 5. Cancer
psychological effects normally associated only inability to think 6. Marijuana burnout(slow
with dreams, schizophrenia, or religious 5. Acute panic anxiety movement, unaware of
exaltation. reaction surroundings)

- It produces changes in in time and spaces

Phencyclidine (PCP)
perception, delusion s (false beliefs) and
hallucinations may be mild or overwhelming,
depending on dose and quality of drugs (e.g.
LSD, Mescaline, Marijuana).
- It heightens sensory signal, but this is often
accompanied by loss of control over what is
experienced.
- Other hallucinogens can come in many forms,
including plants and cough suppressants.
Cannabinoids (Cannabis sativa)
(C.N. Marijuana, cannabis, Indian hemp,pot,
grass, weed, refer, dope, maryjane, sinsomilla,
damo, acapulco gold, flower, pampa-pogi)
Phencyclidine (PCP) is a synthetic dissociative
drug originally developed as a general anesthetic
PCP is illegally manufactured as tablets, capsules,
or colored powder and can be snorted, smoked or
eaten.
Produces strong hallucinatory effects associated
with violent, uncontrolled & irresponsible
behavior
PCP disrupts the functioning of receptors for the
neurotransmitter glutamate, which plays a major
role in the perception of pain as well as in
learning, memory, and emotion.
MAJOR METABOLITE: Phencyclidine HCl
TOXIC EFFECTS: Stupor & coma

Delta-9-tetra-hydrocanabinol ( 9 -THC) is the Slang Terms for PCP

principal psychoactive component Marijuana/PCP
It looks like green tobacco (it can reach a Straight PCP: PCP and MDMA:
combination:
burning temperature of 1,000 F or 540 C) Angel Dust / Wet Elephant
Angel hair Dust Blunt Flipping
Can be taken by smoke in pipes/cigarettes Amoeba Happy Stick Pikachu
Can be taken in food, candies Amp Fry Sticks
Can be sniffed in powdered form Belladonna Love Boat
Can be mixed with honey & butter Animal Trank
Zoom
Lipophilic
Detected in urine: 3-5days; for chronic user 4 Lysergic acid diethylamide (LSD)
weeks LSD, or "acid," is sold as tablets, capsules, liquid,
URINARY METABOLITE: or on absorbent paper
11-nordeltatetrahydrocannabinol (THC-COOH) It is manufactured from a lysergic acid compound
found in ergot, a fungus that grows on grains.
Classifications of Cannabis Produces effect at low dosage (20ug)
Plants Causes blurred or undulating vision
Dried leaves
Panic reactions- bad trip
Residue
LSD causes hallucinogenic effects by disrupting
Sticks
the interaction of the neurotransmitter serotonin
Seedlings
Seeds
and nerve cells
Hahshish The most common form of LSD is blotter acid
Brownies sheets of paper that have been laced with LSD.
Tea bags Tablets known as microdots are also very
Stalks common.
 1. Depression of the central nervous system:
SEDATIVES drowsiness, impaired judgment, and diminished
- Drugs which may reduce anxiety and motor skills
excitement. CNS depressant. (e.g. Barbiturates, 2. Dose-related anterograde amnesia: they can
Non-barbiturates, tranquilizer, alcohol significantly impair ability to learn new
information.
- An effective SEDATIVE agent should reduce 3. Dependence: may occur at usual doses taken
anxiety and exert a calming effect with little or beyond several weeks
no effect on motor or mental functions. 4. Withdrawal: may occur even when
discontinuation is not abrupt (e.g., by 10%
- A HYPNOTIC drug should produce drowsiness
every 3 days). Symptoms include: tachycardia,
and encourage the onset and maintenance of a
increased blood pressure, muscle cramps,
state of sleep that as far as possible resembles
anxiety, insomnia, panic attacks, impairment of
the natural sleep state
memory and concentration, perceptual
disturbances, derealization, hallucinations,
EXAMPLES: Barbiturates & Benzodiazepine
hyperpyrexia, seizures. May continue for
months.
BENZODIAZEPINES: wildly used, not to lead
5. Rebound anxiety: return of target symptoms,
general anesthesia, or death.
with increase intensity.
6. Respiratory or Cardiovascular depression
BARBITURATES: the older sedative-hypnotics,
general depression of central nervous system.
With such drugs, an increase in dose above that
needed for hypnosis may lead to a state of
general anesthesia. At still higher doses, it may
depress respiratory and vasomotor centers,
leading to coma and death.

COMMONLY ABUSED BARBS:

Secobarbital
Pentobarbital
Phenobarbital

COMMONLY ABUSED BENZODIAZEPINE:

Diazepam (Valium)
Chlordiazepoxide (Librium)
Lorazepam (Ativan)

Potentiate the effects of heroin

Toxicity of this agents are initiated by ethanol
MAJOR METABOLITE: Secobarbital
TOXIC EFFECT: Respiratory depression