TOXICOLOGY QUESTIONS ANSWERS TOXICOLOGY QUESTIONS ANSWERS

1. It is a scientific discipline, overlapping with 1. Toxicology 20. 20. Botulinom toxin (Clostridium botulinum)
biology, chemistry, pharmacology, and 21. Examples of Toxins 21. Hemotoxin (venomous snakes)
medicine, that involves the study of the 22. 22. Mycotoxin (fungus)
adverse effects of chemical substances on 23. ___________ of toxins is needed to reach
living organisms and the practice of systemic effects and most are absorbed 23. Absorption
diagnosing and treating exposures to toxins through passive diffusion especially in the GI
and toxicants. tract wherein substances need to diffuse across
2. Exogenous agents that can have an adverse 2. Xenobiotics cell membranes.
effect on a living organism. 24. T or F: Toxins that are not absorbed 24. True
3. Exogenous agents that have an adverse 3. Poisons from the gastrointestinal tract do not produce
effect on a biological system; however, these systemic effects.
substances are from animal, plant, mineral, 25. Toxins that are not absorbed from the 25. Local
or gas. gastrointestinal may produce ______ effects,
4. Endogenous substances biologically 4. Toxins such as diarrhea, bleeding, and malabsorption,
synthesized either in living cells or in which may cause systemic effects secondary
microorganisms. to toxin exposure.
5. These refer to substances that are not 5. Toxicant and toxic 26. __________ (50%) has the highest 26. Suicide
produced within a living cell or mortality rate of poisoning cases.
microorganism and are more commonly used 27. _________ exposure (30%) occurs most 27. Accidental
to describe environmental chemicals. frequently in children.
6. 6. Ingestion (most common) 28. ________________ of either therapeutic or 28. Accidental drug overdose (30%)
7. Routes of Exposure 7. Inhalation illicit drugs is relatively common in
8. 8. Transdermal absorption adolescents and adults.
9. Hydrophobic substances route of exposure 9. Passive diffusion 29. The ________ poisoning cases are a result 29. Remaining
10. These substances cannot passively diffuse 10. Ionized substances of homicide or occupational exposure.
across the membranes. 30. ___________ exposure primarily occurs in 30. Occupational
11. Antibiotics (environmental drug exposure) industrial and agricultural settings.
11. 12. Antidepressants (environmental drug 31. __________ can become protonated in 31. Weak acids, nonionized
12. Examples of Xenobiotics exposure) gastric acid resulting in a _______ species,
13. 13. Perfluorinated compounds (chemical which can be absorbed in the stomach. (E.g.,
14. exposure) ASPIRIN)
14. Brominated compounds (chemical 32. ____________ can be absorbed in the 32. Weak bases
exposure) intestine where the pH is largely neutral or
15. 15. Venoms from poisonous snakes/spiders slightly alkaline.
16. 16. Arsenic 33. 33. Rate of dissolution
17. Examples of Poisons 17. Lead 34. Other Factors that influence the 34. Gastrointestinal motility
18. 18. Poison hemlock 35. Absorbance of toxins from the GI 35. Resistance to degradation in the GI tract,
19. 19. Carbon monoxide and interaction with other substances.
 TOXICOLOGY QUESTIONS ANSWERS TOXICOLOGY QUESTIONS ANSWERS

36. This is the measurement of the relationship 36. Dose-Response Relationship 52. It is defined as the capacity or degree of a 52. Toxicity
between the dose of a substance administered substance to induce damage to an organism.
and its overall effect (the response), either 53. _______ toxicity is defined as single, 53. Acute toxicity
therapeutic or toxic. short-term exposure, the dose is sufficient to
37. The dose–response relationship implies 37. Increase, increased cause immediate toxic effects.
that there will be an _______ in the toxic 54. ______ toxicity is defined with repeated 54. Chronic toxicity
response as the dose is _________. and frequent exposure for extended periods
38. The ______ makes the poison. 38. Dose of time (months to years) at doses that are
39. Predicted dose that would produce a toxic 39. TD50 (Toxic Dose) insufficient to cause an immediate acute
response in 50% of the population. response.
40. Predicted dose that would result in death 40. LD50 (Lethal Dose) 55. This is performed if substance is not 55. Tox Screen
in 50% of the population. known; usually urine or blood specimens.
41. Dose that would be predicted to be 41. ED50 (Therapeutic Dose) 56. This is performed if substance is known 56. Targeted testing
effective or have a therapeutic benefit in (e.g., occupational hazards).
50% of the population. 57. 57. Toxicokinetics
42. ________________ is the ratio of the 42. Therapeutic Index 58. Analysis of Toxic Agents 58. Preanalytical Variables
TD50 (or LD50) to the ED50. 59. Considerations 59. Clinical Setting
43. Drugs with a _____ therapeutic index 43. Large, fewer 60. The study of all kinetics of all substances
demonstrate _____ toxic adverse effects when at toxic dose/exposure levels; taken into 60. Toxicokinetics
the dose of the drug is in the therapeutic account; toxic agents exhibit unique
range. absorption, distribution, metabolism, and
44. This relates to the individual's health 44. Individual Dose-Response Relationship elimination.
status as well as changes in xenobiotic 61. Elimination patterns, analyte stability, and 61. Preanalytical Variables
exposure levels. specimen collection
45. This describes the change in health effects 45. Quantal Dose-Response Relationship 62. 62. Patient clothing
of a defined population based on changes in 63. 63. Skin
the exposure to the xenobiotic. 64. Common sources of External 64. Hair
65. Contamination 65. Collection environment (e.g., dust,
66. aerosols, antiseptic wipes)
66. Specimen handling variables (e.g.,
container, lid, preservatives)
67. Urine testing: ___________ are preferred
46. (variable elimination patterns throughout the 67. 24 hour urine collections
47. day) more accurate than random urine
48. collections.
49. 68. _____________ used as urine 68. Concentrated acids
50. preservatives; specimen tubes.
51.
 TOXICOLOGY QUESTIONS ANSWERS TOXICOLOGY QUESTIONS ANSWERS

69. Use of acid-washed pipette tips, 69. Prevent 83. 83. Alcohols
containers, and other supplies to _______ 84. Toxicology of Specific Agents 84. Cyanide
contamination. 85. 85. Carbon monoxide, and caustic agents
70. Exercise precautions to prevent 70. Loss of toxic agents 86. 86. Metals and metalloids
__________ due to in vitro volatilization and 87. _________ can cause disorientation,
metabolism. confusion, and euphoria, but can progress to 87. Alcohols
71. ____ washing removes calcium deposits 71. Acid unconsciousness, paralysis, and with high-
among others. level exposure, even death.
72. Toxicokinetics example: exposure to 72. Excreted in fecal material 88. Alcohol is the common ________ effect on 88. Depressant
methylmercury could be missed if testing is the central nervous system (CNS).
performed on urine as methylmercury is 89. Specific toxicities are mediated by 89. Biotransformation
primarily________________. ___________ of alcohols to toxic products.
73. Tests Used for the Analysis of 73. Screening Test (1st step) 90. Acetaldehyde toxic metabolite_____. 91. Asian Flush
74. Toxic Agents 74. Confirmatory Tests (2nd step) 91. 91. Ethanol
75. Quantitative and report the concentration 92. Alcohols 92. Methanol
of the substance in the specimen. 75. Confirmatory Test 93. 93. Isopropanol
76. Rapid, simple, qualitative; positive or 94. 94. Ethylene Glycol
negative. 76. Screening Test 95. It is a leading cause of economic, social,
77. Screening: ____ Analytic Sensitivity; ____ 77. Good; Low and medical problems; can cause fetal alcohol 95. Ethanol
Specificity. syndrome or fetal alcohol effects.
78. A _____ result can rule out a drug or 78. Negative, positive, presumptive positive 96. A condition in a child that results from 96. Fetal Alcohol Syndrome
toxicant; however, a ______ result should be alcohol exposure during the mother’s
considered a __________ until confirmed by a pregnancy.
second, more specific method, which is the 97. Blood alcohol concentration: __ mg/dL: 97. 80 mg/dL
second step of the test process, or a the statutory limit for motor operation.
confirmatory test. 98. Chronic consumption: about __ g of 98. 50 g
ethanol per day for about 10 years. Hepatic
Identify what Confirmatory Test is used on: steatosis Alcoholic hepatitis Alcoholic
79. Organic compounds 79. Thin-layer chromatography (TLC) liver disease Liver cirrhosis
80. Volatile substances 80. Gas chromatography (GC) 99. It is found in many household cleaners; 99. Methanol
81. Inorganic compounds 81. Inductively coupled plasma-mass homemade liquors.
82. Reference method for quantitative spectrometry (ICP-MS) or atomic absorption 100. ________ can cause severe metabolic 100. Formic acid
identification of most organic compounds as (AA) methods acidosis and optic neuropathy.
the detector. 82. Gas chromatography coupled with a mass 101. Rubbing alcohol; both isopropyl and 101. Isopropanol
spectrometer (GC–MS) acetone are CNS depressant.
102. A common component of hydraulic fluid 102. Ethylene Glycol
and antifreeze.
 TOXICOLOGY QUESTIONS
103. Ingestion of ethylene glycol by children is
relatively common because of its __________.
104. Effects of Ethylene Glycol
105. Determination of
106. Alcohols
Pre-analytical
107. ______________ should only be cleaned
with an alcohol-free disinfectant.
108. T or F: Specimens must be capped at all
times to avoid evaporation.
109. T or F: Sealed specimens can be
refrigerated or stored at room temperature
for up to 14 days without loss of ethanol.
110. Nonsterile specimens or those intended
to be stored for longer periods of time should
be preserved with ___________ to avoid
increase in ethanol content resulting from
________________________.
Analytical
111. _________ is the established reference
method for ethanol determinations.
112. _________: Freezing point depression,
increases in serum osmolality correlate well
with increases in serum ethanol concentration.
113. Serum osmolality increases by
approximately __ mOsm/kg for each __ mg/dL
increase in serum ethanol.  SCREENING
TEST.
114. ___________is the measured plasma
osmolality minus calculated osmolality.
115. ____________: NADH produced can be
monitored directly by absorbance at ___ nm
or can be coupled to an indicator reaction.
ANSWERS TOXICOLOGY QUESTIONS ANSWERS
103. Sweet taste 116. It is produced by incomplete 116. Carbon monoxide
combustion of carbon-containing substances.
104. Severe metabolic acidosis and rapid It is colorless, odorless, and tasteless gas that
formation and deposition of calcium oxalate is rapidly absorbed into circulation from
crystals in the renal tubules renal tubular inspired air.
damage. 117. It is a stable complex of carbon 17. Carboxyhemoglobin (COHb)
105. Pre-analytical monoxide that forms in red blood cells when
106. Analytical carbon monoxide is inhaled.
118. COHb reduces the carrying capacity of 118. Hypoxia
hemoglobin for oxygen, which impairs the
107. Venipuncture site release of oxygen to the tissues and results in
___________ (brain and heart).
108. True 119. Treatment for carbon monoxide 119. 100% oxygen therapy
poisoning
109. True 120. A ____________ color/apprearance is the 120. Cherry red
one tell-tale indicator of carbon monoxide
poisoning.
110. Sodium fluoride, contamination due to 121. Screening: Add __ mL of __% NaOH to 121. 5 mL of 40% NAOH to 5 mL
bacteria __ mL of an aqueous dilution of the whole
blood specimen. Persistence of a pink color of
the solution is consistent with a COHb level
of 20% or greater.
122. 122. Differential spectrophotometry (most
123. Confirmatory for Carbon monoxide common)
111. Gas Chromatography (GC) 123. Gas chromatography (reference method)
Differential Spectrophotometry
112. Osmolality
124. T or F: Principle: Different forms of 124. False (present)
hemoglobin not present with different spectral
113. 10 mOsm/kg; 60 mg/dL absorbance curves.
125. By measuring the absorbance at __ to 125. 4 to 6; calculation
__ different wavelengths, the concentration of
the different species of hemoglobin, including
114. Osmolal gap COHb, can be determined by ___________.
115. Enzymatic method; 340 nm
 TOXICOLOGY QUESTIONS ANSWERS TOXICOLOGY QUESTIONS ANSWERS

Gas Chromatography 135. Cyanide Analytic: _______________ and 135. Ion-specific electrode (ISE) methods and
126. Principle: Carbon monoxide is released 126. Potassium ferricyanide ____________________________are the most photometric analysis following two-well
from hemoglobin after treatment with common methods. microdiffusion separation
____________. 136. Chronic low-level exposure to cyanide
127. After analytic separation, carbon 127. Changes in thermal conductivity is generally evaluated by determining a 136. Urinary thiocyanate
monoxide is detected by _________________, ______________ concentration.
and the COHb concentration can be 137. 137. Arsenic (As)
determined. 138. 138. Cadmium (Cd)
139. Metals and metalloids 139. Lead (Pb)
128. These are chemical and physical agents 128. Caustic agents 140. 140. Mercury (Hg)
with the potential to cause tissue destruction; 141. 141. Pesticides
exposure to a strong acid or alkaline 142. It is a common homicide and suicide
substance is associated with injury, agent and occurs in agriculture and smelting 142. Arsenic
aspiration and ingestion present the greatest industries.
hazards. 143. ________ and ___________ in foods 143. Arsenobetaine and Arsenocholine
129. _______  pulmonary edema and shock, 129. Aspiration such as clams, oysters, scallops, mussels,
which can rapidly progress to death. crustaceans (crabs and lobsters), and some
130. _________  lesions in the esophagus 130. Ingestion bottom-feeding finfish.
and gastrointestinal tract perforation  144. Inhalation of _________ demonstrates 144. Arsine gas; most acute
hematemesis, abdominal pain, and possibly the _________ toxicity.
shock. 145. Some toxins can bind to sulfhydryl 145. Mees’ lines
131. Super toxic substance that can exist as a 131. Cyanide groups in keratin found in hair and
gas, solid, or in solution; a component of fingernails that results in __________.
some insecticides and rodenticides; inhalation, 146. Analysis of arsenic: method/technique? 146. Atomic Absorption Spectrophotometry
ingestion, or transdermal absorption. (AAS)
132. Cyanide expresses toxicity by binding to 132. Heme iron 147. An environmental pollutant, taken up by
__________. agricultural crops; pigment found in paints and 147. Cadmium
133. Binding to _____________ causes an plastics; used for electroplating and
uncoupling of oxidative phosphorylation galvanizing; mining and processing of many
ETC disabled decrease in ATP Increases 133. Mitochondrial cytochrome oxidase other metals; cathodal material of nickel-
in cellular oxygen tension and venous pO2 cadmium batteries.
occur as a result of lack of oxygen utilization.
134. Cyanide clearance is primarily 134. Rapid enzymatic conversion to 148. Cadmium routes of exposure 148. Tobacco Smoking, consumption of
mediated by__________________________, thiocyanate shellfish, organ meats, lettuce, spinach,
a nontoxic product rapidly cleared by renal potatoes, grains, peanuts, soybeans, and
filtration. sunflower seeds.
 TOXICOLOGY QUESTIONS ANSWERS TOXICOLOGY QUESTIONS ANSWERS

149.
150. Cadmium effects
151.
152. Analysis of Cadmium: method/technique
153. This disease is characterized by severe
osteomalacia and osteoporosis from the long
term consumption of cadmium-contaminated
rice.
Lead
154. Lead routes of exposure:
155. Lead Distribution:
156. Lead toxicity:
157. ________ exposure: Abdominal or
neurological symptoms (Encephalopathy).
158. _______ exposure behavioral changes,
hyperactivity, attention deficit disorder and a
decrease in intelligence quotient (IQ) scores.
159. ________ exposure demyelinization of
peripheral nerves resulting in a decrease in
nerve conduction velocity.
160. The normal threshold for blood lead
levels (BLL) set by the Centers for Disease
Control and Prevention is __ μg/dL.
161. For ___ ug/dL Growth deficits
162. For ___ ug/dL Anemia
163. For ___ ug/dL permanent IQ and
hearing deficits.
149. Nephrotoxic tubular proteinuria, 164. Effects of Lead
glucosuria, and aminoaciduria addition to renal 165.
dysfunction, concomitant
150. Parathyroid dysfunction and vitamin D
deficiency
151. Itai-itai Disease 166. Accumulation of aminolevulinic acid
152. AAS and protoporphyrin increase in zinc
protoporphyrin __________.
153. Itai-itai Disease 167. Lead specimen collection:
168. Analysis of Lead
169. Lead Confirmatory
154. Mostly ingestion, susceptibility depends Mercury
on age (infants absorb more lead) 170.
155. Bone and soft tissue (with bone being 171. Mercury Forms
the largest pool), kidneys, bone marrow, 172.
circulating erythrocytes, and peripheral and
central nerves.
156. Dose-dependent manner
157. Acute
173. Common toxic route:
158. Low level
174. Mercury Effects
159. Higher levels 175. Analysis of Mercury
160. 10 μg/dL 176. Insecticides, herbicides, fungicides,
rodenticides are ___________.
177. Major route of pesticides
161. >10 ug/dL 178. Pesticides can lead to __________
162. >20 ug/dL exposure (No PPE when handling).
163. <10 ug/dL 179. Organophosphates, carbamates, and
halogenated hydrocarbons are ____________.
180. __________ are the most abundant and
are responsible for about one-third of all
pesticide poisonings.
164. Enzyme inhibition: vitamin D
metabolism (decrease both 25-hydroxy and 1,
25 dihydroxy vitamin D) Bone abnormality
165. Heme synthesis pathwayAnemia
(Basophilic stippling)
166. Screened for toxicity
167. Tan-top (K2EDTA tube)
168. Chromogenic reactions and anodic
stripping voltammetry method
169. Graphite furnace AAS has been used to
confirm whole BLLs; Quantitative ICP-MS
170. Elemental (liquid at room
temperature) may be ingested without
significant effects
171. Inorganic salts Nephrotoxic
172. Component of organic compounds
(methylmercury) extremely toxic! Brain
and peripheral nerves
173. Consumption of contaminated foods GI
absorbance
174. Brain and peripheral nerves (divalent
state)
176. AAS using whole blood or an aliquot of
a 24-hour urine specimen; Anodal stripping
voltammetry
176. Pesticides
177. Contamination of food
178. Chronic occupational exposure
179. Insecticides
180. Organophosphates
 TOXICOLOGY QUESTIONS
181. ___________and ___________ can
inhibit enzyme acetylcholinesterase (AChE).
182. Organophosphates and carbamates
analysis
183. T or F: Treatment is based on history and
clinical judgment.
Salicylates
184.________________ is a common type of
salicylates and commonly used analgesic,
antipyretic, and anti-inflammatory drug.
185. MOA: Decreasing ____________ and
__________ formation through the inhibition
of _______________.
186. Salicylates can cause _________
syndrome in children.
187. It is a rare condition that causes swelling
in the liver and brain after a viral illness or
infection like the flu or chickenpox. It is often
seen in children and teenagers who take
aspirin to treat symptoms during a viral illness
or infection.
188. Salicylates Toxicity:
189. Analysis of Salicylates
190. Several immunoassay methods are
available; ___________ (salicylate reacts
with ferric nitrate to form a colored complex
that is then measured spectrophotometrically.
191. This is also known as Paracetamol and
Tylenol and can cause hepatotoxicity (liver
damage).
192. Analysis of Acetaminophen
ANSWERS TOXICOLOGY QUESTIONS ANSWERS
181. Organophosphates and Carbamates Acetaminophen Toxicity
193. Acetaminophen conjugated to harmless 193. Glucuronide & Sulfate metabolites
182. Measurement of serum ________________ when taken in usual
pseudocholinesterase (SChE) activity doses by patients w/ normal liver function.
183. True 194. W/ overdose - ________________ are 194. Phase II metabolic pathway; P450-
overwhelmed, & a ______________ converts dependent system
some of the drug to a reactive intermediate
(N-acetyl-p-benzoquinoneimine).
184. Acetylsalicylic acid or aspirin 195. This intermediate is conjugated w/ 195. Glutathione; glutathione
____________ to a 3rd harmless product if
____________ stores adequate.
185. Thromboxane and prostaglandin; 196. If glutathione inadequate, reactive
cyclooxygenase intermediate combines w/______________, 196. Essential hepatic cell proteins
resulting in cell death.
186. Reye’s syndrome 197. Prompt administration of other
_______________ (eg, acetylcysteine) may 197. Sulfhydryl donors
be life-saving after an overdose.
198. In severe liver disease, stores of 198. Glucuronide, sulfate, & glutathione
187. Reye’s syndrome _________________ depleted, making patient
susceptible to hepatic toxicity w/ normal
doses of acetaminophen.
199. _____________ (eg, ethanol) increase 199. Enzyme inducers; increased production
188. Mixed acid-base disturbance, lactic acid acetaminophen toxicity because they
build up, and ketosis increase phase I metabolism more than
189. GC and Liquid chromatography (LC) phase II metabolism, resulting in
methods: highest analytical sensitivity and _______________ of the reactive metabolite.
specificity
200. Two-Tiered Testing for 200. Screening
190. Trinder reaction 201. Drug Abuse 201. Confirmatory: GC-MS
202. These are therapeutic drugs used for
narcolepsy and attention deficit disorder; 202. Amphetamine and methamphetamine
stimulants with high abuse potential. (Street Name: Crank, Glass, Ice)
191. Acetaminophen 203. Over-the-counter medications, including 203. Ephedrine, pseudoephedrine, and
___________________________________. phenylpropanolamine.
204. Effects of amphetamine and
192. The reference method for the methamphetamine 204. Hypertension, cardiac arrhythmias,
quantitation of acetaminophen in serum is convulsions, and possibly death.
HPLC.
 TOXICOLOGY QUESTIONS
205. Analysis of Amphetamine and
Methamphetamine
Methylenedioxymethamphetamine
(MDMA)
206. MDMA is also known as ________.
207. Onset of effect is _______ minutes, and
duration is about _____ hours.
208. Effects of MDMA
209. Analysis of MDMA
Anabolic Steroids
210. Effects of chronic steroid use
211. In males, chronic steroid use is associated
with ______________________________.
212. In females, steroid abuse causes
__________________________________.
Cannabinoids, Tetrahydrocannabinoids
(THC), MARIJUANA, MARY JANE,
HASISH, SPACE BROWNIES, weed
213. ____________ compounds found in
marijuana.
214. The major urinary metabolite
is_____________________. This metabolite
can be detected in urine for up to __ days
after a single use or up to __ weeks following
chronic, heavy use.
ANSWERS
205. Screening: Immunoassay systems;
Confirmatory: LC or GC methods
206. Ecstasy
207. 30 to 60 min; 3.5 hours
208. Hallucination, euphoria, empathic and
emotional responses, and increased visual and
tactile sensitivity.
209. Confirmed with GC-MS
210. Chronic use: toxic hepatitis, accelerated
atherosclerosis and abnormal aggregation of
platelets stroke and myocardial infarction,
enlargement of the heart ischemia of heart
muscle cells cardiac arrhythmias and
possible death.
211. Testicular atrophy, sterility, and
impotence
212. The development of masculine traits,
breast reduction, and sterility
213. Psychoactive
214. 11-nor-tetrahydrocannabinol-9-carboxylic
acid (THC-COOH); 5 days, 4 weeks
TOXICOLOGY QUESTIONS ANSWERS
215. ____________ tests for THC-COOH 215. Immunoassay; GC–MS
are used to screen for marijuana consumption,
and _________ is used for confirmation.
216. Both methods are ______________ and 216. Sensitive and specific; passive inhalation
because of the low limit of detection of both
methods, it is possible to find THC-COOH in
urine as a result of ______________.
217. ______________ standards have been 217. Urinary concentration
established to discriminate between passive
and direct inhalation.
Cocaine, COKE, salt, blow
218. Cocaine is a local ______ with few 218. Anesthetic, therapeutic
adverse effects at ________ concentrations.
219. At higher circulating concentrations, it 219. CNS stimulator
is a potent ____________ that elicits a sense
of excitement and euphoria.
220. Only a ______ portion of the parent 220. Small, urine
drug can be found in ______ after an
administered dose.
221. The primary product of hepatic 221. Benzoylecgonine
metabolism is ___________, which is largely
eliminated in urine.
222. The half-life of benzoylecgonine is __ to 222. 4 to 7 hours; 3 days
__ hours; however, it can be detected in urine
for up to __ days after a single use.
223. The presence of this metabolite in urine 223. Sensitive and specific
is a ______________ indicator of cocaine use.
224. In chronic heavy abusers, it can be
detected in urine for up to __ days after the 224. 20 days
last dose.
225. The primary screening test for 225. Measurement of benzoylecgonine; by
detection of cocaine use is _______________ immunoassay
in urine by __________.
226. Confirmation testing is most commonly 226. GC–MS
performed using _________.
 TOXICOLOGY QUESTIONS ANSWERS

227. A drug that is extracted from the poppy 227. Opiates

plant (papaver somniferum); Analgesia,
sedation, and anesthesia.
228. ________ occurring: opium, morphine, 228. Naturally
and codeine.
229. _____________ modified: Heroin, 229. Chemically
hydromorphone (Dilaudid), and oxycodone
(Percodan).
230. ____________: Meperidine (Demerol), 230. Synthetic
methadone (Dolophine), propoxyphene
(Darvon), pentazocine (Talwin), and
fentanyl (Sublimaze).
231. Opioid overdose effects: 231. P-C-R (Pupillary constriction, Comatose,
232. Treatment: Respiratory depression)
233. Analysis of Opiates 232. Naloxone
234. _________ is the method of choice for 233. Screening by immunoassay
confirmation testing. 234. GC-MS method

Sedatives-Hypnotics
235. T or F: CNS depressants. 235. True
236. ____________________ are the most 236. Barbiturates and benzodiazepines
common types of sedative–hypnotics abused.
237. ________________________ are the 237. Secobarbital, pentobarbital, and
more commonly abused barbiturates. phenobarbital
238. _________________________ are the
most commonly abused benzodiazepines. 238. Diazepam (Valium), chlordiazepoxide
239. T or F: Overdose with sedatives– (Librium), and lorazepam (Ativan)
hypnotics initially presents with lethargy and
slurred speech, which can rapidly progress to 239. True
coma.
240. _____________ is the most serious toxic 240. Respiratory depression; hypotension
effect of most of these agents though
___________ can occur with barbiturates as
well.
241. The toxicity of many of these agents is 241. Ethanol
potentiated by _______ use.
242. Screening (barbiturate & benzodiazepine) 242. Immunoassay
243. Confirmatory 243. GC or LC methods