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CH 6 - Toxicology
CH 6 - Toxicology
Toxicologists
Due to prevalence of
abuse, laws have
been instituted to
regulate driving while
under the influence –
intoxication.
The degree of intoxication can be
influenced by:
Body weight
Rate of absorption through stomach and small
intestines directly into the blood stream
Influenced by presence/absence of food
Total time taken to consume the alcohol
Type of alcohol consumed – diluted/undiluted
The longer total time required for complete
absorption, the lower will be the peak alcohol
concentration
Methods had to be
developed to assess
levels of intoxication
at the time of arrest
These had to be
reliable to withstand
court presentation
What does Alcohol do to the Body?
It depresses the CNS – Brain
Extent of depression is directly proportional to
concentration of alcohol within the nerve cells
Specifically the forebrain
Eventually alcohol will affect the central and
rear portions of the brain
Most resistant and last to fail are in the
medulla which regulates respiration and heart
activity
What does Alcohol do to the Body?
Most tests rely on blood – the medium for
circulating alcohol throughout the body
Research confirms the direct proportional
relationship of:
Blood alcohol concentration to brain alcohol
concentration
Maximum Blood Alcohol Content (BAC) may
not be reached until 2-3 hours after time of
consumption – more likely within 30-90 min.
from final drink until absorption process is
complete
What does Alcohol do to the Body?
Alcohol will become uniformly distributed
throughout the watery portion of the body
at complete absorption – 2/3 of body
volume
Liver begins the elimination process of 95-
98% of the alcohol by oxidation
In the presence of the enzyme alcohol
dehydrogenase, alcohol is converted into
acetaldehyde and then to acetic acid which is
oxidized to carbon dioxide and water
What does Alcohol do to the Body?
Remaining 2-5% is excreted unchanged in
the breath, urine, and perspiration.
Amount exhaled is in direct proportion to
concentration of alcohol in the blood
Using Henry’s Law, Alveoli air is approximately
2,100:1 – alcohol content in 1 ml of blood =
2,100 ml of alcohol content in alveoli air
Elimination or “burn off” rate can vary by
30% between individuals, but average is
0.015% w/v (weight/vol.) per hour
What does Alcohol do to the Body?
Alcohol’s movement through the circulatory
system
After alcohol is ingested it moves down the
esophagus into the stomach – where about 20% of
the alcohol is absorbed through the stomach lining
into the portal vein.
Remaining 80% is absorbed into the blood through
the lining of the small intestines
Once in the blood it is transported to the liver, heart,
lungs, back to heart to be distributed to all parts of
the body
Circulatory/Respiratory System
1. Blood rich in carbon dioxide is pumped
from the heart into the lungs through the
pulmonary arteries. (Arteries are blood
vessels carrying blood away from the heart;
veins are blood vessels carrying blood to the
heart.)
2. In the lungs, CO2 in the blood is
exchanged for O2.
3. The oxygen-rich blood is carried back to
the heart through the pulmonary veins.
4. This oxygen-rich blood is then pumped
from the heart to the many tissues and
organs of the body, through the systemic
arteries.
5. In the tissues, the arteries narrow to tiny
capillaries. Here, O2 in the blood is
exchanged for CO2.
6. The capillaries widen into the systemic
veins, which carry the carbon-dioxide-rich
blood back to the heart.
Circulatory/Respiratory System
During period of alcohol absorption,
alcohol concentration within arterial
(oxygenated) blood will be considerably
higher than in venous (deoxygenated)
blood.
Blood drawn for testing comes from the
veins in the arm. The true level of alcohol
may not be accurate during the early
phases of absorption. Alcohol levels will
equalize as absorption continues into later
and final stages.
Breath-Test Instruments
Breathalyzer Test
Widely used until
1990
A device for collecting
and measuring the
alcohol content of
alveolar breath
Breathalyzer Test
A subject blows into a mouthpiece that
leads to a metal cylinder which causes a
piston to rise to a height that exposes two
vent holes. When collection of alveolar
breath is complete the piston drops back
into place trapping the collected ~52.5 ml
or 1/40 of 2.100 ml of alveolar breath.
Breathalyzer Test
This trapped alveolar breath can then be
analyzed as it passes into a glass ampoule
containing 3 ml of 0.025% potassium
dichromate and 0.025% silver nitrate in
sulfuric acid and water.
A BAC of .08%
or .10% in most
states in equivalent to
intoxication for most
drivers
Federal standard for
bus and truck
operators is .04%
Alcohol and the Law
Implied consent comes with obtaining a license
to operate a motor vehicle
Driver has a choice – submit to test or be
subject to loss of license for a given period of
time.
Schmerber v. California
Court ruled against defendant – the Fifth Amendment
only prohibits self-incrimination. Being compelled to
furnish “physical” evidence such as fingerprints,
photographs, measurements, and blood samples are
not protected by the Fifth Amendment
Role of the Toxicologist
First attempt to narrow down type of toxic substance
based on victim’s symptoms, postmortem pathological
exam, exam of victim’s personal effects, nearby
presence of empty drug containers or household
chemicals
Next, use general screening procedures
Test for small quantities that may be remaining
Must be aware that the body always processes
substances – few substances enter and completely leave
the body in the same chemical state – most are
metabolized – so test for the metabolite
Must also assess for substance’s toxicity
Toxicological Techniques
90% of drugs analyzed is for alcohol and cocaine
The toxicologist must devise an analytical
scheme that will successfully detect, isolate, and
specifically identify a toxin
Large number of drugs are either acidic (H+) or
alkaline (OH-)
By controlling the pH of a water solution into which
blood, urine, or tissues are dissolved, the toxicologist
can control the type of drug that will be recovered.
Acidic Drugs
Acid drugs are extracted from an acidified
water solution with organic solvents such
as chloroform.
Barbiturates
Acetylsalicylic acid (aspirin)
Alkaline (Basic) - Drugs
Basic drugs are extracted from an alkaline
water solution with organic solvents
Phencyclidine
Methadone
Amphetamines
Cocaine
Sample
Extraction at appropriate pH
SCREENING TEST
Immunoassay
Gas Chromatography
Thin-Layer Chromatography
CONFIRMATION TEST
Gas Chromatography-Mass Spectrometry
Heavy Metal Poisons
Rarely encountered
Arsenic, bismuth, antimony, mercury, and
thallium
Extraction into HCL solution – insert a copper
strip (Reinsch Test) – positive presence of a
heavy metal will develop a silvery or dark
coating on the copper.
Confirm with atomic absorption
spectrophotometry, emission spectroscopy, or
X-Ray differaction
Carbon Monoxide – A Commonly
Encountered Poison
CO binds with hemoglobin carboxyhemoglobin
Methods to determine concentration of CO in the
blood:
Spectrophotometric methods examine bloods visible
spectrum to determine the relative amount of
carboxyhemoglobin to oxyhemoglobin or total
hemoglobin
Treat a volume of blood with a reagent to liberate the
CO then measure with gas chromatography.
Measured as percent saturation – 50-60% saturation
is considered fatal when combined with .2% BAC 35-
45% saturation maybe fatal
Carbon Monoxide – A Commonly
Encountered Poison
Smokers usually have an 8-10% saturation
In fire evaluation – determination of
victim’s condition prior to fire.
If victim was alive at time of fire they would
have a high % CO saturation
If victim was dead at time of fire they would
have low % CO saturation since they could not
breath in any of the fumes