Talk:Toxicology: Difference between revisions

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====Acetaminophen====
====Acetaminophen====
[[Acetaminophen]] (Tylenol, or paracetamol), is a common OTC [[analgesic]] and [[antipyretic]], and is the most common medication overdose.  
[[Acetaminophen]] (Tylenol, or paracetamol), is a common OTC [[analgesic]] and [[antipyretic]], and is the most common medication overdose.  
In
A small percentage (5%) of the active compound is metabolized in the liver by the [[CYP]]2E1 enzyme to [[NAPQI]], a toxic metabolite that normally binds to a [[sulfhydryl]]-containing compound called [[glutathione]].   
A small percentage (5%) of the active compound is metabolized in the liver by the [[CYP]]2E1 enzyme to [[NAPQI]], a toxic metabolite that normally binds to a [[sulfhydryl]]-containing compound called [[glutathione]].   
However, in large does, glutathione stores are depleted, allowing NAPQI to bind to other sulfhydryl-containing compounds in the liver, eventually leading to hepatic [[necrosis]].  In cases of massive hepatic failure, renal injury can also occur, which can lead to [[acute kidney failure]]. <ref> Chyka, P.  Clinical Toxicology.  Pharmacotherapy: A Pathophysioligic Approach 6th. ed. DiPiro et al. 2005.</ref>
However, in large does, glutathione stores are depleted, allowing NAPQI to bind to other sulfhydryl-containing compounds in the liver, eventually leading to hepatic [[necrosis]].  In cases of massive hepatic failure, renal injury can also occur, which can lead to [[acute kidney failure]]. <ref> Chyka, P.  Clinical Toxicology.  Pharmacotherapy: A Pathophysioligic Approach 6th. ed. DiPiro et al. 2005.</ref>



Revision as of 23:31, 6 February 2007

I'm not finding any good sources on the History. Just a note for anyone with some spare time. Bryan Eskew 23:07, 6 February 2007 (CST)

I'm just framing out the article right now, editing a bit from Wikipedia. Bryan Eskew 22:07, 6 February 2007 (CST)


Toxicology is the study of the adverse effects of chemicals on living organisms. It looks at the source, symptoms, distribution, short and long term effects, detections, mechanisms, and treatments of poisons, especially regarding human physiology. Toxins can come from virtually any source, but usually are from drugs, household supplies, cosmetics, industrial chemicals, biological sources, and chemicals used in agriculture. [1]

Almost any chemical can be toxic; it is the dose that determines the toxic effect. As Paracelsus, the father of modern toxicology said, “Sola dosis facit venenum” (only dose makes the poison). Paracelsus, who lived in the 16th century, was the first person to explain the dose-response relationship of toxic substances. Also, some things are not toxic at certain does, but when taken with another chemical, produce a synergistic effect that manifests as a toxicity. An example is acetaminophen and ethanol: when combined at their respective non-toxic doses, they can produce a toxic effect [2].

History

Paracelsus,(1493 - 1541) is widely regarded as "the father" of modern toxicology. He is credited with the classical phrase "All things are poison and nothing is without poison; only the dose makes a thing a poison." Mathieu Orfila is considered to be the modern father of toxicology, having given the subject its first formal treatment in 1813 in his Trait des poisons, also called Toxicologie generate.

Epidemiology

Poisoning ranks as the second leading cause of accidental injury deaths in the United States, behind motor vehicle accidents. In the United States in 2003, 28,700 people died of poisoning, with 68% of those deaths unintentional. Poison control centers listed over 2 million poison exposure cases in 2004, and emergency departments reported 577.866 visits from accidental poisoning victims. [3]

Most unintentional poisonings were caused by legal and illegal drugs, such as opioids, cocaine, NSAIDS, benzodiazepenes, along with cosmetics, cleaning substances, foreign bodies, OTC drugs, and pesticides. [4]

Quantification

The classical toxicology test has been the LD50 (lethal dose 50), which refers to the concentration of drug required to kill 50% of the test subjects (usually mice or rabbits) in a certain amount of time. The higher the LD50, the more toxic the substance is. This test can also be applied to achieve other percentages, for example the LD10 (dose to kill 10% of the subjects), or the LD100 (the minimum dose to kill all of the subjects)

Toxins

Drugs

Acetaminophen

Acetaminophen (Tylenol, or paracetamol), is a common OTC analgesic and antipyretic, and is the most common medication overdose. A small percentage (5%) of the active compound is metabolized in the liver by the CYP2E1 enzyme to NAPQI, a toxic metabolite that normally binds to a sulfhydryl-containing compound called glutathione. However, in large does, glutathione stores are depleted, allowing NAPQI to bind to other sulfhydryl-containing compounds in the liver, eventually leading to hepatic necrosis. In cases of massive hepatic failure, renal injury can also occur, which can lead to acute kidney failure. [5]

Long term ethanol use induces the CYP2E1 enzyme, which produces larger amounts of NAPQI from dose of acetaminophen. This combination can cause liver failure with normal doses of acetaminophen.

Biology

Poisons

General Treatment

References

  1. Chyka. Clinical Toxicology. Pharmacotherapy: A Pathophysiologc Approach.
  2. Draganov P. et al. Alcohol-acetaminophen syndrome. POSTGRADUATE MEDICINE. Vol 107, Num 1, 200.
  3. Poisoning in the United States: Fact Sheet. CDC. http://www.cdc.gov/ncipc/factsheets/poisoning.htm
  4. Clinical Toxicology, 2006:44:803.
  5. Chyka, P. Clinical Toxicology. Pharmacotherapy: A Pathophysioligic Approach 6th. ed. DiPiro et al. 2005.