Drug Identification and Toxicology

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Drug Identification and Toxicology

Chapter 9
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Introduction

• Toxicology the study of poisons and the
  identification of drugs and other substances a
  person may have used for medicinal, recreational,
  or criminal purposes. Toxicology also examines
  the harmful effects of poisons and drugs on the
  body.
• Toxicity degree to which a substance is
  poisonous or can cause injury. This depends on
  many factors
• Dose
• Duration (frequency and length of exposure)
• Nature of exposure (ingested, inhaled,
  intravenously, from dermal contact)
• Interactions with other substances or medications
  already present
• Forensic toxicology helps determine the
  cause-and-effect relationships between exposure
  to a drug or other substance and the toxic or
  lethal effects from that exposure. Besides
  drugs, this includes heavy metals, solvents and
  vapors, radiation and radioactive materials,
  dioxins/furans, pesticides, and plant and animal
  toxins

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History

• Toxins are classified by how people are exposed
  to them
• Intentionally drugs to treat an illness
• Accidently overdoses or harmful combinations
• Deliberately suicide or to harm or kill others
• Sophocles was the earliest reported victim of
  poisoning (399 BC) By the 17th century,
  poisoning had become a profession, especially
  arsenic (nicknamed inheritance powder). It was
  until the 1800s when a chemical analysis to test
  for arsenic poisoning had been developed.

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Murder By Poison

• Although popular in murder mysteries, its not a
  common form of murder. Only about 0.5 of all
  homicides are from poisoning.
• Testing for a vast array of possible toxins can
  be a challenge to the toxicologist. They must
  determine from acute poisoning (high dose over a
  short period of time like cyanide) and chronic
  poisoning (lower doses over long periods of time,
  like mercury and lead)
• Accidental deaths from drug overdoses are more
  common than deaths from poisoning.

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Drugs and Crime

• Illegal drugs like heroin and lysergic acid
  diethlaminde (LSD) are drugs with currently no
  accepted medical use in the US.
• Controlled substances are defined as legal drugs
  whose sale, possession, and use are restricted bc
  of the effect of the drugs and potential for
  abuse (narcotics, depressants, stimulants)
• Drug abuse violations topped the list of the
  seven leading arrest offenses in the US in 2005.
  Drug offenders make up more than half of the
  federal prison system population and about 20 of
  the state prison population.

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Controlled Substances

• Hallucinogens
• From plants, and affect the users perceptions,
  thinking, self-awareness, and emotions. These
  include peyote, marijuana, and some mushrooms.
  LSD, MDMA (ecstasy), and PCP (angel dust), are
  chemically manufactured
• LSD originally was a fungus that grows on rye and
  is one of the more potent mood-changing chemicals
• PCP was developed as an anesthetic, but is no
  longer used.

DRUG CHARACTERISTICS OF OVERDOSE
MDMA (ecstasy) Increased heart rate and BP, muscle cramps, panic attacks, seizures, loss of consciousness, stroke, kidney failure, death
Mescaline (peyote) Hallucinations, euphoria, dizziness, vomiting, up heart rate, dilated pupils, diarrhea, headaches, anxiety and irrationality
LSD Dialated pupils, loss of appetite, sleeplessness, high temp, high heart rate and BP, sweating, dry mouth, tremors, confusion, distortion, hallucinations
PCP High heart rate and BP, convulsions, sweating, dizziness, numbness, heart failure (death), drowsiness, psychosis that can last weeks.
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• Narcotics
• Act to reduce pain by suppressing the central
  nervous system. Like opium and its derivatives
  heroin and codeine. These painkillers are very
  habit forming

DRUG CHARACTERISTICS OF OVERDOSE
Opium Difficulty breathing, low BP, weakness, dizziness, confusion, loss of consciousness, cold clammy skin, small pupils.
Heroin, codeine, morphine (hydrocodone, vicodin, lortab, tylenol 3) Difficulty breathing, low BP, coma, spasms of the stomach or intestines, constipation, nausea, vomiting, sleepiness, blue fingernails and lips, death
Methadone (dolophine), morphine Difficulty breathing, drowsiness, coma, low BP, muscle twitches, blue fingernails and lips
Oxycodone (percocet, oxycontin) Slow, difficult breathing, seizures, coma, confusion, tiredness, cold clammy skin, small pupils
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• Stimulants
• Increase feelings of energy and alertness while
  suppressing appetite. Depression often results
  as the effect of the drug wears off.
  Amphetamines, methamphetamines, and cocaine
  (including crack) are highly addictive

DRUG CHARACTERISTICS OF OVERDOSE
Amphetamines (speed) High BP, rapid heart rate, agitation, irregular heartbeats, stroke, seizure, coma, death
Cocaine/crack cocaine Dangerous rise in body temp, sweating, tremors, seizures, irregular heartbeats, stroke, confusion, heart attack, bleeding in the brain, death
Methamphetamines Dangerous rise in body temp, profuse sweating, confusion, rapid breathing, high heart rate, dilated pupils, high BP, kidney failure, bleeding in the brain, death
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• Anabolic steroids
• Promote cell and tissue growth and division,
  similar to testosterone. Created to treat
  hypogonadism (low testosterone levels in males)
  and are used for many reasons in medicine. In
  1930s, weightlifters and body builders discovered
  their potential, but had side effects, like acne,
  baldness, high BP, impaired fertility, cancer,
  and heart attacks.
• Depressants
• Drugs like barbiturates and benzodiazepines that
  relieve anxiety and produce sleep. They reduce
  body functions, such as heart rate, by acting on
  the central nervous system and increasing the
  neurotransmitter called GABA which makes the user
  very calm. Side effects include slurred speech,
  loss of cordination, and intoxication similar to
  that of alcohol. OD-ing can cause coma or death.

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Other Organic Toxins and Alcohols

• Organic toxins poisonous substances produced by
  living organisms, usually proteins that cannot be
  broken down by another organism. Snake venom and
  bee stings are good examples (most are dermal or
  ingested)
• ALL ALCOHOLS ARE TOXIC TO THE BODY. Methanol is
  not directly poisonous but the liver converts it
  to formaldehyde. Ethanol (grain alcohol) is
  produced by fermentation of sugars in fruits,
  grains, and veggies. The body converts ethanol
  to acetaldehyde and then acetic acid. To much
  acetaldehyde can accumulate in the blood and may
  produce dehydration, and classic symptoms of a
  hangover. Sometimes, the consumer will pass out
  and not wake back up.

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Bacterial Toxins

• Botulism is the most poisonous substance known to
  humans. Produced by the bacterium Clostridium
  botulinum and acts as a neurotoxin, paralyzing
  muscles by blocking the release of the
  neurotransmitter acetylecholin.
• This toxin is extremely deadly in very small
  amounts. The toxin may be ingested from
  contaminated food, like canned veggies, cured
  pork, smoked or raw fish, and honey or corn
  syrup.
• This bacterium can be killed by heating up food
  at 176 degrees Fahrenheit (at least) for 10
  minutes. Purified botulinum toxin (botox) has
  been safely used in medicine to treat several
  ailments.
• Clostriduium tetani is the bacteria that produces
  tetanus, a potentially deadly nervous system
  disease (often called lockjaw because symptoms
  start in the jaw). It blocks nerve signals from
  the spinal cord from reaching the muscles and
  causes spasms so severe, bones can break and
  muscles can tear. 1 million deaths per year, 5
  per year in the US.

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Heavy Metals and Pesticides

• Pesticides were created for the control of
  insects, mice, fungi, bacteria, weeds, etc. and
  are by definition toxic and can cause severe
  illness and death.
• Metal compounds like arsenic, lead, and mercury
  are very poisonous and have also been used for
  suicide and homicide. Can be introduced to the
  body by ingestion, inhalation, or absorbtion
  through the skin. They are stored in the soft
  tissues of the body.
• Other lethal agents include gases like hydrogen
  cyanide (Hitlers gas chambers), carbon monoxide,
  and potassium chloride (stop production of ATP
  needed for cellular function) or sodium pentothal
  (lethal injections stops the heart from being
  able to create electrical impulses)

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DRUG CHARACTERISITCS OF OVERDOSE
Pesticides Phosphate-containing pesticides that accumulate in fatty tissue leading to an excess of acetylcholine causing nerve impulses, twitching, seizures, sweating, diarrhea, coma, and death.
Lead Nausea, abdominal paoin, insomnia, headache, weight loss, constipation, anemia, kidney problem, vomiting, seizure, coma and death. Blue discoloration appears along the gumline in the mouth.
Mercury Mad Hatters Disease is a progressive disorder as mercury is absorbed and accumulates. Causes flu-like symptoms. Chronic poisoning causes irritability, personality changes, headache, memory and balance problems, ab pain, nausea, salivation and damage to the mouth.
Arsenic Within 30 min, ab pain, severe nausea, vomiting and diarrhea, dry throat, difficulty speaking, cramps, convulsion. Chronic exposure produces skin leasions and pigment changes.
Cyanide OD can be fatal in 6-8 min. Rapidly causes weakness, confusion, coma, and pink skin from high blood oxygen saturation. Produces and almond like odor.
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Bioterrorism Agents

• Ricin component of waste product of the
  manufacture of castor oil. Lethal in quantities
  as small as 500 mg (size of a pin head). Can be
  inhaled as a mist or powder, ingested as food or
  drink, or injected. Stops cells from creating
  proteins causing cell death. Large amounts of
  cells die, you die.
• Anthrax Bacillus anthracis that forms
  endospores. Infected animals can transfer to
  human, but no known cases of human to human
  contamination. Can enter the body by inhalation,
  ingestion, or skin absorption.