1. Introduction in toxicology. Determination of toxicity. Dose-response curve. Mode of entry of toxins. Lecture 1

2. Clinical Toxicology -20 to 50 compounds tested -Many routine kits available -Automation possible Analytical Toxicology -8000 pharmaceuticals are currently used - 40000 other potentially toxic compounds exist - routine kits available for screening for some common drugs - no automation

3. Types of Intoxication: Known origin Unknown origin Causes of intoxication % Ethanol 32 Benzodiazepines 60 Tricyclic antidepessants 13 Barbiturates 6 Acetaminophen 1 Salicylates 2

4. Tests to be available for oriented screen in emergency toxicology Compound Preferred sampleIntoxication originPreferred technique CyanideWhole blood (heparinized) Fire, suicide, potassium ferrocyanide treatment microdiffusion + colorimetry, head-space GC Ethylene glycol (antifreeze) SerumAbuse (with urinary excretion of oxalate) GC Cholinesterase activityWhole blood (heparinized) Organophosphates (pesticides) Photometry Bromide, fluorideSerumIndustrySelective electrode, ion chromatography Pesticides (paraquat, diquat) Whole blood (heparinized), random urine AgricultureColor tests, GC, HPLC Halogenated hydro­ carbons (solvents, chloral hydrate) Whole blood, random urine, gastric fluid Industry, abuseColor test, GC Heavy-metals screenWhole blood (heparinized), random urine Industry, accidental (children) Atomic absorption, flame emission MethaemoglobinWhole blood (heparinized) Nitrate and nitrite exposure, abuse of certain vasodilators ("poppers") Spectroscopy, color test, GC

5. Analytical techniques used in emergency toxicology Spot tests Immunoassays Gas chromatography GC-MS HPLC and LC-MS Thin layer chromatography

6. Dose-response curve What is there that is not poison? All things are poison and nothing without poison Solely the dose determines that a thing is not a poison

10. log C Highly toxic toxic effective drug dangerous drug food nonactive + - 0 Non-linear response curves

11. Mode of entry of toxins Skin transport Respiratory route Oral route

12. log C time log C time One-compartment kinetics Two-compartment kinetics

13. Cocaine metabolic profile. BE-benzoyllecgonine, EME-ecgonine methyl ester,CE- cocethylene