-
These act in conjunction with nervous systems to maintain a state in the body which functions optimally and is disease free.
Hormones
-
These are chemical substances produced and secreted into the blood by an organ or tissue, and has a specific effect on target tissue.
Hormones
-
Hormones affect the body as a _______.
Whole
-
What are the three chemical types of hormones?
-
Steroid hormones are produced in what three places?
- Adrenal gland
- Gonads
- Placenta
-
These are lipid soluble hormones synthesized from cholesterol
Steroidal hormones
-
What is the plasma half life of steroidal hormones?
60-100min
-
What are the two types of protein hormones?
- Peptide hormones
- Glycoprotein hormones
-
These hormones are synthesized as prohormones.
Peptide hormones
-
These hormones are composed of alpha- and beta- chains.
Glycoprotein hormones
-
These are water soluble hormones that are produced, then stored and released as needed.
Protein hormones
-
These hormones have properties intermediate to steroids and proteins.
Amines
-
These amines behave like protein hormones.
-
Thes amines behave like steroid hormones
- Thyroxine(T4)
- Tiiodothyronine(T3)
-
These hormones are thought to produce effects via interaction with receptor on outer surface of cell membranes.
Protein hormones
-
This acts a second messenger by translating hormone binding into cellular action
(cAMP)
-
Cellular action in protein hormones ceases rapidly after loss of _______.
Stimulus
-
These hormones pass through cell membrane and interact with an intracellular receptor.
Steroid hormones
-
This is the portion of the brain located in walls and floor of third ventricle, directly above pituitary gland.
Hypothalamus
-
What are five hypothalamus associated disorders?
- Tumors
- Inflammatory/degenerative processes
- Congenital problems
- Growth failure in emotionally deprived children
- Anorexia nervosa
-
This protein hormone is produced by the anterior pituitary gland and is involved in cell division, protein synthesis, and bone growth.
Growth hormone (GH)
-
What are three conditions that would cause a decrease in adult growth hormone?
- Decreased muscle mass
- Increased body fat
- Decreased bone density (osteoporosis)
-
This protein hormone is produced in the anterior pituitary gland and is involved in milk production.
Prolactin (PRL)
-
After delivery prolactin levels can reach what levels?
200-300 ng/mL
-
This peptide hormone is produced in the posterior pituitary and stimulates water reabsorption by kidneys.
ADH (vasopressin)
-
This peptide hormone is produced in the posterior pituitary and stimulates uterine muscle contraction.
Oxytocin
-
To produce these two hormones the thyroid gland actively acquires iodine.
- Triiodothyronine (T3)
- Thyroxine (T4)
-
These two amide hormones are produced in the thyroid. They stimulate O2 consumption and metabolic rate in tissue.
- Triiodothyronine (T3)
- Thyroxine (T4)
-
This peptide hormone is produced in the thyroid and lowers blood calcium levels.
Calcitonin
-
What is the most useful test for assessing thyroid function?
TSH
-
Serum total T3, rT3, and T4 levels are usually measured by which two assays.
- Radioimmunoassay (RIA)
- Chemiluminometric assay
-
When the eyes protrude because of edema in eye socket tissues in cases of hyperthyroidism or Graves’ disease it is called what?
Exophthalmic goiter
-
How many parathyroid glands do most people have?
Four
-
This peptide hormone is produced in the Parathyroid and raises blood calcium levels.
PTH
-
These are paired organs located atop upper pole of each kidney.
Adrenal glands
-
This part of the adrenal gland is linked to sympathetic nervous system.
Adrenal medulla
-
This part of the adrenal gland is composed of three layers each responsible for different hormones.
Adrenal cortex
-
These amine hormones are produced in the adrenal medulla and are released in emergency situations.
- Epinephrine
- Norepinephrine
-
This steroid hormone is produced in the adrenal cortex; it raises blood glucose levels and stimulates the breakdown of protein.
Cortisol
-
This steroid hormone is produced in the adrenal cortex; it is used to reabsorb sodium and excrete potassium.
Aldosterone
-
This steroid hormone is produced in the adrenal cortex; it stimulates reproductive organs and brings about sex characteristics.
Sex hormones
-
This syndrome can be caused by and adrenal cortex tumor.
Cushing syndrome
-
Hormonal secretions by the anterior pituitary are all _______ hormones.
Protein
-
This peptide hormone is produced by the anterior pituitary; it stimulates the adrenal cortex.
Adrenocorticotropic hormone (ACTH)
-
This protein hormone is produced in the anterior pituitary; it is involved in cell division, protein synthesis, and bone growth.
Growth hormone
-
This protein hormone is produced in the anterior pituitary; it is involved in milk secretion.
Prolactin (PRL)
-
These glycoproteins are produced in the anterior pituitary; they are involved in egg and sperm production.
Gonadotropics (FSH, LH)
-
This glycoprotein is produced in the anterior pituitary; it stimulates the thyroid.
Thyroid stimulating hormone (TSH)
-
Pituitary tumors cause ________ secretion.
Increased
-
Where are the Islets of Langerhans located?
Pancreas
-
What are the three cell types in the Islet of Langerhans and what do they secrete.
- Alpha- secrete glucagon
- Beta- secrete insulin
- Delta- secrete somatostatin
-
This protein hormone is produced in the pancreas and lowers blood glucose levels.
Insulin
-
This protein hormone is produced in the pancreas and raises blood glucose levels.
Glucagon
-
These steroid hormones are produced in the ovaries and stimulate female sex characteristics.
-
What hormones does the placenta secrete?
- Estrogen
- Progesterone
- Wide variety of protein hormones
-
This steroid hormone is secreted by the testes and stimulates male sex characteristics.
Androgens (testosterone)
-
This classic hormone methodology is cumbersome and expensive; it requires a host organism.
Bioassay
-
If the binding reagent is an antibody, the assay is ___________.
Immunoassay
-
If the binding reagent is a transport protein, the assay may be called _____________.
Competitive protein binding assay
-
If the binding reagent is a receptor, the assay is ________.
Receptor assay
-
What is the simplest way to identify an assay?
By the label used
-
What is the most commonly used immunoassay?
ELISA
-
This type of immunoassay utilizes radio-labeled hormone as tagged hormone.
RIA
-
In this immunoassay, the antibody is labeled instead of hormone.
IRMA
-
In this immunoassay, enzyme tag is used vice radioactive label.
ELISA
-
What are the two purposes of drug monitoring?
- ID non-compliance
- Ascertain effectiveness of dosage
-
What are the four general processes that a body has to handle a foreign compound?
- Absorption
- Distribution
- Metabolism
- Excretion
-
What are the three routes for absorption?
- Orally
- Rectally
- Parenterally (IV, IM)
-
What are two factors for optimum utilization in absorption?
- Route of administration
- Is drug utilized as is or as metabolite
-
Body interprets drug as __________.
Foreign material
-
Insoluble drugs are converted to soluble by what organ?
Liver
-
Under normal renal performance, most drugs and their metabolites are excreted in ______ via the ______.
-
________ have little capacity to eliminate drugs.
Neonates
-
This will affect drug disposition due to hormonal changes and increased fluid volume.
Pregnancy
-
What are three diseases that can affect drug disposition?
- Hepatic function
- Cardiac capacity
- Renal function
-
What admin data is needed for drug testing procedures (5)?
- Pt name, SSN, DOB, sex
- Date/time of last dose
- Date/time of collection
- Amount of last dose
- Name of drug
- Pt diagnosis
-
What are three appropriate samples for drug testing?
- Non-hemolyzed serum
- Non-hemolyzed plasma (red/dark blue top)
- Urine
-
This is collected prior to dose when drug concentrations are lower.
Trough
-
This is collected after dose (60 min) when drug concentrations are higher.
Peak
-
How long after a dose is a sample collected for peak testing?
60 min
-
Most drugs/metabolites are stable for several days at what temperature?
Room temp
-
This methodology detects a wide variety of drugs.
Thin layer chromatography (TLC)
-
This methodology is better for ID of drugs than TLC.
Gas Chromatography (GC)
-
This methodology measures drugs simultaneously.
HPLC
-
This is the method of choice for drug testing.
EIA
-
This is an effective smooth muscle relaxant that stimulates CNS and increases respiratory rate.
Theophylline
-
What is the therapeutic and toxic range for Theophylline?
- Therapeutic range: 10-20 ug/mL
- Toxic: >25 ug/mL
-
This drug improves cardiac contractions in CHF, 70% is absorbed orally.
Digoxin
-
How long after dosing of digoxin should a specimen be collected?
8 hrs after
-
Digoxin levels may rise ____ ng/mL in first eight hours.
8-10
-
What are the therapeutic and toxic ranges for digoxin?
- Therapeutic: 0.8-2.0 ng/ml
- Toxic : >3 ng/ml
-
This drug is used to correct ventricular arrhythmias associated with MI, and also digitalis intoxication.
Lidocaine
-
What is the therapeutic and toxic range for lidocaine?
- Therapeutic: 1.5-5.0 ug/ml
- Toxic: .5.0 ug/ml
-
This drug is used in the treatment and therapy of febrile seizures and neonatal seizures.
Phenobarbital
-
Which drug is tested based on the angle change of polarized fluorescence emitted by a fluorescent molecule?
Theophylline
-
What is the therapeutic range for Phenobarbital?
15-40 ug/ml
-
This is the primary drug in the treatment of absence (petit-mal) and myoclonic seizures.
Valproic acid
-
What is the therapeutic and toxic range for valproic acid?
- Therapeutic: 50-100 ug/ml
- Toxic: >100 ug/ml
-
This multipurpose antibiotic is quickly diminished due to dose related toxicities primarily aplastic anemia.
Chloramphenicol
-
What is the therapeutic and toxic range for chloramphenicol?
- Therapeutic: 10-20 ug/ml
- Toxic: >25 ug/ml
-
This antibiotic is effective against GPC/GPR, S. Epi, S. Aureus; it also prevents cell wall synthesis.
Vancomycin
-
What is the therapeutic range for vancomycin (peak and trough)?
- Trough: 5-10 ug/ml
- Peak: 30-40 ug/ml
-
What are the toxic ranges for vancomycin (trough and peak)?
- Trough: >20 ug/ml
- Peak: >80 ug/ml
-
Regular checking of __________ levels is used to alert exposed persons to any change in the level of this essential enzyme before it can cause serious illness.
Cholinesterase
-
Evaluation of this drug is used secondary to insecticide exposure.
Cholinesterase
-
What are the specimen requirements for cholinesterase?
- Plasma (EDTA)
- Spate plasma from cell immediately
-
What is the normal reference value for cholinesterase?
4,000-12,000 U/L
-
To determine levels of ethanol in blood what is measured?
NADH
-
What is the methodology for ethanol testing?
Reactive enzyme assay (REA)
-
Ethanol tests are drawn using what tube?
Sodium fluoride (gray top)
-
Abuse of this commonly used analgesic leads to respiratory alkalosis.
Salicylate
-
What is the therapeutic and toxic range for salicylate?
- Therapeutic: <30 mg/dL
- Toxic: >30mg/dL
-
This commonly used analgesic if not taken as directed could cause liver necrosis 3-4 days post OD.
Acetaminophen
-
The toxic agent in acetaminophen is the __________ not the parent drug.
Metabolie
-
What is the antidote for acetaminophen overdose?
N-acetylcysteine
-
What is the therapeutic and toxic range for acetaminophen?
- Therapeutic: 10-25 mg/ml
- Toxic: 100-250 mg/ml
-
What are the four purposes of testing for drugs of abuse?
- Pre-employment
- Random testing
- Employees exhibiting s/s of abuse
- Forensics
-
What are the two methods to screen for drugs of abuse?
-
What are the two methods to confirm drugs of abuse?
-
What are the specimen requirements for drugs of abuse?
Urine
-
What are the initial and confirmatory test levels for marijuana?
- Initial: 50 ng/ml
- Confirmatory: 15 ng/ml
-
What is the initial and confirmatory test level for cocaine?
- Initial: 300 ng/ml
- Confirmatory: 150 ng/ml
-
What is the initial and confirmatory test level for opiate metabolite?
- Initial: 300 ng/ml
- Confirmatory: 300 ng/ml
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