Alcohol Testing...

One of the major substances of abuse nowadays aside from cigarette smoking is ethanol (alcohol). Ethanol functions as a depressant of the central nervous system. Alcohol’s effect includes the blockage of inhibitory centers, leading to perception of being stimulated. Risk-taking behaviors often increases after the consumption of alcohol, for example, level of aggressive humor may rise. Most common cause why people tend to abuse alcohol is because of depression, economic and social problems. This is why it is considered as one the most important and controversial substance of abuse at the present time.

PHARMACOLOGY

Ethanol is consumed on different beverages which are expressed as proof. Proof is twice the percentage of ethanol in the beverage.

Example: 90 proof vodka = 45% ethanol content

Variety of alcoholic beverages contains different ethanol content as seen in the table below.

APPROXIMATE ETHANOL CONTENT OF ALCOHOLIC BEVERAGES
Beverage	Ethanol content (%)
Beer	3 – 6
Ciders	4 – 5
Wines	8 – 15
Sherry, madeira, port	18 – 20
Whiskey, gin	40 – 45
Vodka	40 – 50
Brandy	45 – 50
Rum	50 – 70

With this, we should be able to evaluate on how much ethanol has been taken in a given period of time, not on how many drinks a person has consumed. This is because ethanol will be in the bloodstream in 1 hour and there would be a specific blood alcohol level wherein intake of ethanol may be lethal. The table below will show the stages of impairment at specific blood alcohol level.

STAGES OF IMPAIRMENT BY ETHANOL
Blood Alcohol (%, w/v)	Signs and Symptoms
0.01 – 0.05	No obvious impairment, some changes observable on performance testing
0.03 – 0.12	Mild euphoria, decrease inhibitions, some impairment of motor skills
0.09 – 0.25	Decreased inhibitions, loss of critical judgment, memory impairment, diminished reaction time
0.18 – 0.30	Mental confusion, dizziness, strongly impaired motor skills (staggering, slurred speech)
0.27 – 0.40	Unable to stand or walk, vomiting, impaired consciousness
0.35 – 0.50	Coma and possible death

Blood alcohol analysis is requested whether the need is strictly medical or if some legal action may be forthcoming which would involve use of the test results. The following tests are done in the analysis of blood alcohol.

SAMPLING

1. 1.       Blood obtained from venipuncture.
2. *  Do not use with an alcohol swab when cleansing site on the arm. Instead, use soap and water.
3. 2.       8 – 10mL of whole blood in a sterile container containing oxalate and sodium fluoride.
4. 3.       Separate plasma.
5. 4.       Sample must be slightly stoppered at all times.

GAS CHROMATOGRAPHY - provides the most useful information when analyzing ethanol.

1. 1.       Serum sample is injected directly onto the column after being mixed with an internal standard.
2. 2.       Separation occurs within a few minutes.
3. 3.       Observe and identify alcohols methanol, ethanol, and isopropanol.

ENZYMATIC ANALYSIS - reaction employs alcohol dehydrogenase with NAD+ as coenzyme. Acetaldehyde  is formed as the ethanol is oxidized, with the generation of NADH used as a marker for the reaction.

COMMON INDICATORS OF ETHANOL ABUSE
GGT	Increases can be seen before the onset of pathologic consequences.
AST	Increases in serum activity can occur in many non-ethanol-related conditions.
AST/ALT ratio	A ratio greater than 2.0 is highly specific for ethanol-related liver disease.
HDL	High serum HDL is specific for ethanol consumption.
MCV	Increased erythrocyte MCV is commonly seen with excessive ethanol consumption.
	Increases are not related to folate or vitamin B12 deficiency.

Drug Testing in Schools? Agree or Disagree?

Issues and controversies have aroused regarding to the abuse of different drugs. Teenagers and even the children has been the major victim of drugs. Drugs…a powerful substance which turns an individual to his opposite side, the darker one. Are we losing the battle against this destructible drugs? How can we control and save minors from the chaos that drugs bring them?

A lot of teenagers nowadays are in to drugs. Addiction as what we term it which causes a lot of consequences among young people. It brings chaos to the life of each individual.Crimes are everywhere because of drugs. The safety of many people are being in risk just because of this problem.

           Drug testing is one of the most technical ways on how we can detect drug abusers. The only limit of this is that, it is only available for those who can and who will avail it. Then, the question is, shall we approve drug testing in schools? My answer, on my opinion, is YES. Drug testing should be done. I have met a lot of people, at different age, which has been using drugs for years. Some have stopped and controlled their selves, while most of them not. Experiences from their stories tell that they abused drugs because of peer pressure, depression and family problems. And the most affected group are the teenagers, mostly, students. I believe that drug testing if approved on schools will somehow help and minimize the use of drugs. 

Toxics. Drugs. Alcohol. A JOURNEY TO HAPPINESS OR A CALL TO DEATH?

Friday.  June 18, 2010. Well, it is not quite unusual for us, teenagers, to hang out with our friends especially on weekends. The story that my going to impart to you guys is one of my extraordinary experience in my life and it taught me one very good lesson about socializing to other people. Intriguing huh?  But what is its connection with our topic toxicology? Read and find out for yourself.

As my introduction goes, it was Friday night (June 18), while we are having our lunch break after the Seminar class, my friend, Princess (not our classmate), texted me if I am available to hang out with her friends that night. Well since I have nothing to do that day I texted her back and said that I can go with her.

Our meeting place is at SM Pampanga and I was expecting that she was already with her friends. But I was wrong. Absolutely wrong. She was with this short dark guy who looks very unusual and definitely not familiar. She introduced me to him, and his name is Gerald. I approached him politely as much as I could even though he looks suspicious to me as if he’s going to do no good that night. And yes, I was right. He’s definitely what I thought from the first time I saw him. I asked Cess if she knows that guy for a long time and she answered no, he is just her textmate, and he wanted to meet her. After that, the friends of Gerald came over to meet us. The scenario was very weird. Most especially Kirsh. Kirsh is a handsome guy honestly, he’s cute but seems to be out of the world. He’s laughing with nothing to laugh for and it annoyed me a lot that time. Monice, looks like Joh, her personality, everything. She’s just like the replica of Joh. And the others? I didn’t mind them, they’re not that interesting anyway. They invited us to go to Total to drink and we just went with the flow. When we were in the jeepney, Monice brought out something on her bag. Looks like clorets or a candy and she asked Kirsh if he want some. Kirsh nodded and Monice gave him. With that moment, Cess whispered to me and she said, “megkamali ka ta yata pekyabayan”. I was surprised with what she said because in the first place she was the one who invited me and now what the hell is she telling me. From that moment, I was not at ease with the people around me. I didn’t understand what’s going on.

Until we reached Total, Gerald bought some food and drinks while Monice talked to us, trying to entertain us, the new ones in the group. Monice asked if we are still studying and I said yes, taking up Medical Technology. Princess answered no, she stopped with the course Pharmacy. They were surprised when they knew that we are both from the medical field and they were most interested with Cess knowing that her course is BS Pharmacy. Then for the second time, Cess whispered to me, “alistu ka mu”. I didn’t understand why I have to do that but it made me nervous that time. Then after a moment, they were now talking about drugs. Valium, Tegretol, Pruvera, Cytotec, Stiroge, Atenolol. That I was figured out that these people abuses drugs! Cess is a bit at tension right now and she was trying to be as calm as she could. We are both worried of what they could do. We both monitor each of their moves. Until it came to a point that they dared Cess to take Valium. I knew Cess would not agree but I was wrong, she took it. She smiled, and got something from her bag. Vitamin B complex. She drank and took the Vitamin B. She’s fine. But I am worried if she would be on a high after a while. What am I going to do if that happened? Definitely I have no Vitamin B or what. And then Cess told the group that I have to go. I was shocked with her action. And she winked at me and said, “muli na ka, pota nanu pang gawan da, yaku agyu ku, muli nku din pinandit eka tamu pin pweding misabe mako”.  I followed her instruction to me and besides I also wanted to escape that place quickly. The moment I left the place, Cess is still fine, normal. But the others? No. They are on a high. Insane. Whatever. Kirsh had a deep cut on his arms when he is skateboarding, but it seems that his body is numb of any pain. Definitely they are on drugs.

That was the story, and it left me a lesson, never be too confident to trust strangers. And with its connection to toxicology, basically about the use of drugs, their proper use not in abusing them.

Tests for Pancreatic Hormones

The previous topic of my blog is all about the pancreas and the hormones it secretes. Now that have a knowledge of the 3 hormones that it secretes; the insulin, glucagon and somatostatin, let us now get to discover on the different tests done in the laboratory for the screening of these hormones. For these hormones, blood tests are usually done in the laboratory. 

INSULIN

Insulin testing is done along with the glucose and C-peptide levels in the circulation. It is helpful in the diagnosis of insulinomas and helps in the determination of acute or chronic hypoglycemia. For the insulin resistance, insulin and C-peptides levels produced endogenously by the beta cells are checked. This helps in the diagnosis of type 2 Diabetes. Another test that may be performed is the glucose tolerance test (GTT). In this test, the insulin together with the glucose level are measured for the evaluation of the insulin resistance in the body.

Normal Value= 5 - 20 mcU/mL

The tests are ordered in situations wherein the blood glucose is low or if the condition has an acute or chronic hypoglycemia. 

Insulin levels are increased in conditions such as Acromegaly and Cushing's syndrome. On the other hand, decreased insulin levels are seen on people suffering from Diabetes and Hypopituitarism. 

GLUCAGON

The test for glucagon is usually done in screening conditions such as hypoglycemia or in some cases in multiple endocrine neoplasia (MEN) type I and glucagonoma.  

The specific test done for the testing of glucagon is the radioimmunoassay (RIA) which checks this hormone in the blood of the patient. The normal range for glucagon is 50 - 100 pg/ml.

Reference/s:

McPherson, R. A.,et.al.HENRY'S CLINICAL DIAGNOSIS AND MANAGEMENT by LABORATORY  METHODS, 21st edition.

http://www.labtestsonline.org

http://www.nlm.nih.gov/med

http://www.medhelp.org

Pancreatic Gland and the Hormones Secreted

Hormones play an important role in the homeostasis of our body's activity. With our new assignment about hormones, I was tasked to discuss about the pancreatic gland and its hormones and their corresponding functions in the body. 

The pancreatic gland can be both an endocrine and exocrine gland. It can be classified into exocrine gland for it produces pancreatic juices which contains digestive enzymes that pass through our small intestines. As for its endocrine function, the pancreas is the gland which produces the endocrine hormones such as the insulin. For this topic, the endocrine function of the pancreas will be mainly discussed. 

Pancreas has clusters of cells which we call the islets of Langerhans and these contains four types of cells: the alpha cell, beta cell, delta cell and the gamma cells. Pancreatic hormones include the insulin, glucagon and the somatostatin. 

*islets of Langerhans

Insulin

This hormone is secreted by the beta cells together with the amylin. It helps in the regulation of blood glucose . Its action includes the absorption and usage of blood glucose which decreases the blood sugar levels and maintaining it in its normal range. This hormone is secreted in response to high blood glucose and is inhibited in low blood glucose.

Glucagon

Glucagon helps insulin regulate the blood glucose in its normal range. It is secreted by the alpha cells of the islets of Langerhans. Its action is to produce glucose in cases of low blood glucose level. This is secreted in response to low blood glucose and is inhibited in high blood glucose.

Somatostatin

The hormone responsible for the regulation of the production and excretion of other hormones. This slows down the production of other hormones in response to high levels of other hormones. It is secreted by the delta cells which consists of two polypeptides.

Reference/s:

Principles of Human Anatomy and Physiology by Tortora

Modern Biology by James Otto

http://www.endocrineweb.com/pancreas.html

Photo Credits:

http://i238.photobucket.com/albums/ff177/salviaforme/album2/pancreaglandendocrine.jpg

http://upload.wikimedia.org/wikipedia/commons/f/f0/Langerhanssche_Insel.jpg

Endocrinology, Toxicology and Drug Testing

Clinical Chemistry 3 will deal about endocrinology, toxicology and drug testing. Before we begin with our discussions, it is important for us find out what these three terminologies mean.

Endocrinology tackles about the different hormones in the body which are produced from the different endocrine glands that we have. Hormones are substances in the body which plays an important role in our body's homeostasis. Each hormone in our body are secreted by a specific endocrine gland when it is stimulated to send signals or messages to initiate the organs of the body for its function.they are responsible for the different physiological activities of our body.

On the other hand, toxicology deals with the different toxins in the body which we may classify as the study of poisons. Toxic substances which may affect our body are being studied in this field of science as to their other uses; if they could be beneficial to mankind and to the advancement in healthcare technology.

Last is drug testing. Drug testing is the procedure wherein biological specimens such as urine, blood, etc. are examined. This is performed to lessen or if possible eliminate the abuse of drugs.

Reference/s:

• Bishop, Michael L. et. al.CLINICAL CHEMISTRY: PRINCIPLES, PROCEDURES, CORRELATIONS, 5th ed. 2005
• Otto, James H. MODERN BIOLOGY.1985