TOXICOLOGY

              Eight  million people are poisoned annually.

Twenty thousand drugs and commercial products are available for ingestion.

Poisoning can be intentional (suicidal / homicidal)) or unintentional
(children, elderly people & patients with psychiatric disorders) or environmental
such as in lead related jobs (printing houses, battery factories etc…)

The major signs and symptoms of poisoning are coma,seizures,acidosis,cardiac
arrythmia,vomiting & diarrhoea.

Al Borg Laboratory has introduced the latest technology that can detect 350
toxicants using sensitive & specific chromatographic techniques.Unkown
samples and biological fluids (urine, serum, aspirates..) are suitable for testing.

DRUGS  OF  ABUSE ASSAY:

Habituation is the psychological dependance on drugs,
while Addiction is the physical dependance on drugs such as; Alcohol,
Amphetamines, Barbiturates, Cannabinoids, Opiates, Cocaine, 
Benzodiazepines, Methadone, Phenyl Cyclidine etc…….

Screening for drugs of abuse is usually requested by the police for
medico-legal purposes, or by institutions as a pre-employment check up,
or by parents of  children and teenagers who are worried about their
offsprings especially if they notice changes in their behavior or a drop in
their accademic acheivement.

Al Borg laboratory uses fluorescent polarisation to detect drugs of abuse
in urine or blood samples. If urine is used,specific gravity must be reported
with every sample to exclude dilution with water or additives, which may
interfere with the test result. We strongly, recommend  that patients  give
urine samples under the supervision of a family member to avoid tampering
with the sample.

THERAPEUTIC  DRUG  MONITORING :

Therapeutic drug  monitoring is essential to avoid side effects and to reach
the optimum clinically effective dose.

ANTIEPILEPTICS                      F  Depakene, Epanutin, Phenobarbital, Tegretol,
Zarontin, Rivotril and Mysoline.

PSYCHOACTIVES                    F  Lithium .

BRONCHODILATORS              F  Theophylline .

IMMUNOSUPPRESSANTS      F  Cyclosporin and Tacrolimus FK506.

CHEMOTHERAPEUTICS         F  Methotrexate .

ANTIBIOTICS                              F  Chloramphenicol , Gentamycin etc...

Factors influencing serum concentration of drugs ;

1.   Time of sampling :

                 Drugs should be assayed when they have reached a steady state

                 except if toxicity is suspected. Peak and trough blood samples are

                 always preferred to single evaluations.

2.   Drug formulation :

                 Changing one brand of drug for another should be carried out very

                 carefully and dosage must be rechecked. Once the change has been

                 made & the patient reached a steady state , remeasure the serum

                 concentration of the drug.

3.  Drug interaction :

                 Simultaneous intake of more than one antiepileptic drug may result in

                 potentiation of one another or antagonism. Each addition of a new

                 drug necessitates remeasurement of serum concentration after a

                 steady state is reached.

4.   Age :

                 Each age group should receive the appropriate dosage to avoid toxicity

                 especially from infancy to childhood & at onset of puberty.

5.   Hepatic, Renal & Cardiac disease :
                 Such conditions affect rate of drug excreation from the body & may lead
                  to toxicity although the patient is receiving a therapeutic dose.
                  Routine liver and kidney function tests should be performed.