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Chapter contents

CHAPTER 1. Chemistry of Alcohol

Historical Review. Chemical and Physical Properties. Units of Measurement. Alcoholic Beverages. Spirits. Wine. Sake. Beer and Herbals. Cider. Coolers.

CHAPTER 2. Pharmacodynamics of Alcohol

Metabolism. Alcohol Dehydrogenase. Microsomal Enzyme Oxidizing System. Catalase. Ethyl Glucuronide. Aldehyde Dehydrogenase. Acetate Metabolism. Reaction Velocities. Inhibition and Acceleration of Alcohol Metabolism.

CHAPTER 3. Pharmacokinetics of Alcohol

Blood Alcohol Curve. Alcohol Absorption. Physiological Factors Affecting Absorption. Effect of Dosage Form on Absorption Rate. Effect of Food on Absorption Rate. Effect of Drugs on Absorption Rate. Composite Absorption Time. Gastric Alcohol Metabolism. Alcohol Distribution in the Body. Body Compartments. Volume of Distribution. Blood Reservoirs. Elimination of Alcohol. Elimination Rate. Factors Affecting the Elimination Rate.

CHAPTER 4. Alcohol Measurement in the Body

Introductory Remarks. Collection and Handling of Specimens. Blood Sample Collection. Post-Mortem Specimens. Physiological Limitations. Post-Mortem Changes. Alcohol Formation. Alcohol Diffusion. Analytical Procedures. Oxidimetric Methods. Enzymatic Methods. Chromatographic Methods. Lachrymal and Saliva Analysis. Alcohol Estimates Based on Osmolality Gap. Confirmatory Tests. Measurement Error.

CHAPTER 5. Breath Test Physiology

Pulmonary Physiology. Anatomy of the Lungs. Components of Respiratory Air. Pulmonary Alcohol Exchange. Laws of Physical Chemistry. Blood to Breath Alcohol Exchange. Blood to Breath Alcohol Ratio. Factors Affecting the Blood to Breath Alcohol Ratio. Blood to Breath Ratio in Rebreathed Air. Effect of Disease on Pulmonary Physiology. Effect on Reliability of Breath Tests. Adequacy of Breath Sample. Legal Limits Based on Breath Alcohol.

CHAPTER 6. Breath Test Technology

Historical Review. Alcohol Screening Devices. Wet Chemistry Analyzers. Breathalyzers. Infrared Analyzers. Intoxilyzers. AlcoTest. Datamaster. Other Infrared Analyzers. Servotek Breath Alcohol Analyzer. Electrochemical Analyzers. Fuel Cell Technology. Intoxilyzer Series. Intoximeter Series. Dräger AlcoTest Series. Semiconductor Sensors. Vehicle Ignition Interlock Devices. Passive Alcohol Sensors. Breath Specimen Preservation. Mouth Alcohol and Slope Detection. Alcohol Inhalation. Acetone Interference. Electromagnetic Interference. Particulate and Ionic Interference. Accuracy and Precision of Breath Tests. Administrative and Technician Error. Biological Error. Cumulative Error. Training of Instrument Technicians.

CHAPTER 7. Empirical Blood Alcohol Estimation

General Considerations. Retrograde Extrapolation. Prefatory Estimates. The Widmark Model. Cybernetic Simulations. AlcoTrace Simulations. Data Entry. Case Simulation. Model Verification. Case Examples. Corroboration of Test Results. Questioned Inference. Insufficient or Uncertain Consumption. Estimates in the Absorptive Phase. Effect of Delayed Absorption. Simulation Based on Apparent Elimination Rate. Uncertainty of Elimination Rate. Estimates in the Distribution Phase. Simulation of Suppositions.

CHAPTER 8. Toxic Action of Alcohol

The Nervous System. Anatomy and Function. Action Chronology. Sympathetic Action on Alcohol Absorption. Effect of Shock on Blood Alcohol. Mechanisms of Action. Tolerance. Brain Alcohol. Effect of Alcohol on Special Senses. Vision. Hearing and Smell. Tactile and Pain Sensitivity. Emetic Action. Effect on Intent, Ability, and Behavior. Perception. Memory. Stimulant Effect. Psychic Effects. Ataxia. Pathological Intoxication. Intoxication and Criminal Intent. Self-Assessment of Intoxication. Alcohol Intoxication and Hangover. Correlation of the BAC with Clinical Symptoms. Recognition of Intoxication. Orthostatic Hypotension.

CHAPTER 9. Alcohol and Driving

State of Knowledge. Research Endeavors. The Challenge of Safe Driving. Road Hazard Models. Role of the Driver. Cell Phone Use. Chronic Fatigue. Countermeasures. Epidemiological Studies. The Holcomb Study. The Toronto Studies. The Coldwell Study. The Grand Rapids Study. The Bloomberg Study. The British Columbia Studies. Roadside Surveys in Germany. Other Epidemiological and Road Studies. Alcohol-Related Pedestrian Casualties. Laboratory Studies. Recognition of Impairment. Detection of Impaired Driving. Detection of Impaired Behavior. Standardized Field Sobriety Tests. Tandem Gait Test. One-Leg Balance Test. Romberg Test. Hand-to-Eye Coordination Test. Nystagmus Tests. Combinations of Tests. Breath Alcohol Odor. Video-Recorded Sobriety Tests. Blood Alcohol as Corroborative Evidence. Alcohol and Motorcycle Accidents. Effect of Alcohol on Aircraft Operation. Natural Diseases as a Cause of Accidents. Head Injury. Post-Concussion Syndrome.

CHAPTER 10. Pathology of Alcohol

General Remarks. Alcoholic Ketoacidosis. Alcohol-Induced Hypoglycemia. Blood Disorders. Anemia. Leukopenia. Coagulation Disorders. Electrolyte Disturbances. Endocrine Disorders. Gastro-Intestinal Disorders. Alcoholic Liver Disease. Alcoholic Pancreatitis. Disorders of the Alimentary Tract. Water Imbalance and Diuresis. Neurologic Disorders. Peripheral Neuropathy. Wernicke's Encephalopathy. Korsakoff's Psychosis. Alcoholic Cerebellar Degeneration. Delirium Tremens. Alcoholic Hallucinosis. Fetal Alcohol Spectrum Disorder. Alcohol and Drowning. Immunity. Alcohol and Cancer. Acute Alcohol Poisoning. Thermoregulation. Moderate Drinking and Health. Surgical Complications. Biochemical Markers of Alcohol Abuse. Trait Markers of Alcoholism. Detox Accupuncture Treatment.

CHAPTER 11. Drug Intoxication

General Overview. Epidemiology. Regulatory Strategy Planning. Essentials of Drug Kinetics. Bioavailability and Absorption. First Pass Effect. Protein Binding. Volume of Distribution. Drug Metabolism. Enzyme Activity. Effect of Diseases. Effect of Alcohol on Drug Metabolism. Effect of Drugs on Alcohol Metabolism. Pharmacodynamic Interactions. Half-Life. Mechanisms of Alcohol and Drug Interaction. Mathematical Modeling. Acute Overdose. Hazardous Drugs. Alcohol Infusions. Amphetamine and Related Stimulants. Anabolic Steroids. Anorexics. Antibiotics. Anticholinergics. Anticonvulsants. Antidepressants. Antidiarrheals. Antihistamines. Anti-inflammatory Drugs. Antimalarials. Antipsychotics. Antitubercular Drugs. Antiviral Agents. Anxiolytics. Bactericides. Caffeine. Cannabis. Cardiovascular Drugs. Cholinesterase Inhibitors. Cocaine. Crowd Control Agents. Decongestants. Dissociative Drugs.  Diuretics. GHB. Hallucinogens. Hypolycemic Agents. Inhalants. Lipid-Lowering Drugs. Local Anesthetics. Muscle Relaxants. Nicotine. Opioid Narcotics. Sedatives and Hypnotics. Toluene. Miscellaneous Drugs. Drug Addiction. Recognition of Drug Intoxication. Laboratory Testing. Quality Assurance. Test Specimens. Adulterated Urine Specimens. Analytical Techniques.

CHAPTER 12. Workplace Alcohol Testing

Legal Provisions. Policy and Compliance. Recognition of Alcohol Abuse. Breath Alcohol Technicians. Alcohol Screening Devices. Evidential Breath Test Devices. Calibrating Units. Testing Procedure. Choice of Equipment.

CHAPTER 13. Workplace Drug Testing

Legal Provisions. Application. Specimen Collection. Certification of Laboratories. Laboratory Procedures. Quality Assurance.

Appendix A

Alcohol in Medicinals.

Appendix B

Therapeutic and Toxic Drug Concentrations in Serum.

Appendix C

Cytochrome P450 Drug Interactions.

Appendix D

Mathematical and Statistical Equations

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