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Toxicology > Midterm Pre & postlab (Antidotes) > Flashcards

Midterm Pre & postlab (Antidotes) Flashcards

1
Q

A processed charcoal that is obtained from the burning of carbonaceous substances. It involves extensive treatment w/ steam, CO2, O2, ZnCl, H2SO4, H3PO4, at 500-900°F that increases surface area.

A. Activated Charcoal
B. EDTA
C. N-acetylecysteine
D. Naloxone

A

A. Activated Charcoal

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2
Q

they are significantly bound?

A

Organic molecules

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3
Q

they are generally less well bound?

A

LMW & polar compounds

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4
Q

they are also not appreciably bound?

A

certain inorganic salts

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5
Q

this antidote has an adsorption at a ratio of approximately 10:1 and administered in1g/kg PO or gastric tube as aqueous suspension?

A

Activated charcoal

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6
Q

chelating agent especially for lead intoxication; hypercalcemia

A

Ethylenediaminetetraacetic acid (EDTA)

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7
Q

in chronic chronic Pb exposure, a medical condition characterized by high levels of calcium in the blood?

A

Hypercalcemia

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8
Q

the BLL that can be considered as Pb poisoning?

A

> 150mcg/dL

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9
Q

Dosing of EDTA for adult and children?

A

Adult: 2-4g or 30-50mg/kg
Children: 1000-1500mg/m2

IV q24H as continuous IV dil. 2-4mg/mL in NS or D5%
symptomatic: admin. for 3-5days

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10
Q

a precursor to glutathione, direct sulfhydryl binding agent; an antioxidant that helps neutralize the toxic metabolites of APAP that can damage the liver?

A

N-acetylcysteine (NAC)

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11
Q

Dosing of NAC:

A

140mg/kg LD dil. in juice or soda
MD: 70mg/kg q4H

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12
Q

competitive opioid antagonist; takes effect 1-2 mins. after IV. Used in opioid overdose

A

Naloxone

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13
Q

longer elimination t1/2 and DoA; discontinued in US. Used to treat alcohol dependence.

A

Nalmefene

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14
Q

active Po; prevent recidivism in patients detoxified after opioid abuse, and reduce alcohol craving.

A

Naltrexone

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15
Q

Dosing of Naloxone:

A

Adults: 0.4-2mg IV initially, repeat at 2-3 mins. interval; 0.4-0.8mg/h continuous IV (NS or D5%), titrate for effect.

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16
Q

Specific chelating agent for iron (free)

A

Deferoxamine

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17
Q

it is water soluble & renally excreted as (?)

A

Red ferrioxamine complex…orange-pink/vin rose

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18
Q

Dosing of Deferoxamine:

A

5 mg/kg/h IV increasing over 15 mins as tolerated,
do not exceed 15mg/kg/h

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19
Q

enzyme that converts a small portion of the drug into a toxic metabolite known as N-acetyl-p-benzoquinone imine (NAPQI).

A

P450 (CYP2E1)

20
Q

product of the combination of glutathione to NAPQI to form nontoxic substance?

A

Cysteine & Mercapturic acid conjugates

21
Q

Dosing of Paracetamol poisoning:

A

Children: >200mg/kg
Adults: 6-7g

22
Q

Early manifestations of Paracetamol poisoning

A

anorexia & NV

23
Q

After 24-48 hrs. manifestations of Paracetamol poisoning

A

AST & ALT levels rise; evident hepatic necrosis

24
Q

Paracetamol poisoning is diagnosed by?

A

Nomogram; electrolytes (anion gap), liver enzymes

25
Q

a tool used to assess the risk of liver damage following paracetamol overdose.

A

Rummack-Matthew nomogram

26
Q

chemical asphyxiant binds to these to block the aerobic utilization of oxygen?

A

cellular cytochrome oxidase

27
Q

a much less toxic compound that is excreted in the urine?

A

Thiocyanate

28
Q

level of Hydrogen cyanide to be considered as cyanide poisoning:

A

150-200ppm

29
Q

level of ingested Na or K salts to be considered as cyanide poisoning:

A

200mg

30
Q

Antidote for Cyanide poisoning

A

Hydrocobalamin
Nithiodote

31
Q

Universal antidote is composed of:

A

2 parts AC
1 part TA
1 part MgO

32
Q

forms a protective film relieving inflammation and irritation

A

Demulcent

33
Q

Examples of demulcent:

A

Milk
egg albumin (egg white)

34
Q

this prevents absorption by binding with heavy metals

A

Demulcent

35
Q

Cyanide poisoning is diagnosed by:

A

lactic acidosis
elevatad venous O2 saturation
“bitter” almond odor

36
Q

Abrupt onset of profound toxic effects present in cyanide poisoning shortly after exposure:

A

Headache
Nausea
Dyspnea (SOB)
Confusion

37
Q

2 active ingredients of Nithiodote:

A

Na nitrite inj. IV
Na thiosulfate IV

38
Q

Management of Poisoning:

A
  1. Accurate history taking
  2. Stabilization of patient’s condition
  3. Physical examination
  4. Laboratory examination
  5. Decontamination
  6. Poison-specific treatment – antidote
  7. Disposition
39
Q

History Taking: 5 W’s

A

Who – demographics (name, age, weight, etc.)
What – identify the drug/ toxin and dose
When – time and date
Where – route of administration and the geographic location
Why – intentional or accidental

40
Q

Emergency evaluation treatment:

A

A-irways, B-reathing, C-irculation, D-isability, E-xposure

41
Q

Essential Laboratory Tests:

A

• Serum osmolality and osmolar gap
• Electrolytes
• Serum glucose
• BUN and creatinine
• Liver profile
• Urinalysis
• ECG
• Pregnancy test
• Tests to detect specific chemical/drug levels

42
Q

Decontamination:

A

• Wash skin and irrigate eyes
• Emesis or gastric lavage
• Charcoal or cathartic
• Hemodialysis, Hemoperfusion

43
Q

neutralizes the poison by changing its chemical nature or oxidize the poison into non-toxic or insoluble form. Ex, Na thiosulfate

A

Chemical antidote

44
Q

one that prevents absorption of the poison. Ex. AC

A

Mechanical antidote

45
Q

one that counteracts the effects of poison by producing opposing
physiologic effect. Ex. Naloxone

A

Physiologic antidote

46
Q

work by forming a complex with the metal ion, which can then be excreted from the body through urine or feces. Ex. EDTA

A

Chelating agents

Toxicology (10 decks)

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