Chemistry 11 (Poisons) Flashcards
(57 cards)
95% of lead ingested is distributed in
RBCs and bone
lead is toxic by ___ and ___
inhibiting enzymes with sulfhydrul group
toxic to mitochondria directly
in kidneys, lead is toxic to
renal tubular cells
lead inhibition of ___ in RBC precursors leads to buildup of ____
gamma-ALA-dehydratase and ferrochetalase
free etythrocytes protoporphyrin (FEP)
___ and ___ are increased in both lead poisoning and iron def
FEP and ZPP
lead inhibition of ___ causes increaqsed osmotic fragility of RBCs
sodium channel ATPases
2 ways iron def enhances lead tox
last step of heme synth (iron into protoporphyrin) inhibited by iron def
increased intestinal absorption of iron and lead
end stage renal manifestations of lead tox
aminoaciduria
glycosuria
phasphaturia
syndrome that looks like end stage lead tox on kidneys
Fanconi renal syndrome
classic peripheral neurpathic symptom of lead tox
bilatera wrist drop
preferred method for testing lead
atomic absorption spectrophotometry
blood level of lead that needs to be detected
10 microgram/dL
lead chelating agenst
dimercaprol (BAL), CaNa-EDTA, D-penicillamine, succimer
blood lead level indication for inpatient tx
> 70
CO has greater affinity for ___ than ____
Fetal than HbA
2 ways CO is toxic
directly to intracellular oxidative mechanisms
increased production of NP
CO levels in non-smoker and smoker
0.4-2%
2-6%
CO can be produced endogenously by
breakdown of heme
hepatic metabolism of dichloromethane (methylene chloride) in paint and removers
method that may give falsely reassuring O2 sat in CO poisoning
pulse-ox
In pt with CO poisoning from fire, should also test for
cyanide
T1/2 of CO on room air and 100% O2
6hrs, 1hr
Rumack-Matthew nomogram is for
acetaminophen
timing of initial blood sample for tylenol
4hrs post ingestion
tx for tylenol tox
n-acetylcysteine
