Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Head & Neck 2-My Flashcards > Dental Toxicology (6 questions) > Flashcards

Dental Toxicology (6 questions) Flashcards

1
Q

Father of toxicology who said “the dose makes the poison” “All substances are poisons; there is none which is not a poison. The right dose differentiates a poison from remedy”

A

Theophrastus Phillippus Aureolus Bombastus von Hohenheim aka Paracelsus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

In 1930 the name of Food, Drug, and insecticide Administration shorted to

A

Food and Drug Administration (FDA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

1960’s Thalidomide disaster, drug used for?

A

nausea associated with pregnancy. Sold over the counter. Found to be teratogenic. Caused phocomelia (underdeveloped limbs).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Toxicology

A

is the study of the adverse effects of chemical, physical, or biological agents on living organisms and the ecosystem, including the prevention and amelioration of such adverse effects”-Society of Toxicology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

FDA (Food and Drug Administration)

A

control/regulates drugs used for human and veterinary drugs, dietary supplements, medical devices, food products, cosmetics, products that emit radiation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Toxicants

A

substance that produces adverse biological effects of any nature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

posisons

A

toxicant that cause immediate death or illness when experienced in very small amounts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

toxins

A

specific proteins produced by leaving organisms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Bioaccumulation

A

The accumulation of a substance, such as a toxic chemical, in various tissues of a living organism. Bioaccumulation takes place within an organism when the rate of intake of a substance is greater than the rate of excretion or metabolic transformation of that substance. Happens in the SAME ANIMAL.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Biomagnification

A

The increasing concentration of a substance, such as a toxic chemical, in the tissues of organisms at successively higher levels in a food chain. DIFFERENT ANIMAL BUT SAME FOOD CHAIN. Process of taking non-toxic chemical to a chemical one.
e.g. PCB (Polychlorobiphenyls in Great Lakes), Mercury in Minimata bay in Japan)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Bioactivation

A

The metabolic activation of xenobiotic compounds into reactive, toxic compounds. Body turns it toxic. e.g. tylenol.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Detoxification

A

physiological or medicinal removal of toxic substances from the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What form of Mercury is toxic?

A

Dimethylmercury (organic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Fluoride antidote?

A

1% CaCl2 or calcium gluconate or milk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Tylenol target organ?
maximum adult use?
What entitiy cause toxicity?
Antidote?

A

Liver
4g in 24 hours
NACQI
N-acetylcysteine (NAC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Cocaine antidote?

A

no specific antidote

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Antidepressants antidote?

A

No specific antidotes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Cardiovascular drug: Digoxin antidote?

A

Digiband

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Cardiovascular drug: Calcium channel antagonists?

A

Antidote: Activated charcoal within 1-2 hours, IV calcium chloride in serious poisoning, positive inotropes, insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Name 3 regulatory agencies

A

FDA
EPA
OSHA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

EPA (environmental protection agency)

A

the objective of the EPA is to: ‘use its best endeavours – a) to protect the environment; and b) to prevent, control and abate pollution and environmental harm.’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

OSHA (Occupational Safety and Health Administration)

A

OSHA assure safe and healthful working conditions for working men and women by setting and enforcing standards and by providing training, outreach, education and assistance.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

State the year in which FDA established?

A

1930

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Ex. of Biomagnification in Great Lakes and marine life?

A

PCB (a pesticide) aka persistent organic pollutants are endocrine disruptures. Chemicals get magnified as they go to higher levels in the food chain. e.g. zooplankton feed off phytoplankton thus more PCB conc. in that.

More mercury in large fish like Shark in marine life.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Explain biotransformation and processes involved in it?

A

Biotransformation- chemical alternation of chemicals such as nutrients, aa, toxins, and drugs in the body.

Lipophilic chemical–>Hydrophilic Chemical–>readily excreted

Accumulation–>Phase I–> Phase II

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

LD50

A

Dose that is lethal in 50 % of the exposed animals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Median Toxic dose (TD50)

A

toxic dose in 50 % of the population or Lethal dose (LD50)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Median effective dose (ED50)

A

effective dose in 50 % of the population

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Therapeutic Index (Window)

A

margin of safety;

how selective a drug is in producing its desired effects over adverse effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Additive Effect

A

1+1 = 2
if two compounds that causes similar types of toxicity together cause an effect that is sum of the individual effects
Toluene & p-xylene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Synergism

A

1=1 =5
if two compounds together causes an effect that is stronger than additive effect of the two
Ethanol & CCL4 & Tylenol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Potentiation

A

0+1 = 3
if one of the compounds is not toxic by itself, but enhances the toxicity of another compound
2-propranolol & CCl4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Antagonism

A

1+0 = 0

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Subacute: exposure period?

A

1-14 days

35
Q

Subchronic: exposure period?

A

14-28 days

36
Q

Chronic toxicity: exposure period?

A

6-24 months

37
Q

Preclinical studies

A

sdfsss

38
Q

four phases of clinical FDA evolution of New Drugs

A

Phase I:
Effect of drug under investigation in healthy volunteer human subjects (20-80)
Determine toxicity and dose, PK
Phase II:
Effectiveness of drugs in human subjects for particular indication
Well controlled, monitored, small studies in patients [several hundred (100-300)]
Phase III:
Double blind study, compares effect against standard treatment
Extrapolation to general population for risk benefit analysis & information for physician labeling
Several thousand (1000-3000) subjects are involved
Phase IV:
Post marketing surveillance

39
Q

Institutional Review Board (IRB):

A

Ethical treatment & full consent for studies

Roseman has IRB (members are from Faculty, Staff, Community)

40
Q

Pb-drug example? Target organ? Toxicity mechanism? Trreatment/Antidote?

A 
Drug example: piston-engine aircrafts
Coal-fired plants (major source 
	in environment)
Lead-based paints (old houses)
Auto emissions (TEL, now rare) 
Toxicity mechanism: 
Coal-fired plants (major source 
	in environment)
Lead-based paints (old houses)
Auto emissions (TEL, now rare) 
Target organ: Encephalopathy (acute, emergency), Anemia, CNS deficits
Treatment/Antidote: Chelation Therapy (IV)
41
Q

Mercury (Hydragyrum) sources

A

Contaminated drinking
dental amalgam, water, Coal-fired power plants (~13 tons/year), Food (fish, waterfowl etc.) contaminated with mercury, Mercury thermometers, Leaching of mercury from badly fitting dental amalgams, Vaccines containing thimerosal, Button cells (battery)

42
Q

Most toxic form of mercury?

A

Dimethylmercury (organic)

43
Q

Hg Toxicity Mechanism

A

Interacts with SH groups in enzymes, causes necrosis of proximal tubular epithelium, Organic mercury is more toxic to CNS

44
Q

Hg target organ?

A

Toxicokinetics: Absorbed from respiratory tract, GIT and organic form from skin also; Metabolised to divalent mercury; Distributed mainly to kidney, brain; Excreted in urine and faeces (inorganic) or in faeces (alkyl Hg)

45
Q

Hg antidote

A

chelation

46
Q

Hg Antidote MOA

A

Chelation Dimercaprol

47
Q

Acetaminophen (Tylenol)-poisoning signs

A

Phase 1- No symptoms or mild GI symptoms such as vomiting

Phase 2- Right upper quadrant abdominal tenderness, Tachycardia, Hypotension

Phase 3- Jaundice, Coagulopathy, including GI bleeding, Hepatic encephalopathy

Phase 4- Resolution

48
Q

Acetopminophen target organ

A

Liver and kidney

49
Q

Acetominophen Poisoning-Antidote

A

Activated charcoal (AC) can adsorb APAP and is useful as a decontaminant if given within 1 hr of ingestion
N-acetylcysteine (NAC) is the specific antidote - p.o. usually given in cola drinks to mask taste
NAC reacts directly with NAPQI and prevents cellular damage
NAC is a glutathione precursor&raquo_space; repletes glutathione storage&raquo_space; conjugate NAPQI
NAC has some non-specific cellular protective effects, anti-oxidant effects
Effective when given within 8 hrs of ingestion

50
Q

Sedative Hypnotics-

A

benzodiazepines

barbituates

51
Q

Sedative Antidote

A

Flumazenil Antidote to Benzodiazepine Overdose/Poisoning

Barbituates have no antidote

52
Q

Opiods (Morphine, hydrocodone, methadone, oxycodone) antidote?

A

non-selective opioid antagonist

e.g. Naloxone, Naltrexone

53
Q

CVS drugs (Cardiovascular drugs)-Calcium channel antagonists; antidote?

A

Activated charcoal within 1-2 hours, IV calcium chloride in serious poisoning, positive inotropes, insulin

54
Q

CVS drug-Digoxin; antidote?

A

Digiband

55
Q

Tricyclic Antidepressants; antidote?

A

No specific antidotes; activated charcoal, gastric lavage, treated with symptomatic care and intravenous sodium bicarbonate

56
Q

Stimulants and Street Drugs

A 
Cocaine
Amphetamine
Methamphetamine
Heroin
Lysergic acid diethylamide (LSD)
Khat
Bath salts
57
Q

Cocaine: acute toxicity?

A

Prevents reuptake of DA» increased DA in CNS

58
Q

Cocaine: antidote?

A

No specific antidote
Treatment is symptomatic
Convulsion > diazepam
Myocardial ischemia > nitrates, beta blockers, Ca channel blockers
Hypertension > nitroprusside, phentolamine, Ca++ channel blockers

59
Q

Methods for decontamination

A 
Activated charcoal
Emetics
Cathartics
Gavage
Whole bowel irrigation
Enhancing elimination (Hemodialysis/hemoperfusion,
Urine pH manipulation)
60
Q

Activated charcoal advantage/dis.

A

Pro: Adsorbs substances to prevent systemic absorption

Con: Mostly aromatic molecules & gases are adsorbed.
Limited value after 1-2 hours of ingestion

61
Q

Emetics (a medicine or other substance that causes vomiting)

A

Syrup of Ipecac

Should be administered with 30-60 minutes of ingestion

62
Q

Orogastric Lavage (stomach pumping or gastric irrigation, is the process of cleaning out the contents of the stomach)

A

Removes stomach content through a large bore tube until the return is clear

63
Q

Cathartics ( a substance that accelerates defecation)

A

MOA: increases motility of intestine, decreases intestinal residence time
Agents:
Sorbitol or Magnesium citrate

64
Q

List chemicals/drugs for which hemodialysis may be helpful?

A

Amphetamines, antibiotics, isoniazid, phenobarbitol, salicylates, thiocyanates

65
Q

Explain how urine pH manipulation helps elimination of toxicant?

A

Mechanism of Action: ionic chemicals are trapped in urine (prevent reabsorption)
Acidified urine will enhance elimination of weak bases
Alkalinized urine will enhance elimination of weak acids

66
Q

State few services that are provided by poison control centers?

A

Assessment, treatment recommendations, signs and symptoms, decontamination recommendations, locating antidotes/antivenoms, pill and toxidrome identification
Toxidrome: The chemical structure of a compound. Lab tests take too long for a diagnosis, in the clinic we want to use signs and symptoms as a quick way to diagnose the chemical grouping/toxidrome/category of toxin in order to treat the patient quickly.

67
Q

emesis

A

vomiting

68
Q

emesis induced by

A

ipecac tincture

69
Q

antidote of morphine

A

naloxone

70
Q

antidote of diazepam

A

flumazenil

71
Q

overdose scenario morphine

A

urine pH manipulation

72
Q

amphetamine overdose

A

urine pH manipulation

73
Q

tricyclic antidepressant poisoning

A

activated charcoal

74
Q

overdose of delayed release drugs

A

magnesium citrate

polyethylene glycol lavage solution

75
Q

Patient tried to kill themselves, doesn’t remember what they took. Have symptom of nausea and after 24 hours lab results showed serum of ALT(Alanine transaminase) in blood. What drug did they try to overdose on?

A

Acetaminophen (Tylenol)

76
Q

Diazepam

A

Flumazenzil

77
Q

Acetaminiphin convertered to NAQI

A

Bioactivation

78
Q

TI

A

TI=LD50/ED50

79
Q

Nalaxone (NARCAN)

A

opiods

80
Q

Succimer (CHEMET)

A

heavy metal

81
Q

Calcium (IV)

A

CCBs

82
Q

Overdose situation treated with acidification of urine using ammonium chloride

A

Morphine (Weak base)

83
Q

ALT and AST is a ___ specific enzyme

A

liver

Head & Neck 2-My Flashcards (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions