Exam 12: Environmental Toxicology and Antidotes Flashcards Preview

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Flashcards in Exam 12: Environmental Toxicology and Antidotes Deck (48):
1

NOAEL

No Observed Adverse Effect Level: Highest dose that doesn't produce a statistically significant toxic effect

2

RfD

Reference Dose: Estimated daily exposure that is assumed to have no adverse health impact on the human population

3

6 Common causes of anticholinergic toxicity

1. Atropine
2. Scopolamine
3. Antihistamines
4. Antiparkinson's (amantidine)
5. Antipsychotics
6. Plants (Belladonna)

4

Treatment for anticholinergic poisoning

Physostigmine

5

Treatment for seizures caused by too much of a stimulant

Benzos

6

Treatment for tachycardia caused by too much of a stimulant

Lidocaine

7

Treatment for ventricular fibrillation caused by too much of a stimulant

Lidocaine

8

Treatment for opioid toxicity

Naloxone

9

Treatment for Cholinergic syndromes

Cholinergic antagonist like Atropine
Pralidoxime is only used for Organophosphate poisoning

10

Mechanism of activated charcoal. Limitation?

Non-specific chelator that limits drug absorption
Doesnt work as well if a drug is rapidly absorbed

11

Use of Whole-bowel irrigation (actual substance that is used)

Non-absorbable polyethylene glycol
Used after large ingestion of drugs that are poorly absorbed by activated charcoal

12

Difference between organophosphates and carbamate insecticides

Carbamates are reversible acetylcholinesterase inhibitors (treat with atropine only)
Organophosphates are irreversible (Treat with atropine and pralidoxime)

13

Chlorinated insecticides mechanism

Inhibit voltage-gated Na+ channels, leading to seizures, tremors, weakness, twitches, etc.

14

2 Treatments for Chlorinated insecticides (DDT)

1. Activated charcoal/gastric lavage
2. Anticonvulsants (slowly infused)

15

Pyrethrins symptoms and treatments (2)

Bronchospasm, numbness, seizures
1. Charcoal/lavage
2. Bronchodilators for bronchospasm

16

Problem with methanol

Metabolized to formaldehyde by alcohol dehydrogenase (blindness, metabolic acidosis)

17

Methanol treatments (2)

1. Treat acidosis with bicarb
2. Fomepizole (Alcohol dehydrogenase inhibitor)

18

2 consequences of Ethylene glycol ingestion

1. Hypocalcemic tetany
2. Oxalicaciduria - crystals

19

2 treatments for Ethylene glycol poisoning

1. Calcium for their hypocalcemia
2. Fomepizole

20

Result of Diethylene glycol poisoning (treatment)

Anuric renal failure
Supportive/symptomatic care

21

Sources of lead poisoning

1. Food/water
2. Dust
3. Paint chips

22

4 effects of lead poisoning

1. Microcytic anemia
2. Weak wrist and ankle extensors
3. Lead encephalopathy
4. Colic loss of apatite

23

First and second line treatments for severe lead poisoning

1. Succorer
2. EDTA

24

Treatment for cerebral edema in lead poisoning

Dexamethasone

25

Why are children most at risk of lead poisoning?

They absorb up to 40% of that ingested, adults only 10%

26

2 effects of lead on kids

1. Deteriorates their BBB
2. Low IQ, ADHD, behavior problems

27

Arsenic poisoning source

Rural/municipal water supplies

28

Arsenic acute intoxication signs/symptoms

Hemorrhagic gastroenteritis
Garlic odor on breath

29

Arsenic chronic intoxication signs/symptoms

Hyperkeratosis, exfoliative dermatitis

30

Arsenic poisoning mechanism

Binds to -SH groups on proteins and causes severe oxidative stress

31

Arsenic toxicity treatment

Dimercaprol

32

Treatment for inhalation of arsenic gas

This only occurs in miners
Supportive therapy only

33

Methylmercury sources

Gold mining
Fish
Grain fungicide

34

Signs and symptoms of mercury poisoning

Ataxia, loss of balance, sensory defects, visual defects, deafness, dysarthria
THESE ARE ALL IRREVERSIBLE

35

Who should avoid eating predatory fish?

Pregnant women
Canned tuna is probably safe though

36

Mercury in cavity fillings

They pose little hazard
Dentists ARE NOT supposed to advocate their removal

37

When is chelation therapy used

Severely elevated metal levels or toxicity

38

Chelation therapy consideration

Only reduces readily accessible pool of metal. After therapy, blood levels of the metal can rebound

39

Edentate Calcium Use, Side effects, tocixity

EDTA
1. Lead poisoning antidote
2. Chills, fever, nausea voliting
3. Nephrotoxic at high dose

40

Penicillamine use

Wilson's disease
also for lead poisoning

41

Succimer use, advantage

First orally effective chelator
Works faster than EDTA in lead poisoning

42

First sign of CO poisoning

Headache

43

CO poisoning treatment

Hyperbaric O2

44

Treatment for cyanide toxicity

Hydroocobalamin
Reacts to form vitamin B12

45

Asbestos antidote

There isn't one
Dont get exposed

46

PCBs and Dioxin signs and symptoms

Chloracne, nausea, vomiting, headache

47

Dioxin treatment

None!!

48

Bisphenol A (BPA)

Leached from plastic into food and water
Exposure in utero MAY be linked to neural and behavioral defects