Group 1

Question 1

What is glucagon, and how is it produced?

Answer 1

Glucagon is a polypeptide hormone produced by alpha cells in the pancreas, stomach cells, and intestinal enteroendocrine cells. Modern glucagon is synthetic, made via recombinant DNA technology using E. coli or yeast.

Question 2

What are the clinical uses of glucagon?

Answer 2

Antidote for beta-blocker or calcium channel blocker overdose (used with insulin therapy).
- Treatment for severe hypoglycemia (e.g., insulin overdose).

Question 3

How does glucagon work in overdose cases?

Answer 3

Binds to G-protein coupled receptors (GPCRs) → activates adenylate cyclase → increases cAMP → enhances heart contractility and raises blood glucose.

Question 4

What is the dosing protocol for glucagon in overdoses?

Answer 4

• Initial dose: 3–10 mg IV bolus over 1–2 minutes.
• Maintenance: 1–5 mg/h infusion if effective.

Question 5

What are the adverse effects of glucagon?

Answer 5

• Common: Nausea, vomiting.
• Serious: Transient hypertension, arrhythmias, anaphylaxis, rebound hypoglycemia.

Question 6

When should glucagon NOT be used?

Answer 6

• Absolute contraindications: Hypersensitivity, pheochromocytoma, insulinoma.
• Relative contraindications: Lactose allergy (powder form), neonates with low glycogen.

Question 7

What are common sources of methanol exposure?

Answer 7

Windshield wiper fluid
antifreeze
industrial solvents
fuels
perfumes
some cosmetics.

Question 8

How does methanol cause toxicity in the body?

Answer 8

1. ADH converts methanol → formaldehyde.
2. Aldehyde dehydrogenase converts formaldehyde → formic acid.
3. Formic acid causes metabolic acidosis and optic nerve damage (blindness)

Question 9

What are the signs of methanol poisoning?

Answer 9

• Early: Headache, confusion, blurred vision.
• Severe: Coma, blindness, metabolic acidosis.

Question 10

How is methanol poisoning treated?

Answer 10

• Antidotes: Fomepizole or ethanol (inhibit ADH).
• Hemodialysis to remove methanol/formic acid.
• Sodium bicarbonate to correct acidosis.

Question 11

How is methanol poisoning treated?

Answer 11

• Antidotes: Fomepizole or ethanol (inhibit ADH).
• Hemodialysis to remove methanol/formic acid.
• Sodium bicarbonate to correct acidosis.

Question 12

What are the long-term effects of methanol poisoning?

Answer 12

Irreversible blindness, neurological damage (e.g., Parkinsonism), and chronic acidosis.

Question 13

How does ethanol act as an antidote for methanol poisoning?

Answer 13

Ethanol competitively inhibits ADH with higher affinity than methanol, preventing its conversion to toxic metabolites.

Question 14

What is the dosage of ethanol for methanol poisoning?

Answer 14

• IV (10% ethanol):
  
  • Loading dose: 8 mL/kg.
  • Maintenance: 0.5–1.5 mL/kg/h.
• Oral (95% ethanol):
  
  • Loading dose: 0.7 mL/kg.
  • Maintenance: 0.1 mL/kg hourly.

Question 15

What are the adverse effects of ethanol therapy?

Answer 15

• CNS/respiratory depression, hypoglycemia, nausea, hypothermia, electrolyte imbalances (e.g., hyponatremia).

Question 16

What parameters are monitored during ethanol therapy?

Answer 16

• Blood ethanol levels (target: 100–150 mg/dL).
• Blood glucose, ABGs (for acidosis), electrolytes, renal function.

Question 17

Why is hemodialysis used in methanol poisoning?

Answer 17

Removes methanol and formic acid from the blood, especially in severe cases (e.g., acidosis, organ failure).

Question 18

What is the role of sodium bicarbonate in methanol poisoning?

Answer 18

Corrects metabolic acidosis caused by formic acid accumulation