Group 10 Flashcards
(31 cards)
What are the clinical uses of penicillamine?
- Wilson’s disease (copper chelation).
- Cystinuria (reduces cystine excretion).
- Rheumatoid arthritis (immunomodulation).
What are sources of penicillamine toxicity?
- Therapeutic mismanagement (improper dosing).
- Drug interactions (e.g., with immunosuppressants).
- Genetic susceptibility (e.g., autoimmune disorders).
Name three adverse effects of penicillamine.
- Nephrotoxicity.
- Bone marrow suppression.
- Autoimmune reactions (e.g., lupus-like syndrome).
What is the primary use of edetate calcium sodium?
Chelation therapy for lead poisoning (binds lead for renal excretion).
What are risks of toxicity with edetate calcium sodium?
- Nephrotoxicity (esp. in renal impairment).
- Essential mineral depletion (e.g., zinc, iron).
- Tissue irritation (if administered IM instead of IV).
How is edetate calcium sodium administered?
IV infusion (preferred route to avoid tissue damage).
What lab parameter must be monitored during therapy?
Renal function (e.g., serum creatinine, BUN).
Classify rodenticides by type and provide examples.
- Anticoagulants (e.g., warfarin, brodifacoum).
- Cholecalciferol (vitamin D₃).
- Bromethalin (neurotoxic).
What is the mechanism of toxicity for anticoagulant rodenticides?
Inhibit vitamin K epoxide reductase → disrupts clotting factor synthesis → coagulopathy.
How is cholecalciferol poisoning treated?
- Glucocorticoids (reduce calcium absorption).
- IV fluids and diuretics (enhance calcium excretion).
- Bisphosphonates (inhibit bone resorption).
What is the key risk of bromethalin rodenticides?
No known antidote; causes cerebral edema and seizures (supportive care only).
What antidote is used for anticoagulant rodenticide toxicity?
Vitamin K₁ (phytonadione).
Define toxicity and its significance.
Toxicity refers to the harmful effects of substances on biological systems, necessitating risk assessment and management.
What are preventive measures for rodenticide exposure?
- Secure storage away from children/pets.
- Use tamper-resistant bait stations.
- Public education on safe handling.
What systemic effect is common to all three rodenticide types?
Neurological dysfunction (seizures, cerebral edema) in severe cases.
How do edetate calcium sodium and penicillamine differ in chelation?
- Edetate: Targets lead and heavy metals.
- Penicillamine: Targets copper (Wilson’s disease) and cystine.
Why is renal monitoring critical for edetate calcium sodium?
It is renally excreted; pre-existing kidney disease increases nephrotoxicity risk.
What are acute effects of edetate calcium sodium toxicity?
Hypocalcemia, arrhythmias, hypotension (due to rapid chelation of calcium).
What chronic effect is associated with prolonged penicillamine use?
Cutaneous changes (e.g., elastosis perforans serpiginosa) and autoimmune disorders (e.g., myasthenia gravis).
How does chronic cholecalciferol (vitamin D₃) rodenticide exposure manifest?
Persistent hypercalcemia → renal calcification, hypertension, and osteoporosis.
What supportive measures are critical for bromethalin poisoning?
- Mechanical ventilation for respiratory failure.
- Anticonvulsants (e.g., benzodiazepines) for seizures.
- Mannitol to reduce cerebral edema.
What is the first step in managing anticoagulant rodenticide ingestion?
Gastric lavage/activated charcoal within 1–2 hours, followed by vitamin K₁ therapy.
What is the half-life of edetate calcium sodium?
20–60 minutes; requires repeated dosing in severe lead poisoning.
How is penicillamine metabolized?
Primarily hepatic metabolism, with renal excretion of chelated metals.
