1. Chemical (most common) 2. Plant 3. Animal (least but most serious)

Intro To Toxicology Flashcards by Ibrahem Salem Rehiel

Define toxicology:

The science of poisons that study toxic substances.

How well did you know this?

Not at all

Perfectly

Sources of toxins:

Chemical (most common)
Plant
Animal (least but most serious)

How well did you know this?

Not at all

Perfectly

Toxicant

Toxic substances from chemicals

How well did you know this?

Not at all

Perfectly

Toixc substance from animals

Venom

How well did you know this?

Not at all

Perfectly

Toxic substances that produced within living cell or organisms

Toxins: like bacterial toxins

How well did you know this?

Not at all

Perfectly

Difference bt venomous and poisonous animals:

Venomous :deliver or inject their venom directly by apparatus (stinger)
Poisonous: don’t deliver it directly, thier entire body cantains toxic substance, it is harmful when it eaten or touch

How well did you know this?

Not at all

Perfectly

Toxins sites action:

Local: corrosives
Systemic(remote): away from site of transmission
Both: oxalic acide (corrosive and reactive)

How well did you know this?

Not at all

Perfectly

Factor effecting action of poisons
Realted to poison:

Dose
Physical statue : gas>liquid>solid
Purity: If impurities are more toxic than poison, more toxicity

How well did you know this?

Not at all

Perfectly

Factor effecting action of poisons
Realted to poison:

Dose
Physical statue : gas>liquid>solid
Purity: If impurities are more toxic than poison, more toxicity

How well did you know this?

Not at all

Perfectly

Factor effecting action of poisons
Realted to person:

Age: child and elderly more sensitive
Healthy: RF or LF
Sensitivity: genetic factors
Sex: female more sensitive (less mass and more fat)

How well did you know this?

Not at all

Perfectly

Factor effecting action of poisons
Realted to mode or exposure:

Inhalation>i.v>i.p>s.c>i.m>i.d>oral

How well did you know this?

Not at all

Perfectly

Factor effecting action of poisons
Environmental factors:

Temperature
Pressure
Humidity
Radiation

How well did you know this?

Not at all

Perfectly

Toxidromes:

Signs and symptoms that related to specific poison

How well did you know this?

Not at all

Perfectly

Definitive care of poisoning cases:

• Measure and identify the toxic agent
• Decrease further absorption
• Enhance elimination
• Antidote (if available)
• Treatment of systemic complications

How well did you know this?

Not at all

Perfectly

The initial approach to poisoned patients should be essentially similar and every case end similar to:

Initial approach to the trauma patient

How well did you know this?

Not at all

Perfectly

Components of the ABCDE approach:

Airways
Breathing
Circulation
Disability( level of consciousness)
Environment

How well did you know this?

Not at all

Perfectly

The most common factor contributing to death from poisoning is:

Loss of airway-protctive reflexes with subsequent airway obstruction.

How well did you know this?

Not at all

Perfectly

In poisoned patients, airway obstruction caused by:

Flaccid tongue
Aspiration of gastric contents
Respiratory arrest

How well did you know this?

Not at all

Perfectly

The most common cause of airway obstruction in unconscious patient is:

The first maneuver to manage it:

Passive obstruction by the tongue

Jaw thrust followed by endotracheal incubation

How well did you know this?

Not at all

Perfectly

If the patient’s mental status is altered or if hypotension exists …give:

Coma cocktail:
100% oxygen
Naloxone
Glucose
Thiamine

Contraindications of induction of emesis:

Convulsions
Hydrocarbons
Corrosives
Sharp object (needle)
Come or decrease gag reflex
Less than 6m age (no gag relfex)
Hemorrhagic tendencies

Charcoal adult dose:

1mg/kg

Charcoal contraindications:

• Instestinal obstruction

• 3C:
Coma
Corrosives
HydroCarbon

• If you already gave Antidote

Can we use cathartics (laxatives) in poisoning management and why

Yes, they enhance the passage of material(toxins) through GIT and decrease the time of contact and absorption

Contraindications of laxatives:

Intestinal obstruction GIT hemorrhage Recent bowel surgery Renal failure (of mg sulfate)

Name two types of laxatives with ex

Irritants that increase motility like caster oil Osmotic that increases osmotic pressure like mg sulfate

Whole bowel irrigation used for:

Clean git from ingested non absorbed toxins

Indication of bowel irrigation

• material that is not absoped by charcoal • massive amount • sustained-release or enter-coated drugs • packets of illegal drugs

What is antidote:

Therapeutic substance used to counteract the toxic action of specific xenobiotic

Classification of antidote according to mechanism of action: A lot of talk

• intacts with poison to from non-toxic complex. • accelerate detoxification. • decrease the rate of conversion of the poison into its toxic mb • Compete on the receptor • block the poison's receptor • Bypass the effect of poison • Antibodies to the poison

Example of antidote that bypass the effect of poison:

O2 in case of CO or cyanide toxicity

Example of antidote that competes the poison for its receptor:

Naloxone

Example of antidote that blocks poison receptor

Atropin in case of A large-scale exposure to a nerve agent or organophosphate insecticide or cholinergic syndrome

Example of antibodies antidote:

Digiband and antivenom

Example of antidote that decreases the rate of conversion of poison to ist toxic mb

Ethanol and fomepizole

Example of antidotes that accelerate detoxification of poisons:

N-actylecysteine and thiosulfate

Physical antidotes

**Adsorbing:** charcoal **Coating**: mixture of egg and milk makes a coat over mucosa **Dissolving**: 10% alcohol or glycerin for carbolic acid

Chemical antidote:

Oxidizing Reduction Precipitating

Example of oxidizing antidote:

Amyl nitrite is used in cyanide toxicity

Examples of reducting antidote:

• Vit c for drug causing Methemoglobinemia • methylene blue for Methemoglobinemia producers

Examples of precipitating antidote:

Starch : it makes blue precipitate with iodine Eggs, skimmed milk or gelatin : for mercury

Mention 2 methods to enhance the excretion of ABSORPED poisons

Manipulation of urine ph Dialysis

Manipulation of urine ph by:

Forced alkaline diuresis Acid diuresis (uncommonly)

Why is acid diuresis dangerous:

Because of the risk of myoglobin precipitation in renal tubules.

Dialyzable substances for good dialysis must have:

Low volume distribution Low molecular weight Low protein binding

Examples for dialyzable substances:

Alcohol Barbiturates Salicylate

Examples of non dialyzable substances:

Opiates Atropine Antidepressants

Peritoneal dialysis acts by:

Considering peritoneum as semi-permeable membrane

Complications of peritoneal dialysis:

Peritonitis Perforation of abdominal organ Dehydration or overhydraion Intra-abdominal bleeding