Introduction To Toxicology Flashcards
(145 cards)
1
Q
Is the ability of the substance to produce injury upon reaching a susceptible site in/on the body
A
Toxicity
2
Q
It is the science of poisons including not only their chemical and physical effects but for their detection and antidotes.
A
Toxicicology
3
Q
Scientist who study this harmful effect and asses the probability of their occurrence are called ________
A
Toxicologist
4
Q
What are the 4 major Disciplines in Toxicology
A
Mechanistic , Descriptive , Clinical and Forensic
5
Q
One of the Discpline in Toxicology that uses results from animal experiments to predict the level of exposure to harmful to humans
A
Descriptive
6
Q
Descriptive Discipline is also known as _________
A
Risk Assestment
7
Q
Refers to toxic substances that are produced naturally
A
Toxins
8
Q
Provides basis of therapy design and develop test for assestment
A
Mechanistic
9
Q
One of the Discpline in Toxicology that study the interelationship between toxin exposure and disease state
A
Clinical Discpline
10
Q
One of the Discpline in Toxicology concerned with medicolegal consequence of toxin exposure
A
Forensic
11
Q
What are the 5 Sub-Discipline of Toxicology
A
Economic toxicology, Forensic Toxicology , Clinical toxicology , Environmental Toxicology, Industrial Toxicology.
12
Q
Refers to toxic substances that are produce by or are a by product of human made activities
A
Toxicant
13
Q
One of the Sub-Discpline in Toxicology that concerned in chemicals used in drugs, Food Additives , pesticides and cosmetics
A
Economic Toxicology
14
Q
One of the Sub-Discpline in Toxicology that helps establish cause and effect relationships between exposure to a drug or chemical and the toxic and lethal effect result
A
Forensic Toxicology
15
Q
Is use to describe the nature of adverse effect produced and the condition neccessary for their production
A
Toxicity
16
Q
One of the Sub-Discpline in Toxicology that evaluate the synergestic effects of chemicals that are contaminant of food , water , soil or the air
A
Environmental Toxicology
17
Q
One of the Sub-Discpline in Toxicology that evaluate the effects of pollutant in the working environment .
A
Industrial (Occupational) Toxicology
18
Q
General Fxn of Toxicology
A
G-I-Q-I-C-D-P-G-M
19
Q
Wrote the famous Treatise on Poison and their antidote
A
Moses Maimonides (1335-1204)
20
Q
Paracelcus is Famous for his word that
A
The Dose Makes the Poison
All Substance are Poison
There is None which is not poison
The right dose differentiate poison from remedy
21
Q
Noted as the Father of Pharmacology
A
Francoise Magendie (1783-1855)
22
Q
French Toxicologist and Chemist, The founder of Science of Toxicology
A
Mathieu Joseph Bonaventure
23
Q
Synthesized caffeine and recieved the nobel prize in chemistry in 1902
A
Emil Fischer 1852-1919
24
Q
4 Basis of Classifying Poisons
A
Base on Its Analysis
Base on the organ or system considered the target site of the effect of the chemical
Mechanism of Toxicity
Manner of Exposure
25
List The 7 Classifications of Toxic Agents
```
Heavy Metals
Solvent And Vapors
Radiation and Radioactive Materials
Dioxins/Furans
Pesticide
Plant Toxins
Animal Toxins
```
26
What are the 2 types of Exposure
Acute Exposure and Chronic Exposure
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An exposure in which the dose is delivered in a single event and the absorption process is rapid
Acute Exposure
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An exposure in which the dose is delivered at some frequency over a period of time
Chronic Exposure
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Measurement of Toxicity is related to ;
```
Characteristic and Condition of Exposure
Route of Administration
Time and Frequency of Exposure
Dose Delivered
Physical and Chemical form of the substance
```
30
Give 4 Routes of Administration
Pulmonary , GIT/Oral , Parenteral, Topical
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Give the 6 Parenteral Route
```
Intravenous
Subcutaneous
Intramuscular
Intradermal
Intraperitoneal
Intraspinal
```
32
Give the 2 Spectrum of toxic effects
Acute Effect and Chronic Effect
33
Toxic Effect that occurs or develop rapidly after a single administration
Acute Effect
34
Those that are manifested after the elapse of sometime
Chronic
35
What are 2 types of Effect base on Locus of Action
Local Effect and Systemic Effect
36
Effects that occur at the site of the first contact between the biologic system and the toxicant
Acute Effect
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Effect that require absorption and distribution of the toxicant to a site distant from its entry point effect are produced
Chronic Effect
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In Chronic effect that frequently involved system is the
CNS
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Classification of toxicant based on their relative toxicities
Give the Toxic Ratings and There Commonly used term
Toxic Ratings Commonly used term
6 Super Toxic
5 Extremely Toxic
4 Very Toxic
3 Moderately Toxic
2 Slightly Toxic
1 Practically Non-Toxic
40
Practically Non-toxic Probable human LD
15g/kg( >1quart)
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Slightly Toxic Probable human LD
5-15g/kg ( between 1pint - 1quart)
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Moderately Toxic Probable human LD
0.5-5g/kg ( bet 1 oz. - 1 pint )
43
Very Toxic Probable human LD
50-500mg/kg ( 1 tsp -1oz.)
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Extremely Toxic Probable human LD
5-50mg/kg ( 7gtts/drops - 1 tsp)
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Super Toxic Probable human LD
> 5mg/kg ( a taste of > 7 drops )
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Defined as an overdose of drugs , medicament , chemicals and biological substance
Poison
47
The 3 Diagnostic workup of a Px who may be a victim of poisoning
1. Complete History
2. Complete Physical examination
3. Appropriate Laboratory Examination
48
Cases of Poisoning that generally fall into 3 categories
1. Exposure to known poison
2. Exposure to an unknown substance which may be a poison
3. Disease of undetermined etiology in which poisoning must be considered as part of the differential Dx.
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Used to refer to the deliberate ingestion of more than the therapeutic dose of a drug or a substance not intended for consumption, usually by an adult in a moment of distress
Self Poisoning/Parasuicide
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Non-intentional ingestion overdose or exposure to drugs, medicaments or poisonous substances
Accidental Poisoning
51
The 7 General approach to the poisoning patient
1. Emergency Stabilization
2. Clinical Evaluation
3. Elimination of the poison
4. Excretion of Absorbed substance
5. Administration of antidote
6. Supportive therapy and observation
7. Dispositions
52
The greatest contributor death from drug overdose is _____________
Loss of airway protective reflexes
53
Emergency stabilization is needed if
ABCDE
54
What are the 6 techniques in Clearing airways
```
Sniffing Position
Chin Lift
Jaw Thrust
Head Down Left Sided Position
Intubation ( Orotracheal . Nasotracheal)
```
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A technique in clearing airways that allows the tongue to fall forward and secretions and vomitus to drain out of the mouth
Head- Down Left sided positon
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A technique in clearing airways that should not be used if there is any suspicion or neck injury
Sniffing Position
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A technique in clearing airways that is used when a Px may have cervical spine injury
Jaw Thrust
58
Enumerate the procedures in CHIN-LIFT
1. The fingers of one hand are placed under the mandible, which is gently lifted upward to bring the chin anterior
2. The Thumb of the same hand depresses the lower lip to open the mouth
3. The Thumb may also be laced behind the lower incisors and simultaneously, the chin is gently lifted
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4 Indications in Orotracheal
1. Inadequate oxygenation
2 Inadequate ventilation
3. Need to control and remove pulmonary secretion
( Bronchial Toilet)
4. Need to provide airway protection in an obtunded Px or a Px with a depressed gag reflex
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2 Contraindication of Orotracheal
1. Severe airway trauma
| 2. Cervical Spine Injury
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What are the procedure in doing Orotracheal intubation
S.A.L.T.
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A device that lifts the tongue off the posterior pharynx, often making it easier to mask ventilate a Px
Oral Airway
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This Lighted tool is vital to placing an endotracheal tube
Laryngoscope
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In Endotracheal tubes the average adult size is
7.0 to 8.0
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Give the 4 advantages of Oratracheal Intubations
1.Performed under direct vision
2. Insignificant risk of bleeding
3.Px need not to be breathing
spontaneously
4.Higher succes rate
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Give the 2 disadvantages of Orotracheal
1. Frequently requires neuromuscular paralysis
| 2. Requires neck manipulation
67
Nasotracheal Intubation is also called as what technique
Blind Technique
68
An intubation where a tube is passed through the nose, larynx , vocal cords and trachea
Nasotracheal
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2 Advantage of Nasotracheal Intubation
1. May be performed in a conscious patient without requiring neuromuscular paralysis
2. Better tolerated once place
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4 Disadvantage of Nasotracheal Intubation
1. Perforation of the nasal mucosa with epistaxis
2. Stimulation of Vomiting in an obtunded Px
3. Px must be breathing simultaneously
4. Difficult in infants anatomically because of anterior epiglottis
71
Clinical Evaluation is composed of
A. History
| B. Physical Examination
72
Hypothermia is a condition in which the Px has a rectal temp of ____
73
Hypothermia may be due to overdose of
B.O.C.A.S
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Things that are noted in History in Clinical Evaluation
1. Time of Exposure
2. Mode of Exposure
3. Intake of other substance
4. Circumstances prior to poisoning
5. Current medication
6. Past Medical History
7. Any Home Remedy Taken
75
Hyperthermia is a condition when the rectal temp is ____
> 40°C
76
Hyperthermia maybe due to overdoseo of :
```
Antihistamine
Amphetamines
Cocaine
Anticholinergic
Isoniazid
```
77
A common finding in alcohol intoxication and salicylates toxicity
Hypoglycemia
78
Hypocalcemia is commonly seen in :
Dancing Firecrackers
Jatropa Seed Ingestion
Complications of severe animal bites and stings
79
Physical Examination in Clinical Evaluation
1. Evaluate general status of a Px
2. Examine Px skin
3. Px breath/odor
4. Auscultate
5. Listen To Px heart
6. Check The abdomen
7. Do a complete neurologic examination
80
Substances that causes Tachycardia
CO, HCN , Organophosphates
| ,Ethanol
81
Substance that causes Bradycardia
Digitalis
82
Substances that causes Hypertension
Cocaine
Caffeine
Amphetamine
Nicotine
83
Substances that causes Hypotension
Antidepressant
Heroine
Opiates
Sedative-Hypnotics
84
Patients breath / Odor with CN poisoning
Bitter almonds
85
Patients breath / Odor in Px with Diabetic Ketoacidosis
Fruity
86
Patients breath / Odor with Sulfur Dioxide , Hydrogen Sulfide poisoning
Rotten Egg
87
Patients breath / Odor with Organophosphate and arsenic poisoning
Garlic
88
An instrument/Tool use to complete neurologic examination
Glasgow Coma Scale
89
The Glasgow Coma Scale comprises three test namely
Eyes , Verbal and Motor
90
The lowest possible GCS
3 ( Coma or Death )
91
The highest possible GCS
15 ( Fully Awake person)
92
What are the 5 Methods in Eliminating Poison
1. External Decontamination
2. Empty The Stomach
3. Limit Gastrointestinal Absorption
4.Dialysis and Hemoperfusion
5 Whole Bowel Irrigation
93
Differences in reponse to toxicant in a population is due to :
```
Genetics
Gender
Age
Nutritional Status
Health Condition
Previous/Concurrent Exposure to other substances
```
94
3 ways in doing External Decontamination
1. Discard Px clothing
2. Bathe or shower the Px
3. Copious irrigation with water in eye contamination
95
2 ways in Emptying the stomach
1. Emesis
| 2. Gastric lavage
96
A substance that is use in Limit Gastrointestinal Absorption
Activated charcoal lavage
97
Where does Lead and Fluoride stored
Bones
98
Biotransformation Occur on what organs
Liver ( Major ) , Lungs , Kidneys and intestines
99
How much is the average concentration of CO in the atmosphere
0.1ppm
100
In heavy traffic the concentration of CO may exceed
100ppm
101
In CO what are the organs mostly affected
Brain and Heart
102
a solvent in paint removers in metabolized to CO
Methylene Chloride
103
The affinity of CO to Hgb
210-250 times that of O2
104
Mechanism of Toxicity of CO
CO bind to Hgb with an affinity of 210-250
Inhibits Cytochrome oxidase
Binds to Myoglobin
105
Net Effects of CO
Tissue Hypoxia
Anaerobic Metabolism
Lactic Acidosis
106
A normal non-smoking adult has COHb level of ?
107
Smokers has COHb level of
5-10 % depending on the habit
108
CO is excreted through what organ ?
Lungs
109
At room air the CO half life is
4 to 6 hrs
110
Half life of CO when breathing 100% O2
40-80 mins
111
Half Life of CO with Hyperbarci O2 therapy
15-30mins
112
Principle signs of CO intoxication
Hypoxia
113
Clinical Presentation of CO poisoning
1. Psychomotor Impairment
2. Headache and tightness of the terporal area
3. Confusion and Loss of Visual Activity
4. Tachycardia , Tachypnea , syncope and coma
5. Deep coma , convulsion , shock and respiratory failure
114
Give the COHb % and Estimated CO concentration with these symptoms None or Mild Headache
5% , 35 ppm
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Give the COHb % and Estimated CO concentration with these symptoms Slight headache dyspnea on vigorous exertion
10% , 50ppm ( 0.005%)
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Give the COHb % and Estimated CO concentration with these symptoms throbbing headache dyspnea with moderate exertion
20% , 100ppm ( 0.01%)
117
Give the COHb % and Estimated CO concentration with these symptoms Severe headache, irratability, fatigue , dimness of vision
30% , 200ppm (0.02%)
118
Give the COHb % and Estimated CO concentration with these symptoms Headache , Tachycardia, Confusion , Lethargy , Collapse
40-50% , 300-500ppm
| ( 0.03% - .05% )
119
Give the COHb % and Estimated CO concentration with these symptoms Coma, Convulsion
60-70% ,
| 800ppm-1200ppm(0.08%-.12%)
120
Give the COHb % and Estimated CO concentration with these symptoms rapidly fatal
80% , 1900ppm ( .19%)
121
Immediate Dangerous to Life or Death in CO is
1500ppm ( .15%)
122
Several exposure to 1000ppm or .1% may result to what
50% saturation of COHb and fatal Poisoning
123
Dx in CO poisoing
History of Exposure
Cherry Red skin
Bright red venous blood
Measurement of COHb
124
Specific drug and antidote in CO poisoning
Administer OXYGEN in the highest possible concentration
125
CO poisoning Enhance elimination
Hyperbaric Oxygen which provides 100% OXYGEn under 2-3 atm pressure
126
4 Synonyms of HCN
1. CYCLON
2. Formonitrile
3. HDNC Hydridonitridocarbon
4. Hydrocyanic Acid (prussic)
127
Mechanism of Toxicity in HCN
1. Binds to the Cytochrome A and by inhibiting reoxidation
2. Inhibit Electron Transport
Prevents cellular respiration and Decrease ATP production
3.Produce severe metabollic acidosis
4. Cyanohemoglobin which cannot transport oxygen
128
Clinical Presentation
```
Initially ( Tachypnea )
Respiratory depression and cyanosis
Hypotension
Convulsion
Coma
Death will occur in minutes at signifcant amt.
```
129
A treatment for HCN poisoning using inhalation
Amyl Nitrite
130
A treatment for HCN poisoning using Intravenous administration
Sodium thiosulfate and Sodium nitrite
131
A treatment for HCN poisoning using Oral administration
Hydroxycobalamine
132
Odor of Formaldehyde
Pungent Odor
133
how much concentration of Formalin is there as disinfectant and tissue fixativee
37-40%
134
Formalin as a Disinfectant and tissue fixative contains how many concentrations of methanol
6-15%
135
In Formalin methanol acts as
Stabilizer
136
Give 5 Uses of Fomarldehyde
1. Use as disinfectant in hemodialyzers
2. Sporocidal
3. Preparation of Vaccines
4. Preservatives
5. Irritant
137
Mechanism of Toxicity of Formaldehyde
Causes precipitation of proteins and will cause coagulation necrosis in exposed tissue
138
PEL of Formaldehyde
1ppm
139
IDLH of Formaldehyde
2ppm
140
How much vol will it take to result death in 37% formalin
30ml
141
Formate intoxication due to formaldehyde alone be given with _____
Folic Acid
142
What causes cutaneous bullae
Barbiturates and CO poisoning
143
What causes diaphoresis
Organophosphate , salicylates , and amphetamine toxicity
144
what causes flushing
alcohol , CN and CO
145
what causes dry skin and hyperpyrexia
atrophine , anticholinergic agents
