Toxicology

Question 1

A molecule with 2 or more electronegative groups that can form stable coordinate complexes with multivalent cationic metal forms

Answer 1

CHELATING AHENT/CHELATOR

Dimercaprol
Succimer
Penicillamine
Edetate Calcium Disodium (EDTA)
Deferoxamine, Deferasirox, Deferipone

Question 2

Co-administered with EDTA in severe chronic lead poisoning

Answer 2

Dimercaprol

Question 3

Industrial exposures
Children who have ingested large quantities of chips or flakes of lead containing paint (PICA)

Peripheral neuropathy (WRIST DROP)

Anorexia, anemia, tremor, weight loss, GI symptoms

Answer 3

Chronic Inorganic Lead Poisoning (Plumbism)

TREATMENT:
removal from the source of exposure
chelation therapy
oral SUCCIMER in outpatients
EDTA +/- DIMERCAPROL
Dietary modification (high dietary calcium)

Question 4

Widely used in industrial processes

Released during BURNING OF COAL

Toxicity entirely d.t., trivalent form

SWEET GARLICKY ODOR IN BREATH AND STOOLS

Answer 4

Acute Arsenic Poisoning

TREATMENT:
Supportive
DIMERCAPROL - chelation therapy

Question 5

Widely used in industrial processes

Released during BURNING OF COAL

Toxicity entirely d.t., trivalent form

TRANSVERSE BANDS IN NAILS (MEE’S LINES)

SKIN CHANGES - raindrop, hyperpigmentation, milk and roses complexion, hyperkeratosis

Answer 5

Chronic Arsenic Poisoning

TREATMENT:
DIMERCAPROL - chelation therapy

Question 6

Consumption of fish or grains containing methylmercury

MINAMATA DISEASE - cerebral palsy, deafness, blindness, mental retardation

Answer 6

Organic Mercury Poisoning

Question 7

Ingestion of ferrous sulfate tablets

CHRONIC excessive intake – hemosiderosis or hemochromatosis

Answer 7

Iron Poisoning

TREATMENT:
DEFEROXAMINE - chelating agent of choice

Question 8

Delirium, hallucinations, seizures, coma, tachycardia, hypertension, hyperthermia, mydriasis, decreased bowel sounds, urinary retention

Answer 8

Antimuscarinic Poisoning

TREATMENT:
control hyperthermia
PHYSOSTIGMINE

Question 9

Anxiety, agitation, seizures, coma, bradycardia or tachycardia, pinpoint pupils, salivation, sweating, hyperactive bowel, muscle fasciculations, paralysis

Answer 9

Cholinomimetic Poisoning (Organophosphate poisoning)

TREATMENT:
support respiration
ATROPINE and PRALIDOXIME
decontaminate

Question 10

Pupillary constriction
Comatose state
Respiratory depression

Answer 10

Opioids poisoning

TREATMENT:
NALOXONE

Question 11

Coma
Hyperventilation
Acidosis/HAGMA
Fever
Seizures

Answer 11

Salicylates poisoning

TREATMENT:
correct acidosis and fluid and electrolyte imbalance
alkaline diuresis/hemodialysis to aid elimination