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Toxicology Flashcards

(85 cards)

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1
Q

Aspirin MOA

A

uncoupling of oxidative phosphorylation –” icnreased Co2

icnreased heat production

ketone bodies

increased pyruvate and lactate

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2
Q

symptoms of aspirin

A

n/v, fever, tachypnea

fluid loss and dehydration
tinnitus
mixed resp alklaosis and increased anion gap metabolic acidosis

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3
Q

death from aspirin = ?

A

respiratory failure due to central respiratory paralysis

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4
Q

tx of aspirin

A

IV sodium bicarbonate = acidosis and at severe - hemodialysis

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5
Q

acetaminophen death?

A

fulminant liver failure – hepatic encephalopathy and death

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6
Q

tx of acetaminophen?

A

NAC and liver transplant with fulminant hepatic failure

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7
Q

list the amphetamines and other stimulants

end in E

A 
methamphetaminE
methylenedioxymethamphetaminE
cocainE
pseudoephedrinE
ephedrinE
phenylpropanolaminE
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8
Q

sxs of amphetamines and stimulants at usual doses

A

euphora
wakefulness
sense of power
sense of well being

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9
Q

sx of amphetamines and stimulants at higher doses

A

agitation

acute psychosis

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10
Q

o/d of amphetamines and stimulants = ?

A

tachyarrhtymias

seizures and muscular hyperactivity – hyperthermia and rhabdomyolsis

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11
Q

~~~pupils dilated with warm and sweaty skin

A

amphetamines and stimulants

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12
Q

treatment of amphetamines and other stimulants

A

symptomatic only. no specific antidote

  • ammonium chloride* acidification of urine
  • phentolamine or nitroprusside - HT
  • propanolol or esmolol - tachyarrhthymias
  • benzos - seizures
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13
Q

List drugs that have anticholinergic effects

A

anticholinergics
antihistamines
antidepressnats TCAs
antipsychotics

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14
Q

a/se of antihistamines

A

anticholinergic – seizures

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15
Q

a/se of TCAs

A

anticholinergic – CV toxicity

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16
Q

typical presentation of anticholinergic

A

red as a beet - skin flushed
hot as a hare - hyperthermia
dry as a bone - no sweating and dry mucous membranes
blind as a bat – blured vision, cyclopledia, pupillary dilation
mad as a hatter - condusion delirium, tachycardia

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17
Q

treatment of anticholinergics

A

pysostigmine

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18
Q

treatment of TCA overdose

A

so not give physostigmine bc will aggravate cardiotoxicity

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19
Q

most toxic beta blocker

A

propranolol bc at high doses it blocks Na channels

lipophilis and enters the CNS causing seizures and coma

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20
Q

sx of beta blocker

A

bradycardia
hypotension

seizures and cardiac conduction block bc lipophilic and blocks Na channels

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21
Q

tx of bb blocker

A

IV glucagon – increases cAMP

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22
Q

CCB overdose

A

Ca IV
glucagon
epinephrine
to icnreased BP at refractory hyptension

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23
Q

symptoms of TCA

A

antag at muscarnic - mad, hot, blind, dry
alpha blockers - vasodilation
quinidine like depressnat at heart - block na channels - slow conduction and depress contractility

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24
Q

treat TCA overdose

A

NE for hypotehsnion and sodium bicarbonate

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25
MAOi symptoms
severe hypertension reactions when with tyramine foods or drugs like phenylpropnaolamine or ephedrine
26
treat MAOi
phentolamine or labetolol
27
what is serotonin syndrome
MAOI with a serotenergic agent --> overstimulation with 5HT1a and 5HT2 receptors
28
sxs of serotonin syndrome
hyperthermia muscle rigidity myoclonus hyperreflexia
29
treatment of serotonin syndrome
cyproheptadine 5HT2 antag benzos - rigidity, serizures, agitation
30
Neuroleptic malignant syndrome caused by
antipsychotics
31
sx of neuroleptic malignant syndrome
``` muscle ridigity hyperthermia metabolic acidosis confusion FEVER F: fever E: encephalopathy V: vitals unstable E: elevated enzymes R: rigidity of muscles ```
32
tx of neuroleptic malignant syndrome
bromocriptine and dantroline
33
O/d sxs of opioids
letaryg small pupils bp and pulse decrease
34
higher dose o/d opioids
coma respiratory depression apnea
35
treatment of opioids
maintain vitals naloxone nalmefene
36
what is the most common side effect of sulfonylureas and meglitinides?
hypoglycemia
37
how to treat sulfonylureans and meflinitides
glucose bolus IV octretoide - antagonizes insulin release OR diazoxide - antagonize insulin release
38
CO + Hb
carboxyhemoglobin | LEFT SHIFT
39
sx of Co poisoning
headache and tightness in temporal region | death - respiratory paralysis
40
tx of CO
100& O2 hyperbaric
41
Ethanol sxs
disinhibition, lethary, ataxia, impaired judgement, stupor, coma, death
42
ethanol signs
hypoglycemia hypothermia increased anion gap metabolic acidosis
43
tx ethanol
prevent aspiration thiamine IV dextrose correct electrolytes
44
Methanol is found where?
paint solvent photocopying fluid windshield washing fluid
45
what is methanol metabolized to?
formaldehyde
46
consequences of methanol
acidosis retinal damange blindness death - sudden cessation of respiration
47
tx of methanol
ethanol @ oh dehydrogenase fomepizole - inhibits alcohol dehydrogenase bicard hemodialysis
48
Ethylene glycol source
antifreeze
49
ethylene is metabolized to?
aldehydes adn oxalate
50
consequences of ethylene
severe acidosis | renal dmage
51
treatment of ethylene
ethanol | fomepizole
52
a high osmolar gap suggests poisoning with?
methanol | ethylene glycol
53
toxicity from cholinesterase inhibitors found @ whom?
suicidal work exposure terrorist attack
54
sxs of muscarinic overactivation like organophosphates
``` DUMBELS: D - diarrhoea U - urination M - miosis B - brady cardia an dbronchoconstriction E - emesis L - lacrimation S - salivation and sweating ```
55
signs of nicotinic overactivation @ organophosphates
hypertension, tachy or brady muscle twicth and fasiculations most common cause of death is resp paralysis
56
treatment of organophosphates
atropine and pralidoxime
57
treatment of carbamate insecticides
atropine only bc short lived and spontaneously reversible no pralidoxime
58
sources of cyanide
plastic, jewelry, wool, silk, cassave and apricot seed
59
cause of death @ cyanide
respiratory arrest
60
MOA cyanide
high affinity for Fe3+ -- binds heme of cytochrome a, a3 = O2 cant act as final acceptor in the ETC -- CYTOTOXIC HYPOXIA - lactic acidosis
61
treatment of cyanide
provide a large pool of ferric iron to compete for cyanide
62
compnent of cyanide antidote kit
amyl nitrite pearls sodium nitrite sodium thiosulfate
63
how do the components of the cyanide antidote kit work?
nitrites oxidze Hb to methemoglobin (prilocaine) --> forms cyanmethemoglbin and cytochrome oxidase is restored
64
how does thiosulfate help cyanide antidote style?
thiosulfate donates sulger that then makes cyanmethemoglobin thiocyante and methemoglobin by rhodanese --> pee out thicyanate
65
what does methylene blue do?
restores methemoglobin to ferrous form
66
how does hydroxocobalamin help wtih cyanide poisoning?
reacts with cyanide to yield cyanocobalamin (precursor of B12) better because no metemoglobin
67
source of lead
ammunition lead miners battery manufacturers lead containing pain
68
sx of acute lead poisoning
abdominal colic and CNS changtes
69
sx of acute lead poisoning
plumbism peripheral neuropathy - tremor, anaemia, anorexia, weight loss gi symptoms normocytic/microcytic and hypochromic anaemai delta ALA dehydratase and ferrochetlase a
70
treat lead poisoning
diazepam - seizures mannitol and dexamethasone - cerebral oedema chelation - EDTA , dimercaprol siccimer
71
What are you treating? diazepam, manntiol, dexamethasoen, EDTA, dimercaprol, succimer
lead poisoning
72
arsenic
contaminated wine or moonshine and water of fodo contamination - shell fish and other seafood
73
i say diarhhoea ricewater stools and sweet garlicky breath
acute inorganic arsenic poisoning
74
sx or arsine gas
massive hemolysis
75
sxs of chronic organic arsenic poisonings
skin changes cancer RAINDROP
76
MOA arsenic
trivalent react wtih SH uncouple oxidative phosphoylation hemolysis by depleting glutathione in the rbc
77
tx of arsenic
unithiol | dimercaprol
78
MOA mercury
SH groups
79
source of mercury
battery thermometer barometer fish
80
symptoms of mercuric chloride
corrosive - hemorrhagic gastroenteritis
81
symptoms of chronic meurcry poisoning
classic triad 1) tremor 2) neuropsychiatric disturbances 3) gingivostomatis
82
mercury poisoning in children
acrodynia painful erythemia mil
83
treatment of mercury
unithiol and succimer | DO NOT USE DIMERCAPROL
84
iron symptoms
``` vomiting gi bleeding lethardy GRAY CYANOSIS gi necrosis ```
85
treatment of iron
deferoxamine

Pharmacology (70 decks)

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