Toxicology

Question 1

What is toxicology?

Answer 1

Subtopic that covers their

• detection
• effects
• properties
• regulation

Question 2

What does it mean that poisoning is situational, and quantitative in nature?

Answer 2

Any substance can be harmless or toxic depending on when given, and the dose

Question 3

What are the two factors that determines if a drug is poisonous?

Answer 3

Dose

Duration of exposure

Question 4

What are the two reasons to study toxicology?

Answer 4

Protect humans from toxicants

Improve toxicants (abx, pesticides)

Question 5

What are the common poisons in children less than 5 yo?

Answer 5

Plants
Cosmetics
Salicylates
Acetaminophen

Question 6

What are the common poisons in adults?

Answer 6

Barbs
CO
Salicylates
Narcs
Insecticides

Question 7

What is the LD 50?

Answer 7

Dose at which 50% of the animals tested die

Question 8

Legally, a poison is defined at what LD 50?

Answer 8

Less than 50 mg/kg

Question 9

What is the Therapeutic index? A larger number indicates what?

Answer 9

LD50 / ED50

Larger = safer

Question 10

What is the average lethal dose calculated from?

Answer 10

Estimated from accidental deaths in humans

Question 11

What is the primary determinant of toxicity?

Answer 11

Dose

Question 12

What are the three rapid measures that need to be considered with an overdose/poisoning?

Answer 12

Airway
Breathing
Circulation

Question 13

After ABCs are accounted for, what is the next step in an overdose?

Answer 13

Reduce/remove the drug

Question 14

What is the drug used for acute overdose?

Answer 14

Naloxone

Question 15

What are the two things to consider with an unconscious patient?

Answer 15

Glucose/insulin

Naloxone

Question 16

What is the major issue with trying to identify a poison?

Answer 16

Time

Question 17

What are toxidromes?

Answer 17

Comparison of drug or chemical responses of the patient with known toxicology standards

Question 18

What are the two major urine tests?

Answer 18

EMIT
ELISA
TLC

Question 19

What are the two emesis inducers that can be used?

Answer 19

Apomorphine

Syrup of Ipecac

Question 20

What are the two major contraindications for emesis inducers?

Answer 20

Petroleum hydrocarbon solvents d/t chemical pneumonitis

Caustic acid or alkali agent (rupture)

Question 21

What is gastric lavage?

Answer 21

NG tube passed and suction applied

Question 22

When is activated charcoal indicated?

Answer 22

Caustic agents and petroleum

Question 23

What is the MOA of activated charcoal?

Answer 23

Very large surface area, allows for binding or organic toxicants which prevents absorption

Induces emesis

Question 24

How soon should charcoal be administered following ingestion of the poison?

Answer 24

30 minutes

Question 25

Why should charcoal not be given with other drugs used to treat poisoning?

Answer 25

Will reduce their effectiveness

Question 26

What is the MOA of pralidoxime (2-PAM)?

Answer 26

nucleotide reagent that covalently binds to organophosphates and permits rapid excretion

Question 27

What are pralidoxime usually administered with? Why?

Answer 27

Atropine to block muscarinic effects of parasympathetic nervous system

Question 28

What is the MOA of cyanide? What systems are primarily affected?

Answer 28

Binds to and deactivates cytochrome C oxidase. CNS and cardiac tissue are particularly affected

Question 29

What is the LD50 for cyanide? How long does this take to cause death?

Answer 29

2 mg /kg | 1-15 minutes

Question 30

What is the antidote for Cyanide poisoning? MOA?

Answer 30

Amyl nitrate and NaSO4 with O2 Combines with CN to form nontoxic cyanmethemoglobin

Question 31

What is the MOA of botulinum?

Answer 31

Prevents ACh release from nerve terminals

Question 32

What is the antidote to botulinum toxin?

Answer 32

Ab towards botulinum

Question 33

What is the cause of death with botulinum poisoning?

Answer 33

respiratory arrest

Question 34

What are the chelators that can be used in heavy metal poisoning?

Answer 34

EDTA DMSA Deferoxamine

Question 35

What are the heavy metals that can be chelated?

Answer 35

``` Hg Pb As Fe Ag ```

Question 36

What is DMSA, succimer usually used for?

Answer 36

Ar, Hg or Pb poisoning

Question 37

What is the dosage for DMSA (succimer) for kids greater than 12 yo? Less than 12?

Answer 37

10 mg/kg PO for 5 days Same + q12 hours for 14 days after

Question 38

What is the morphology of C. botulinum?

Answer 38

Gram positive drumsticks

Question 39

What is the dose of trivalent antitoxin?

Answer 39

10 ml vial per pt

Question 40

What is used for CN poisoning? MOA?

Answer 40

sodium nitrite | Oxidize a portion of the Hb Fe from the ferrous state to the farric state, converting the Hb into methemoglobi

Question 41

What is the use and MOA of sodium thiosulfate?

Answer 41

Reacts with Cyanmethhemoglobin

Question 42

What is the antidote for alcohol (isopropyl or ethylene glycol) poisoning?

Answer 42

EtOH + dialysis

Question 43

Methanol is converted into what via what enzyme?

Answer 43

Formaldehyde | Alcohol dehydrogenase

Question 44

What is the MOA of fomepizole?

Answer 44

Blocks alcohol dehydrogenase

Question 45

What are the major toxic effects of methanol/ethylene glycol

Answer 45

Renal failure | Blindness

Question 46

CO has a (__)x greater affinity for Hb than O2.

Answer 46

210

Question 47

What is the treatment for CO poisoning?

Answer 47

Artificial respiration with pure O2. Maybe hyperbaric O2.

Question 48

What is the telltale sign of CO poisoning?

Answer 48

HA, lethargy, cherry red skin

Question 49

What is the normal percent of carboxyHb?

Answer 49

2.5% of all Hb for nonsmokers 7-10% of smokers

Question 50

What is the treatment for Warfarin Overdose?

Answer 50

Vitamin K, prothrombin complex or fresh frozen plasma