Toxicology

Question 1

Acute toxicity

Answer 1

ability of substance to cause severe biological harm/death soon after single exposure

Question 2

Chronic toxicity

Answer 2

adverse effects as a result of repeated chemical dosing on a daily basis or exposure to chemical for majority of lifespan

Question 3

LD50

Answer 3

dose at which 50% of animals tested die

Question 4

Legally poisonous

Answer 4

LD50

Question 5

TI

Answer 5

Therapeutic Index
LD50/ED50
larger number = safer drug

Question 6

Emesis inducing agents

Answer 6

Apomorphine

Syrup of Ipecac

Question 7

Contraindications of emetic treatment

Answer 7

Petroleum hydrocarbon - chemical pneumonitis

Caustic acid/alkali - rupture

Question 8

Use of activated charchoal

Answer 8

very large SA for binding of organic toxicants preventing absorption

Question 9

Cathartics

Answer 9

promote rapid movement/elimination of poison through GI tract

Question 10

Antidote of Organophosphate poisoning

Answer 10

Pralidoxime

Atropine

Question 11

Symptoms of organophosphate poisoning

Answer 11

paralysis of diaphragm

Question 12

Cyanide mechanism

Answer 12

deactivates cytochrome c
cell can no longer produce ATP
affects CNS/cardiac tissue
LD50 = 2mg/kg (1-15 min)

Question 13

Antidote of cyanide poisoning

Answer 13

amyl nitrate (inhaled)
sodium nitrate (IV)
sodium thiosulfate with O2 (IV)
whole blood

Question 14

Symptoms of botulinum poisoning

Answer 14

Paralysis

respiratory depression

Question 15

Treatment of botulinum poisoning

Answer 15

ABCs, lavage, emesis, charcoal, antitoxin

Question 16

Botulinum antitoxin

Answer 16

antibodies against botulinum toxin

single dose - 10ml

Question 17

Heavy metal treatment

Answer 17

BAL

DMSA - primary

Question 18

DMSA as treatment

Answer 18

Indication - arsenic, mercury, lead
Adverse rxn - chills, fever, diarrhea
Adults - 10 x 8hrs for 5 days
Kids - 10 x 8 hrs for 5 days plus 10 x 12 hrs for 14 days

Question 19

Alcohol poisoning

Answer 19

normal ethanol metabolic enzymes convert other alocohols into poisonous byproducts

Question 20

Treatment of alcohol poisoning

Answer 20

Competitively bind enzyme with more alcohol

Fomepizole - blocks alcohol dehydrogenase

Question 21

CO poisoning

Answer 21

210x greater affinity for Hb than O2

40-60% may have a cherry red appearance

Question 22

CO treatment

Answer 22

artificial respiration with pure O2

Hyperbaric chamber if sypmtomatic

Question 23

Warfarin poisoning treatment

Answer 23

Vitamin K

Question 24

Opioid poisoning treatment

Answer 24

Competitive blockers
Naloxone - fast action; short duration
Naltrexone - slower but longer duration

Question 25

Methemoglobinemia

Answer 25

heme iron is in ferric state - cannot transport oxygen

Question 26

Methemoglobinemia treatment

Answer 26

methylene blue | chemical reducer

Question 27

Sympathomimetic toxidrome

Answer 27

``` CNS - agitation, hallucination, paranoia Respiratory - none Pupils - dilated Other - HTN, hyperthermia Drugs - cocaine, amphetamine, PCP ```

Question 28

Sedative toxidrome

Answer 28

``` CNS - stupor, coma Respiratory - decreased/failure Pupils - constricted/dilated Other - hypotension, hypothermia Drugs - alcohol, barbiturates, benzodiazepines ```

Question 29

Opioid toxidrome

Answer 29

``` CNS - coma Respiratory - decreased/failure Pupils - miosis Other - opiate triad ^ Drugs - opiates, morphine, codeine, oxy ```

Question 30

Anticholinergic toxidrome

Answer 30

CNS - agitation Respiratory - none Pupils - mydriasis Other - fever, dry skin, urinary retention Drugs - anticholinergics, antidepressants

Question 31

Cholinergic toxidrome

Answer 31

``` CNS - coma Respriatory - none Pupils - miosis Other - fasciculation, incontinence, bradycardia Drugs - organophosphates ```

Question 32

Tricyclic antidepressant toxidrome

Answer 32

``` CNS - coma, agitation Respiration - none Pupils - dilatd Other - dysarrhythmias, convulsions Drugs - TCAs ```

Question 33

Salicylate toxidrome

Answer 33

``` CNS - variable Respriation - maybe increase Pupils - none Other - diaphoresis, tinnitis, agitation, acidosis Drugs - aspirin ```