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Flashcards in Toxicology Deck (51):
1

Cadmium

Targets kidneys, lungs, CV
Chelation

2

Methanol

Metabolism = Formeldehyde
Metabolic Acidosis
Neurotoxicity - Retina/Optic Nerve (BLIND)
Pancreatitis

TX: Lavage w/ bicarbonate, Ethanol, Fomepizole

Hemodialysis if blood levels exceed 50 mg/dL

3

Symp: Intoxication (30 min), Metabolic Acidosis (12-24 hr), OLIGURIC Renal failure (72 hr)

Metabolism = Oxalate

TX: Lavage w/ bicarbonate, Ethanol, Fomepizole

Ethylene Glycol

4

MOA: Binds sulfhydryl groups

Fatal = 120 mg

Arsenic

5

Chlordane, DDT, Lindane

Insecticides - Chlorinated Hydrocarbons
MOA: Ion channels Na+ and Ca2+

Symp: CNS stimulation --> Tremors and then Convulsions

6

Sulfur Oxide

MOA: Forms sulfurous acid on contact with mucous membranes --> Thickens mucus

Symptoms: Bronchospasms, Asphyxiation

TX: Remove source

7

MOA: Potent oxidizer

Symptoms: Irritation, inflammation

TX: Remove source

Ozone

8

Nitrogen Oxide

Brownish irritant gas (combustion)

Symptoms: Pulmonary edema

TX: Remove/manage

9

Brownish irritant gas (combustion)

Symptoms: Pulmonary edema

TX: Remove/manage

Nitrogen Oxide

10

Ethanol

Metabolism: Alcohol Dehydrogenase --> Acetaldehyde

Symp: CNS depression, gastritis, pancreatitis, feminization of males, inhibits ADH/oxytocin secretion

TX: Supportive, Hemodialysis effective but invasive, Disulfiram (alcoholics)

11

Carbamates

Insecticides - Carbaryl, Baygon

Reversible AChE inhibitors

TX: Decontaminate, support. Atropine
*pralidoxamine = contraindicated

12

Mercury

Elemental = vapor, lungs
Organic = skin
Inorganic = GI

Symp: "Mad Hatter"

MOA: Covalent bonds with sulfhydryl groups

TX: Dimercaprol (IM), D-Penicillamine, Succimer

13

Iron

Symp: Corrosive to GI Tract
1. Watery diarrhea with strips of mucosa
2. Quiescent period (6-12 hrs)
3. Acidosis, pulmonary edema, cyanosis
4. Hepatic necrosis

TX: Milk + Vomit, Lavage, DEFEROXAMINE

14

Symp: CNS depression, gastritis, pancreatitis, feminization of males, inhibits ADH/oxytocin secretion

TX: Supportive, Hemodialysis effective but invasive, Disulfiram (alcoholics)

Ethanol

15

Propylene Glycol (PEG)

Food additive (daily intake 34 mg/kg)
Tasteless metabolized to lactic acid

16

Pyrethrins

Insecticides - Fatal oral dose = 50 g

MOA: Targets Na+ ion channels

Symp: Contact dermatitis, asthma, CNS excitation

17

MOA: Blocks synthesis of aromatic hydrocarbons

Glyphosphate

18

Aromatic Hydrocarbons

Benzene, Toluene

MOA: CNS depression

Acute = euphoria, locomotive problems, coma/death
Chronic = Aplastic anemia, pancytopenia, increased risk of leukemia

*Toluene - no myelotoxicity

19

Metabolism = Formeldehyde
Metabolic Acidosis
Neurotoxicity - Retina/Optic Nerve (BLIND)
Pancreatitis

TX: Lavage w/ bicarbonate, Ethanol, Fomepizole

Hemodialysis if blood levels exceed 50 mg/dL

Methanol

20

Amyl Sodium Nitrate - Methemoglobin
Add thiosulfate
Hydroxycobalamin

Cyanide Treatment

21

Lead Treatment

IV EDTA (!!!) - chelates but MUST be given IV because oral will enhance absorption
Succimer - oral chelating agent
Dimercaprol (IM) - in severe poisoning

22

MOA: High affinity for Hgb

Symp: Headaches, nausea, malaise, arrythmias, dyspnea, myonecrosis, renal failure

TX: 100% O2. Decreasing half life under hyperbaric conditions

Carbon Monoxide

23

MOA: CNS depression

Acute = euphoria, locomotive problems, coma/death
Chronic = Aplastic anemia, pancytopenia, increased risk of leukemia

Aromatic Hydrocarbons
Benzene, Toluene

*Toluene - no myelotoxicity

24

Ethylene Glycol

Symp: Intoxication (30 min), Metabolic Acidosis (12-24 hr), OLIGURIC Renal failure (72 hr)

Metabolism = Oxalate

TX: Lavage w/ bicarbonate, Ethanol, Fomepizole

25

Lines on bones/gums

Lead

26

Nickel

Contact dermatitis, carcinogen
Chelation

27

Insecticides - Reversible AChE inhibitors

TX: Decontaminate, support. Atropine
*pralidoxamine = contraindicated

Carbamates
Carbaryl, Baygon

28

Carbon Tetrachloride, Chloroform

Symp: CNS depression, Liver/Cardiotoxicity

TX: Manage based on organ system involved

29

Symp: "Mad Hatter"

MOA: Covalent bonds with sulfhydryl groups

TX: Dimercaprol (IM), D-Penicillamine, Succimer

Mercury

30

Chromium

Nephrotoxic, carcinogen

31

Lead

Paint, gasoline
MOA: Binds to RBCs and is distributed systemically. Binds sulfhydryl groups of proteins
Interferes with Ca2+, Zn2+, iron

Lead line on bones/gums, encephalopathy, anemia

TX: IV EDTA (!!!) - chelates but MUST be given IV because oral will enhance absorption
Succimer - oral chelating agent
Dimercaprol (IM) - in severe poisoning

32

Arsenic

MOA: Binds sulfhydryl groups

Fatal = 120 mg

33

Agent Orange

Chloropenoxy Compounds

Toxicity may be due to dioxin contaminant (TCDD)

Symp: Severe dermatitis, Neurological problems

34

Paraquat

High mortality from accidental poisoning

GI symp: Vomiting, burning, renal/hepatic failure
Delayed pulm: Massive Fibroblast proliferation

TX: Lavage, hemodialysis
Steroids and Cyclophosphamide

35

Cyanide

MOA: Blocks Complex IV of electron transport chain

Venous blood bright red

TX: Amyl Sodium Nitrate - Methemoglobin
Add thiosulfate
Hydroxycobalamin - form cyanocobalamin

36

Symp: Severe dermatitis, Neurological problems

Agent Orange
Chloropenoxy Compounds

37

Food additive (daily intake 34 mg/kg)
Tasteless metabolized to lactic acid

Propylene Glycol (PEG)

38

Symp: Corrosive to GI Tract
1. Watery diarrhea with strips of mucosa
2. Quiescent period (6-12 hrs)
3. Acidosis, pulmonary edema, cyanosis
4. Hepatic necrosis

TX: Milk + Vomit, Lavage, DEFEROXAMINE

Iron

39

Halogenated Aliphatic Hydrocarbons

Carbon Tetrachloride, Chloroform

Symp: CNS depression, Liver/Cardiotoxicity

TX: Manage based on organ system involved

40

Carbon Tetrachloride, Chloroform

Symp: CNS depression, Liver/Cardiotoxicity

TX: Manage based on organ system involved

Halogenated Aliphatic Hydrocarbons

41

High mortality from accidental poisoning

GI symp: Vomiting, burning, renal/hepatic failure
Delayed pulm: Massive Fibroblast proliferation

TX: Lavage, hemodialysis
Steroids and Cyclophosphamide

Paraquat

42

Organophosphates

Parathion, Malathion, Echiothiophate, TPP, Dichlorvos

MOA: Irreversible AChE inhibitor
Symptoms: SLUDGEM

TX: Atropine - treat muscarinic symptoms
Pralidoxamine - AChE reactivator, must be give w/in 24 hrs

43

Carbon Monoxide

MOA: High affinity for Hgb

Symp: Headaches, nausea, malaise, arrythmias, dyspnea, myonecrosis, renal failure

TX: 100% O2. Decreasing half life under hyperbaric conditions

44

Glyphosphate

Roundup

MOA: Blocks synthesis of aromatic hydrocarbons

45

Symptoms: SLUDGEM

TX: Atropine - treat muscarinic symptoms
Pralidoxamine - AChE reactivator, must be give w/in 24 hrs

Organophosphates
Parathion, Malathion, Echiothiophate, TPP, Dichlorvos

46

Ozone

MOA: Potent oxidizer

Symptoms: Irritation, inflammation

TX: Remove source

47

Particulate Matter

Silicosis, Asbestosis
MOA: Inflammation and scarring of lungs

Symptoms: Delayed mesothelioma, dyspnea, tachypnea, Bronchial cancer

48

MOA: Forms sulfurous acid on contact with mucous membranes --> Thickens mucus

Symptoms: Bronchospasms, Asphyxiation

TX: Remove source

Sulfur Oxide

49

Cyanide Treatment

Amyl Sodium Nitrate - Methemoglobin
Add thiosulfate
Hydroxycobalamin

50

Silicosis, Asbestosis
MOA: Inflammation and scarring of lungs

Symptoms: Delayed mesothelioma, dyspnea, tachypnea, Bronchial cancer

Particulate Matter

51

MOA: Targets Na+ ion channels

Symp: Contact dermatitis, asthma, CNS excitation

Pyrethrins
Insecticide