Flashcards in Toxicology I Deck (76):
What are most poisons produced by?
What type of medications produce the greets number of poisons?
What do street drugs rank on the poisons list?
What are the most common non-medication toxicities from?
household cleaning products
Are people actually worried more about lower risks than higher ones?
What are the 2 main goals of toxicology?
1. protection of humans and the environment
2. development of better selective toxicants.
What was paracelsus major statement in terms of toxicology?
All substances are poison, there is none which is not a poison. The right dose differentiates a poison from a remedy.
[1. tried to experiment with toxins
2. tried to distinguish dose ranges
3. requested that active ingredients be extracted to have better and stronger effect]
Is poison a quantatative or qualitative concept?
What is the most lethal toxin?
What is the most lethal manmade toxin?
How many children die each year of unintentional poisoning? leading cause of death?
More than 45,000 (5-17 age) 5th leading cause of injury death
How man unintentional poisoning deaths in the US. in 2014
11.6 per 100,000
T-F--trends of deaths by poison has been falling? motor vehicle accidents?
When does rates of poisoning deaths jump up according to age?
late teens, 20
drops off at 60
highest at 50
Poisoning in young children <5 is most likely caused by what? 2nd cause? 3rd?
Parents medications (over half)
How many of adolescent poisonings are intentional, either as a suicide or substance abuse?
In adults what poisons far outnumber street drugs?
What is the percentage of unintentional poisoning in hospitals by drugs?
What is risk in terms of toxicology?
The probability or likelihood of adverse effects occurring
Is smoke plum or alcohol exposure voluntary? under own control? known risks? common risks? immediate adverse effects? consequences reversible?
5. Alcohol but both can be or not be
6. Alcohol, but both can be or not be.
IS poisoning a growing problem?
What is the 3 step approach to risk prevention?
1. Hazrd Identification and analysis
2. Risk Assessment
3. Risk Management
T-F- inhalation exposure is easy to avoid?
4 key air pollutants?
CO, SOx, NOx, Ozone
Air pollution is a risk factor for what 2 things?
cardiac death and pulmonary conditions
How many US people live in areas with pollutant concentrations deemed unsafe?
What two air pollutants are asphyxiants?
What air pollutants are irritants?
SMOG-OZONE, aldehydes, particles, hydrocarbons
What are the 6 criteria pollutants?
Where does SOx come from?
fossil fuel power plants>>>industry
Where does NOx come from?
Fossil fuel power plants>vehicles
Where does CO come from?
Where does PM come from?
Fires, fossil power plants, industry
Order the air pollutants that cause more severe Acute respiratory health effects
SOx > PM >NOx > CO
Is CO irritanting?
No- there is really no way of knowing
What is CO a result of ?
incomplete combustion with too little oxygen
What is the most abundant pollutant in the lower atmosphere
Death rates of CO are higher in what populations?
Men, blacks, 15-24, and elderly
What states is CO poisoning higher in?
N. and Midwest
T-F-- most CO deaths in garages occur even with doors or windows open?
Is CO hemoglobin reversible?
Yes, but affinity is 220 times greater
If you add .1% if CO in the air, what would be the carboxylhemoglobin percentage?
Obviously in CO poisoning hypoxia is a problem, but what occurs when there is altered dissociation characteristics of oxyhemoglobin?
decreased oxygen release in tissues= cellular asphyxia
Where are the 1st effects of CO?
brain and heart where the demand is high
What binds CO more avidly than hemoglobin A? Why?
Fetal hemoglobin, maternal shift of O2 to the left
What are the main symptoms of mild and medium CO exposure?
Headaches that get worse and then unconsciousness etc.
Why do we get severe headache in CO poisoning?
edema and up intracranial pressure
We know we get heart damage with CO, but do we get congestion and hemorrhages elsewhere?
Yes, in all organs
T-F--CO poisoning is marked by delayed neuropsych impairment?
review the pathology of acute CO poisoning
congestion and hemorrhaging all over
delayed neuropsych impairment
delayed encephalopathy due to autoimmune
What are the symptoms of chronic exposure of CO?
headache- everyone in family
[may be misdiagnosed as influenza, other tips, morning headache in multiple members of family.
What are the CO effects on ST changes?
earlier and longer lasting ST changes
With CO is there a lower threshold for arrhythmias?
Can pulseox detect HbCO?
What lab diagnosis do we usually do for CO? 2
Carboxyhemoglobin- co-oximeter/blood sampling. be aware of time of exposure and measurement
What is Tx for CO?
fresh air, O2 100%, hyperbaric, correct hypotension and acidosis
Do many victims of CO have subtle memory problems after recovery?
yes about 1/3
11% have long term neurpsych problems
Is tobacco smoke a major cause of CO poisoning?
What is a major problem of sulfur dioxide with moisture?
conversion to acids--> acid rain, pH change of soil, metal leaching
IS SO2 water soluble? what does this mean
Yes-->damage in upper airways
heavy breathing may lead to damage in lower airways
Air SO2 levels are in strong association with what?
At 3ppm of SO2, what happens
You can smell it!
50-100 max tolerable dose for 30-60 min
What are the 6 acute affects of SO2?
irritation, cough, burning, lacrimation, difficulty, swallowing
What are the long-term effects of SO2?
Aggravation of chronic cardiopulmonary disease
children- reduced lung function and up respiratory infections
What is the pathophysiology of SO2? leads to what?
sulfur dioxide+moisture--> sulfurous acid (irritation, inhibition of mucociliary transport, vagal stim, constriction)
What is a major treatment of SO2?
Removal from source (no jogging on bad days)
support airway and breathing
What color is NO2?
brownish and highly reactive
What is NO2 a major source of?
NO2+ O2 + light--> NO + O3
Is NO2 water soluble? what does this mean?
Not really, penetrates deep into the lung
What is a very potent respiratory tract toxin? features?
brinchitis, pneumonia, hemorrhagic pulmonary edema, alvolar damage
What is the pathophys of NOx?
lipid peroxidation, decreased ciliary movement, bronchoconstriction, enzyme inhibition
What color is ozone?
bluish, slightly pungent odor
Is ozone soluble? What does this mean?
penetrate deep into the lung
What is the pathophys problem of O3?
forms hydroxy radical--> per oxidation of lipids and oxidation of thiols, amines, proteins
In the stratosphere, ozone problems due to decrease halogenated hydrocarbons leads to what?
UV exposure, skin cancer