Flashcards in Toxicology I Deck (76):
1
What are most poisons produced by?
medication
2
What type of medications produce the greets number of poisons?
OTC analgesics
3
What do street drugs rank on the poisons list?
10th
4
What are the most common non-medication toxicities from?
household cleaning products
5
Are people actually worried more about lower risks than higher ones?
yes
6
What are the 2 main goals of toxicology?
1. protection of humans and the environment
2. development of better selective toxicants.
7
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]
8
Is poison a quantatative or qualitative concept?
Quant.
9
What is the most lethal toxin?
Botulinus Toxin
10
What is the most lethal manmade toxin?
TCDD dioxin
11
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
12
How man unintentional poisoning deaths in the US. in 2014
36,280
11.6 per 100,000
13
T-F--trends of deaths by poison has been falling? motor vehicle accidents?
False
True
14
When does rates of poisoning deaths jump up according to age?
late teens, 20
drops off at 60
highest at 50
15
Poisoning in young children <5 is most likely caused by what? 2nd cause? 3rd?
Parents medications (over half)
Cosmetics
Cleaning supplies
16
How many of adolescent poisonings are intentional, either as a suicide or substance abuse?
Over half
17
In adults what poisons far outnumber street drugs?
prescriptions
18
What is the percentage of unintentional poisoning in hospitals by drugs?
79%
19
What is risk in terms of toxicology?
The probability or likelihood of adverse effects occurring
20
Is smoke plum or alcohol exposure voluntary? under own control? known risks? common risks? immediate adverse effects? consequences reversible?
1.alcohol
2. alcohol
3. Alcohol
4. Alcohol
5. Alcohol but both can be or not be
6. Alcohol, but both can be or not be.
21
IS poisoning a growing problem?
Yes
22
What is the 3 step approach to risk prevention?
1. Hazrd Identification and analysis
2. Risk Assessment
3. Risk Management
23
T-F- inhalation exposure is easy to avoid?
False
24
4 key air pollutants?
CO, SOx, NOx, Ozone
25
Air pollution is a risk factor for what 2 things?
cardiac death and pulmonary conditions
26
How many US people live in areas with pollutant concentrations deemed unsafe?
1/3
27
What two air pollutants are asphyxiants?
CO
cyanide
28
What air pollutants are irritants?
SO2
NO2
SMOG-OZONE, aldehydes, particles, hydrocarbons
29
What are the 6 criteria pollutants?
CO
SO2
NO2
OZone
PM
Lead
30
Where does SOx come from?
fossil fuel power plants>>>industry
31
Where does NOx come from?
Fossil fuel power plants>vehicles
32
Where does CO come from?
vehicle>>fires, smoking
33
Where does PM come from?
Fires, fossil power plants, industry
34
Order the air pollutants that cause more severe Acute respiratory health effects
SOx > PM >NOx > CO
35
Is CO irritanting?
No- there is really no way of knowing
36
What is CO a result of ?
incomplete combustion with too little oxygen
37
What is the most abundant pollutant in the lower atmosphere
Carbon Monoxide
38
Death rates of CO are higher in what populations?
Men, blacks, 15-24, and elderly
39
What states is CO poisoning higher in?
N. and Midwest
40
T-F-- most CO deaths in garages occur even with doors or windows open?
True
41
Is CO hemoglobin reversible?
Yes, but affinity is 220 times greater
42
If you add .1% if CO in the air, what would be the carboxylhemoglobin percentage?
50%
43
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
44
Where are the 1st effects of CO?
brain and heart where the demand is high
45
What binds CO more avidly than hemoglobin A? Why?
Fetal hemoglobin, maternal shift of O2 to the left
46
What are the main symptoms of mild and medium CO exposure?
Headaches that get worse and then unconsciousness etc.
47
Why do we get severe headache in CO poisoning?
edema and up intracranial pressure
48
We know we get heart damage with CO, but do we get congestion and hemorrhages elsewhere?
Yes, in all organs
49
T-F--CO poisoning is marked by delayed neuropsych impairment?
true
50
review the pathology of acute CO poisoning
severe headache
heart damage
congestion and hemorrhaging all over
delayed neuropsych impairment
ischemic anoxia
delayed encephalopathy due to autoimmune
51
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.
52
What are the CO effects on ST changes?
earlier and longer lasting ST changes
53
With CO is there a lower threshold for arrhythmias?
yes
54
Can pulseox detect HbCO?
Not really
55
What lab diagnosis do we usually do for CO? 2
Expired CO
Carboxyhemoglobin- co-oximeter/blood sampling. be aware of time of exposure and measurement
56
What is Tx for CO?
fresh air, O2 100%, hyperbaric, correct hypotension and acidosis
57
Do many victims of CO have subtle memory problems after recovery?
yes about 1/3
11% have long term neurpsych problems
58
Is tobacco smoke a major cause of CO poisoning?
yes
59
What is a major problem of sulfur dioxide with moisture?
conversion to acids--> acid rain, pH change of soil, metal leaching
60
IS SO2 water soluble? what does this mean
Yes-->damage in upper airways
heavy breathing may lead to damage in lower airways
61
Air SO2 levels are in strong association with what?
Asthma episodes
62
At 3ppm of SO2, what happens
You can smell it!
50-100 max tolerable dose for 30-60 min
63
What are the 6 acute affects of SO2?
irritation, cough, burning, lacrimation, difficulty, swallowing
64
What are the long-term effects of SO2?
Aggravation of chronic cardiopulmonary disease
children- reduced lung function and up respiratory infections
65
What is the pathophysiology of SO2? leads to what?
sulfur dioxide+moisture--> sulfurous acid (irritation, inhibition of mucociliary transport, vagal stim, constriction)
66
What is a major treatment of SO2?
Removal from source (no jogging on bad days)
support airway and breathing
decontaminate
67
What color is NO2?
brownish and highly reactive
68
What is NO2 a major source of?
OZONE
NO2+ O2 + light--> NO + O3
O3+NO+dark-->O2+NO2
69
Is NO2 water soluble? what does this mean?
Not really, penetrates deep into the lung
70
What is a very potent respiratory tract toxin? features?
NOx
brinchitis, pneumonia, hemorrhagic pulmonary edema, alvolar damage
71
What is the pathophys of NOx?
lipid peroxidation, decreased ciliary movement, bronchoconstriction, enzyme inhibition
72
What color is ozone?
bluish, slightly pungent odor
73
Is ozone soluble? What does this mean?
penetrate deep into the lung
74
What is the pathophys problem of O3?
forms hydroxy radical--> per oxidation of lipids and oxidation of thiols, amines, proteins
75
In the stratosphere, ozone problems due to decrease halogenated hydrocarbons leads to what?
UV exposure, skin cancer
76