Toxicology L 11-12 Flashcards Preview

Pharmacology Fall 2015 > Toxicology L 11-12 > Flashcards

Flashcards in Toxicology L 11-12 Deck (39):
1

activated charcoal

absorbs toxins
does not absorb heavy metals or lipid soluble solvents

2

average gastric emptying time

4 hours

3

three contraindications for removing stomach contents

after 30 min with corrosive materials
hydrocarbon solvents
altered mental states (coma, etc.)

4

when hemodialysis is most effective

for drugs with lower Vd

5

Ipecac

common emetic

6

ammonium chloride

lowers pH of urine to increase excretion of bases

7

sodium bicarbonate

raises pH of urine to increases excretion of acids

8

magnesium sulfate

cathartic
potent laxitive

9

mannitol

osmotic diuretic

10

deferoxamine mesylate

chelation for iron poisoning

11

dimercaprol

chelation: mercury, arsenic, gold, lead poisoning

12

edetate

chelation: lead

13

penicillamine

chelation
wilson's disease
rheumatoid arthritis
coppe, lead
cysteinuria

14

acetylcystein

acetaminophen toxin inactivation

15

digoxin-specific FAB antibody

cardiac glycoside toxicity inactivation

16

antibodies used for toxins

snake bites
botulinum toxin
others...

17

atropine

antidote for cholinesterase inhibitor poisons

18

pralidoxime chloride

cholinesterase reactivator for organophosphates

19

cyanide package

sodium nitrite
sodium thiosulfate
amyl nitrite

20

ethanol as antidote

antidote for methanol and ethylene glycol

21

fomepizole

alcohol dehydrogenase inhibitor to treat ethylene glycol poisoning

22

bicarbonate as an antidote

treatment of poisoning by cardiac depressants

23

diazepam

treats chemical induced convulsions

24

pyridoxine

isoniazid neuropathy

25

Botulinus toxin
Clostridium botulinum

heat-labile protein
from dirty foods: meats, home canned/bottled items
blocks release of Ach=> flaccid paralysis
vomiting, double vision, paralysis
treatment: emesis, lavage, antitoxin

26

Food poisoning

Salmonella
Bacterium cereus
Staph. aureus
symptoms 2-4 hrs, vomiting, diarrhea, fever, dehydration, shock

27

Bleach ingestion

very strong base
painful damage to mucous membranes and down esophagus
no emesis! no acid! (lead to burns)
give milk, melted ice cream, beaten raw eggs
water if on skin

28

Organophosphates

irreversible cholinesterase inhibitors
SLUD: salivation, lacrimation, urination, defecation
headache, dizziness, weakness, anxiety, nausea, vomiting, sweating, diarrhea, resp. difficulty, pulmonary edema, cyanosis
Treat: atropine, 2-PAM to counteract anti-cholinesterase activity

29

Carbamates

like organophosphates, but can't use 2-PAM

30

Dinitrophenols

uncouple oxidative phosphorylation => increased temperature and metabolic rate

31

Paraquat

redox recycling causes free-radical formation and injury to lungs

32

halogenated hydrocarbons

CCl4 is well-studied
liver metabolism through c P-450 => free-radical formation which causes lipid peroxidation => increased cell calcium and cell death
all are CNS depressants
cause arrhythmias
liver and kidney damage
Treat: remove source, support vitals

33

Methanol

CNS depressant
metabolized into formaldehyde and formic acid
visual disturbances, blindness, metabolic acidosis
can cause death from resp failure and acidosis
Gastric Lavage
50% ethanol, or use fomepizole
Bicarb for acidosis

34

Ethylene glycol

similar to methanol
CNS depression
kidney damage from calcium oxalate chrystals
treat with ethanol and fomepizole

35

Lead Poisoning

accumulates in body, especially bones
Line on gums, constipation, abdominal pain, kidney damage
Children: CNS damage from immature BBB=> irritability, behavior disturbances, loss of recent skills, coma, weakness, paralysis, wrist-drop, ankle-drop
Treat: chelation can cause more harm, but is sometimes necessary

36

Iron

GI irritation, metabolic acidosis, necrosis, hemorrhage
Treat: deferoxamine mesylate

37

Mercury

GI damage is primary cause of symptoms
Abdominal pain, vomiting may be bloody, sever kidney damage => anuria
salivation, mercury line on gums
Coarse jerky movements, delusions, hallucinations, mania (mad as a hatter), tremor, stomatitis

38

Carbon Monoxide

headache, dizziness, stupor
Cherry red carboxyhemoglobin
Treat: 100% O2 fast!

39

Cyanide

smells like almonds
complexes with iron to inhibit mitochondrial use of O2
dizziness, headache, unconsciousness, convulsions, resp. failure
Treat: rapid! sodium nitrite, amyl nitrite+. methemoglobin
sodium thiosulfate binds cyanide