Toxicology L 11-12

Question 1

activated charcoal

Answer 1

absorbs toxins

does not absorb heavy metals or lipid soluble solvents

Question 2

average gastric emptying time

Answer 2

4 hours

Question 3

three contraindications for removing stomach contents

Answer 3

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

Question 4

when hemodialysis is most effective

Answer 4

for drugs with lower Vd

Question 5

Ipecac

Answer 5

common emetic

Question 6

ammonium chloride

Answer 6

lowers pH of urine to increase excretion of bases

Question 7

sodium bicarbonate

Answer 7

raises pH of urine to increases excretion of acids

Question 8

magnesium sulfate

Answer 8

cathartic

potent laxitive

Question 9

mannitol

Answer 9

osmotic diuretic

Question 10

deferoxamine mesylate

Answer 10

chelation for iron poisoning

Question 11

dimercaprol

Answer 11

chelation: mercury, arsenic, gold, lead poisoning

Question 12

edetate

Answer 12

chelation: lead

Question 13

penicillamine

Answer 13

chelation
wilson's disease
rheumatoid arthritis
coppe, lead
cysteinuria

Question 14

acetylcystein

Answer 14

acetaminophen toxin inactivation

Question 15

digoxin-specific FAB antibody

Answer 15

cardiac glycoside toxicity inactivation

Question 16

antibodies used for toxins

Answer 16

snake bites
botulinum toxin
others…

Question 17

atropine

Answer 17

antidote for cholinesterase inhibitor poisons

Question 18

pralidoxime chloride

Answer 18

cholinesterase reactivator for organophosphates

Question 19

cyanide package

Answer 19

sodium nitrite
sodium thiosulfate
amyl nitrite

Question 20

ethanol as antidote

Answer 20

antidote for methanol and ethylene glycol

Question 21

fomepizole

Answer 21

alcohol dehydrogenase inhibitor to treat ethylene glycol poisoning

Question 22

bicarbonate as an antidote

Answer 22

treatment of poisoning by cardiac depressants

Question 23

diazepam

Answer 23

treats chemical induced convulsions

Question 24

pyridoxine

Answer 24

isoniazid neuropathy

Question 25

Botulinus toxin | Clostridium botulinum

Answer 25

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

Question 26

Food poisoning

Answer 26

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

Question 27

Bleach ingestion

Answer 27

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

Question 28

Organophosphates

Answer 28

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

Question 29

Carbamates

Answer 29

like organophosphates, but can't use 2-PAM

Question 30

Dinitrophenols

Answer 30

uncouple oxidative phosphorylation => increased temperature and metabolic rate

Question 31

Paraquat

Answer 31

redox recycling causes free-radical formation and injury to lungs

Question 32

halogenated hydrocarbons

Answer 32

``` 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 ```

Question 33

Methanol

Answer 33

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

Question 34

Ethylene glycol

Answer 34

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

Question 35

Lead Poisoning

Answer 35

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

Question 36

Iron

Answer 36

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

Question 37

Mercury

Answer 37

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

Question 38

Carbon Monoxide

Answer 38

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

Question 39

Cyanide

Answer 39

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