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1

what is ocular decontamination, how do you flush it out

local irritation or permanent corneal damage - requires immediate treatment, flush medial to lateral

2

what is dermal deconamination

irritation, dermatitis

3

what can happen when GI decontamination locally

ingested toxins, gastric irritation -> induce vomiting

4

what can happen when GI decontamination centrally

chemoreceptor trigger zone (CRTZ) ->induce vomiting - the drug binds onto receptors and sends the message to the vomiting centre and then vomits

5

what 3 factors should be considered for GI Decontamination

-time of ingestion
-agents ingested
-clinical status of patients

6

how much time do you have to get out some ingested toxins

1-2 hour window, 17-62% if emesis is done within an hour

7

what are some contraindications for GI decontamination

1. unconscious/depressed
2.CNS stimulant
3. respiratory distress
4. strong acid/alkalis
5.gasoline/ petroleum distillates

8

what are 4 ways of induction for emesis

3% hydrogen peroxide, apomorphine, xylazine, syrup of ipecac

9

3 things to know about 3% hydrogen peroxide induction

-can do an emesis at home - can travel to hospital if less than 1 hour
-higher than 3% HP may cause severe vomiting, mucosal irritation
-1tbsp/20lbs or 1 ml /kg

10

5 things to know about apomorphine induction

1. stimulates the dopamine receptors in the CRTZ
2. rapid onset = first choice
3. IV/SQ? tablet and conjunctival disc
4. side effects include - protracted vomting, CNS depression/stimulation
***5. does not work on cats

11

2 things to know about Xylazine induction

1. side effects outweigh the benefits
2. don't use on cardiac patients

12

2 things to know about syrup of ipecac induction

1. gastric irritant and CRTZ stimulant
2. side effects include prolonged vomiting, cardiotoxic at high dose, hemorrhagic diarrhea, skeletal muscle weakness

13

what is gastric lavage

1. used when you can't use vomiting
2. administration and evacuation of liquid through an orogastric tube
3. effective within the first 1-2 hours post ingestion
4. narrow margin of safety -> lethal dose LD50 = obstruction

14

what does activated charcoal do in GI decontamination

-binds and traps the toxin in the GI tract and exits via feces
-does not get absorbed in the GI tract
Sorbitol/ Cathartic

15

can you give food with activated charcoal

you can, a small amount only because the activated charcoal may bind to the food and won't work on the animal

16

why would you add Carthartic (Sorbitol) with an activated charcoal?

-to accelerate the expulsion from the GI tract
- makes gastrointestinal distress when combined

17

which substances are not absorbed with activated charcoal

1.ethanol
2. fertilizer
3. petroleum distillates
4. heavy metal (mercury)

18

when should you not use an activated charcoal with a patient

vomiting, hydrocarbon, seizure, compromised airway, caustic substance

19

what is toxicology

the study of poison

20

what are the 5 most common poisons

1. ethylene glycol toxicity
2. rodenticide toxicity
3. organophosphate toxicity
4. acetaminophen toxicit
5. phyrethrin toxicity

21

what do you monitory for ethylene glycol toxicity

fluid therapy, urine output, body weight, blood work

22

what is the lethal dose for ethylene glycol toxicity

4.4 ml/kg for dogs
0.9 ml/kg for cats

23

what are initial clinical signs for ethylene glycol toxicity

-dose dependant
-caused by unmetabolized EG
- ~30 min after ingestion
- CNS depression, vomiting, lethargy, seizure, ataxia, PU/PD

24

what should you be careful about for initial clinical signs for ethylene glycol toxicity

they may disappeared, 12 hours post ingestion but they might not actually be recovered

25

what are the clinical signs for ethylene glycol toxicity

-acute renal failure (dogs - 24 to 72 hrs post/ cats - 12 to 24 post)
-anuria (kidneys completely shut down) 72 to 96 hours post
-depression, anorexia, vomiting, seizures, azotemia, uremia, ptyalism, oral ulcers, hyperglycemia

26

what may you find in the lab for testing ethylene glycol toxicity

-metabolic acidosis
-calcium oxalate crystals both monohydrate/ dihydrate crystals
-hypocalcemia

27

what testing can you do for ethylene glycol toxicity

EG test kit
lab test
wood's lamp

28

what treatment can be done for ethylene glycol toxicity

ADH inhibition - only effective when give soon enough (6 to 8 hours post exposure)

29

2 things about ethanol

-has a higher affinity for ADH than EG
-side effects include CNS depression, acidosis, makes hyperosmolality worse, hypoglycemia

30

3 things about 4 methylphyrazole (4-mp)

-strong, competitive inhibitor of ADH
-strong affinity than ethanol
-less intensive monitoring and more predictable