1.0 Toxicology

Question 1

What are some toxicokinetic considerations?

Answer 1

• toxic dose: LD50 (lethal dose in 50% if animals)
• mechanism of action
• acidic or alkalotic?
• how is it absorbed? GIT/bladder/occular/dermal
• does it bind to charcoal?
• how it is metabolized and how is it excreted?
• half-life?

Question 2

What are potential first-line treatment options in the poisoned animal?

Answer 2

(1) treat the patient not the toxin!

(2) emesis

(3) gastric/colonic lavage

(4) activated charcoal

(5) diuresis

(6) dermal decontamination

(7) intralipid

(8) dialysis

Question 3

What does “treat the patient not the toxin” mean?

Answer 3

each patient is unique, and may react to the toxin differently
- treat their clinical signs first

Question 4

When is emesis indicated in the treatment of a poisoned animal?

Answer 4

• if < 4 hours (toxin dependent)
• contraindicated if neurological signs: no gag reflex, recumbent, seizure, unconscious
• contraindicated if caustic: acid / alkali / bleach
• contraindicated for petroleums or detergents (choking/inhalation)

dogs: use apomorphine
cats: a-2 agonists (xylazine, dexmedetomidine, medetomidine)

• hydrogen peroxide not recommended as can cause GUE

Question 5

When is gastric / colonic lavage indicated in the treatment of a poisoned animal?

Answer 5

when ingestion < 4hrs, but emesis is contraindicated (or if ingested large amounts)

Question 6

When is activated charcoal indicated in the treatment of a poisoned animal?

Answer 6

in cases where the toxin is known to bind to AC, or in cases of enterohepatic metabolism

Question 7

When is diuresis indicated in the treatment of a poisoned animal?

Answer 7

in the renal excretion of toxins, or nephrotoxins (lily, rasins, etc)
- no proof that this works

Question 8

When is dermal decontamination indicated in the treatment of a poisoned animal?

Answer 8

dermal toxins (permethrin, engine oil, oil on birds)

Question 9

When is intralipid indicated in the treatment of a poisoned animal?

Answer 9

for lipophilic tocxins (local anesthetics, ivermectin, permethrin, marajuana, mycotixin, etc)

• risk of pancreatitis, lipemia, hypersentitivity

Question 10

When is dialysis indicated in the treatment of a poisoned animal?

Answer 10

ethylene glycol, baclofen, paracetamol, ibuprofen, ivermectin, ethanol, mushroom, aminoglycosides, etc.

Question 11

list common poisons and their antidotes.

Answer 11

Question 12

What are the seizure and tremor poison differentials?

Answer 12

Question 13

What are the anemia poison differentials?

Answer 13

Question 14

What are the renal toxicity differentials?

Answer 14

Question 15

What are the hepatic toxicity differentials?

Answer 15

Xylitol

• increases insulin: hypoglycemic, liver necrosis