Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Toxicology > 2-Diagnosis and Treatment of Toxicity > Flashcards

2-Diagnosis and Treatment of Toxicity Flashcards

1
Q

Managing the mystery poisoning patient

A

Assess the patient, evaluate for immediate life-threatening problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Top three chemical toxicants

A

Ethylene Glycol

Rodenticide

Organophophates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Known exposure

A

Owner saw or highly suspects that animal ingested a particular compound

Initial contact often by phone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Uknown exposure

A

Animal presents with symptoms but no known cause

Much more difficult to diagnose and treat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Ass the patient and follow the steps

A

Evaluate for life-threatening problems and treat

  1. CV function and output
  2. Temperature
  3. CNS, seizures
  4. Hemorrhage
  5. Respiration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

1) Respiratory maintenance

A

Unconscious, paralyzed, and severe respiratory distress patients are candidates for intubation

  • Anesthetize conscious animals
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Ventilation may be needed if

A

Hypoventilation and hypercapnia (PCO2 > 45 mmHg) normal is like 31 I think

Metabolic acidosis (venous pH 7.35) normal is 7.4 tx sodium bicarb

Hypoxia (PaO2<65mmHg) treat with 40% oxygen normal is 90-110

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Prevent aspiration of vomitus

A

Head below the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

2) Control CNS activity

Hyperactivity

A

Seizures

  • Diazepam
    • Inc inhibition of GABA Neuro transmitter
    • treatment of choice (0.5 mg/kg IV)
    • repeat every 10 minutes for up to 2 times
  • Phenobarbital (more potent)
    • Barbituates, not GABA specific (compl. inh CNS)
    • (1-5 mg/kg IV to effect) or pentobarbital
  • Methocarbamol
    • (Robaxin 40-200 mg/kg IV from low dose to effect)
    • Skeletal muscle relaxation to control seizures
    • Use in Stichnine poisonings
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

2) Control CNS activity

Depression

A

Analeptics

  • Can make stabilization difficult

Doxapram

  • Increased respiratory rate (~1-10 mg/kg)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

3) Control cardiovascular function

Tacycardia and Arrhythmias

A

Correct Acid-base, electrolyte or fluid disorders

Lidocaine

  • controls arrhythmias
  • (1-2 mg/kg, IV / 40-80 micrograms/kg/min)

Propranolol

  • adrenergic B-2 agonist (beta blocker, slows heart)
  • dogs: 0.1-2 mg/kg PO TID
  • cats: 2.5-5 mg
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

3) Control cardiovascular function

Hypertension

A

Nitroprusside

  • dialates blood vessels (ex: viagra)
  • constant IV infusion (1-10 microgram/kg/min)

Hydralazine

  • Causes smooth muscle dilation
  • (0.5-1 mg/kg for cats, higher for dogs)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

3) Control cardiovascular function

Fluid therapy

A

Balanced electrolyte solution for shock and dehydration

  • monitors kidney function

Monitor urine output (> 1ml/kg/hr)

Inotrpic drugs

  • DOBUTAMINE (pos inotropic)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

4) Stabilize the patient

A

Priority in animals presenting with severe clinical signs

  • hyper/hypothermia (do slowly to prevent shocking and seizures)

Obtain venous access and draw for laboratory profile and potential diagnostic testing

  • 3cc EDTA tube
  • 2 serum tubes

Once patient is stable, perform more comprehensive physical exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

5) Obtain complete history

A

Most important/overlooked parts of diagnositc toxicity

Once patient is stable, question owner fully to narrow down causes

Four themes

1) prior health status
2) clinical status/signs
3) environment
4) diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Health history

What is important

A
  1. Vaccination history
  2. Medications
  3. Previous dz, infectious, genetic, viral, bacterial
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Current clinical history

A
  1. How long was the problem present?
  2. When was the animal observed sick?
  3. If animals found dead, when were they healthy?
  4. Size of herd?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Clinical signs

CNS

GI

RENAL

A

CNS

  • ataxia
  • seizures
  • depresseion
  • head pressing

GI

  • vomiting
  • diarrhea
  • rumen stasis
  • gut sounds
  • constipation

Renal

  • hematuria
  • crystalluria
  • polyuria
  • glycosuria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Clinical signs

HEPATIC

CARDIAC

HEMATOPOIETIC

A

Hepatic

  • jaundice

Cardiac

  • arrhythmias
  • tachycardia
  • bradycardia

Hematopoietic

  • hemorrhage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Clinical signs should not…

A

be used to dx a particular toxicosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

History

Environment

A

Indoor only

Indoor/outdoor

Fenced yard vs roaming

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Diet

A
  1. New batch, brand, type of diet, confined or roaming
  2. Method of feeding
  3. Presence of moldy or spoiled food
  4. Drinkig water source
  5. Water supply changes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Formulate a rule-out list

A

Populate list of ddx

  • still possible causative agent not a poison
    • infectious
    • metabolic
    • other non-toxic
24
Q

Acute onset of seizures from non-toxicosis

A

Epilepsy

  • rule-out: hx of seizures

Trauma

  • rule out: hx, look for contusions, PE

Hypoglycemia

  • rule out: blood test

Infections

  • rule out: blood test

Hypoxia

25
Ancillary support General supportive care...
Insure adequate urine output Monitor respiratory, cardiac and neurological status Manage clinical signs as the develop Manage secondary hepatic or renal injury Administer GI protectants/anti-emetic
26
Sympotmatic care
Maintain body temp Alleviate pain Prevent irritation of skin, membranes with demulcents, milk sucralfate
27
Decontamination measures
Emesis Activated charcoal Cathartics * Things that stimulate movement of GI * IE: metamucil
28
Emesis
Prevent toxicant absorption Should be done within 60 minutes of exposure Contraindications * gasoline * acidic/basic compounds: DILUTE * non-serious toxicoses
29
Emesis rule of thumb
1) justified in that specific case * ethylene glycol * strichnine * whole bottle of pills 2) toxic dose is ingested 3) no vomiting has yet occured 4) activated charcoal is not an option * gas doesn't bind \*little evidence that emesis improves the clinical outcome in poisoned animals \*save some vomit for analysis
30
Activated charcoal
Animal may eat if mixed with food Earlier=more effective 2-8 g/kg Give 4-6 hours Caution in sedated animals without airway protection Contraindications * corrosive agents: toilette bowl cleaner * non-polar materials
31
Charcoal rule of thumb Give charcoal if:
1) substance in known/thought to be absorbed 2) ingestion was very recent 3) chemical undergoes enterohepatic circulation 4) substance is sustained release 5) animal can tolerate it 6) no need to admin oral meds within 2 hours of giving charcoal
32
Things charcoal doesn't bind to
acids alkalis alcohols/glycols metals oils petroleum distillates detergents
33
Cathartics
Decrease GI transit time, increase movement of toxins and decreases possible absorption of toxin Use as adjunct with activated charcoal to reduce transit time Mineral oil: don't use with activated charcoal Saline cathartic: * MgSO4 or * Na2SO4 * Can add to charcoal or use later
34
Corrosives technique | (gasoline, acids/bases, emulsants)
Use dilution instead of emesis * milk * water * eggs Lipid infusion * organophosphates, ivermectin * new treatment * off label
35
Summary Activated charcoal
Primary Use: * Absorbent material with large surface area * Binds most drugs Limitations/contraindications * Some toxins not absorbed
36
Summary Apomorphine
Primary use * Emetic agent for dogs, pigs Limitations/contraindications * May cause prolonged vomiting
37
Summary Xylazine
Primary Use * Emetic agent for cats Limitations/contraindications * May cause hypotension and bradycardia
38
Summary Gastric lavage
Primary Use * Sustained-release products * Massive overdoses Liminations/contraindications * Invasive * Risk of perforation/rupture
39
Summary Salt water, hydrogen peroxide
Primary use * For at-home induction Limitations/contraindications * Might delay treatment from veterinarian
40
Summary Surgical removal
Primary Use * Lead, pennies, etc Limitations/contraindications * Invasive
41
Summary Whole bowel irrigation
Primary use * Removal of sustained-release pharmaceuticals * For toxins not absorbed by activated charcoal Limitations/contraindications * Primarily for small aniamls * May cause prolonged diarrhea * Safer than gavage
42
Chemical analysis Blood
Test for * Heavy metals * Anticoagulants * antifreeze * cholinesterase * cyanide * chlorinated pesticides Comments * use EDTA or heparin
43
Chemical analysis Serum
Test for * some metals (Cu, Nz) * nitrate * nitrite * ammonia Comments * separate clot from serum
44
Chemical analysis urine
Test for * alkaloids * some metals * antibiotics * drugs * oxalates * cantharidin Comments * freeze * especially useful for paraquat or diquat
45
Chemical analysis liver
Test for * metals * aflatoxin M1 * alkaloids
46
Chemical analysis vomitus
Test for * various poisons * heavy metals * anticoagulants * antifreeze * pesticides Comments * Indicates recent exposure
47
Chemical analysis Kidney
Test for * metals (As, Pb) * Phenolic compounds * oxalates Comments * freeze
48
Chemical analysis Brain
Test for * Chlorinated pesticides * pyrethrins * cholinesterase * metals Comments * freeze
49
Chemical analysis Fat
Test for * chlorinated pesticides * dioxins
50
Anion gap Common toxins associated with an increased anion gap
Calculation: Na+ + K+ - Cl- + HCO3- Toxicans associated with an increased anion gap * Ethylene glycol * Ethanol * Iron * Methanol * Salicylates (aspirin) * Strychnine Normal anion gap 10-12 mEq/L * \>30mEq/L clinically significant
51
Toxins associated with CNS depression
Ivermectin Cholinesterase inhibitors Organophosphate insecticides Carbamate insecticides Blue-green algae Slaframine (muscarinic signs only) Lead Locoweed Ethylene glycol
52
Common toxins associated with seizures
Bromethalin: mitochondrial inhibitor, reduces ATP production Chocolate: theobromine Lead Organochlorine insecticides Pyrethrins/pyrethroids Strychnine Water deprivation/sodium ion toxicosis Water hemlock: most dangerous of poisonous N.A. plants
53
Help for Managing Toxicoses
ASPCA National Animal Poison Control Center College of Veterinary Medicine Chemical Manufacturer
54
Info from callers
Name, phone number Signalment, breed What, how much, how long ago Clinical signs, when did they start
55
Diagnosing unknown toxicity summary
1) History * Health history * Current clinical history * Environment * Diet 2) Clinical signs 3) Pathology/Necropsy 4) Chemical Analysis
56
Prevent further exposures
Change pasture, feed, water Remove baits, old pesticides Bathe or flush for cutaneous or ocular exposures * use small amount of detergent, rinse well * may need to clip animal Educate your clients
57
Managing poisoned/suspected poisoned patients SUMMARY
Assess ABCs * Airway * Breathing * Circulation Control seizures, cardia Metabolic derangements History GI decontamination Supportive and symptomatic care

Toxicology (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions