7-GI and repro Flashcards
1
Q
NSAID examples
A
- Aspirin (acetylsalicylic acid)
- Ibuprofen
- Naproxen
2
Q
NSAIDS-about
A
- absorbed well from stomach and intestinal mucosa
- Dogs sensitive to ibuprofen
- Cats sensitive to aspirin (lack glucuronidation)
3
Q
NSAIDS
MOA
A
- uncouples oxidative phosphorylation at high doses
- inc lactic acid
- metabolic acidosis
- Causes gastric ulceration
- renal toxicity
- inhibition of prostaglandin synthesis and renal blood flow
- analgesic nephropathy
- inhibition of prostaglandin synthesis and renal blood flow
4
Q
NSAID renal toxicity
A
- Vasoconstrictive acute renal failure
- Acute interstitial nephritis
- Fluid and electrolyte imbalances
- Renal papillary necrosis
- Chronic renal failure
5
Q
Aspirin clinical signs
Acute toxicity
A
- Nausea, vomiting (poss w/blood), anorexia
- fever and respiratory stim w/ high doses
- depression, muscle weakness, ataxia, lethargy, seizure, coma
- acidosis with anion gap
- reduced renal flow, renal failure
6
Q
Aspirin clinical signs
Chronic toxicity
A
- Gastric irritation and ulceration is most common problem
- anemia, bone marrow depression
- heinz bodies, thrombocytopenia in cats
- toxic dose dogs: 50 mg/kg/day
- toxic dose cats: 25 mg/kg/day
7
Q
Naproxen
Clinical signs
A
- vomiting (+/- blood)
- Black tarry stool
- diarrhea
- anorexica, weakness, lethargy
- painful abdomen
- pale gums
- other rare
- facial twitching (cats)
- seizures
- depression
- coma
8
Q
NSAID Tox
DX
A
- HX and CS
- GI irritation, lethargy, anemia
- Perforating ulcers: abdominal pain, shock, dark red MM, tachycardia
- Anion gap from acidosis (salicylates)
- Inc in liver enzymes, jaundice
- Dec blood clotting time
- Acute renal failure
- renal tubular cell casts in urine sediment
- inc BUN, Creatinine
- renal tubular cell casts in urine sediment
9
Q
NSAID Tox
TX
A
- Induce emesis and several doses activated charcoal
- Ranitidine/ H2 blocker for GI ulcers
- Misoprostol/sulcralfate for GI ulcers
- Supportive care
- acidosis
- hyperkalemia
- correct electrolyte and glucose levels
- inc renal blood flow and maintain urine flow
- transfusion for severe hemorrhage/anemia
10
Q
Arsenic
about
A
- # 1 priority pollutant worldwide
- Sources
- insecticides: lead and calcium arsenate, treated lumber
- medicine: acute promyelocytic leukemia
- food production: organic arsenic chicken and swine feed additive
- Electronics
- shellfish
- water
11
Q
Inorganic Arsenicals
Pentavalent
A
- reduced and metabolized in rume
- reduces available metabolic energy
- some converted to trivalent form => toxicosis
- serious toxicity to
- GI epithelium and capillary endothelium
- enteritis and shock
- GI epithelium and capillary endothelium
12
Q
Inorganic Arsenicals
Trivalent
A
- binds to -SH groups
- disrupts cellular metabolism
- inhibits phosphorylation enzymes
- reduces metabolism….
- serious toxicity toGI epithelium and capillary endothelium
- enteritis and shock
13
Q
Clinical signs of inorganic arsenic poisoning
A
- Depends on dose
- Acute/Sub-acute exposure
- intense abdominal pain, gastroenteritis
- weakness, staggering gait
- salivation, trembling
- vomiting (dogs)
- PU/PD progressing to oliguria and anuria
- Dehydration, thirst
- posterior paresis
- cold extremities due to poor perfusion
- subnormal temp
- may live for 1-3 days
14
Q
Lesions associate with inorganic arsenic toxicity
A
- Brick red gut (abomasum in ruminants)
- Fluid GI contents, st foul smelling
- soft yellow liver, red congested lungs
- damage to glomerulus and tubules in kidney
15
Q
Inorganic arsenic tox
DX
A
- consider in sudden onset of gastroenteritis or sudden death
- esp animals found in/near water
- liver or kidney arsenic > 5ppm
- Should examine stomach contents of vomitis for As
- Readily absorbed from GI tract, rapidly excreted
- take samples early
16
Q
Inorganic arsenic tox
Tx
A
- GI decon
- no symptoms: emesis then activated charcoal + cathartic
- Begin chelation therapy
- dimercaprol: competes with SH groups for avail As
- Sodium thiosulfate before clinical signs
- Supportive therapy
- Demulcents: sucralfate or kaopectate
- Fluids: dehydration, shock, red renal function
- Poor prognosis once Clinical Signs
17
Q
Zinc
about
A
- Found in all galvanized metals
- nuts, bots, wire (hardwire dz)
- Post 1982 pennies
- big problem in zoos
- common household hazard called into ASPCA
- topical ointments: Desitin, sunscreen
18
Q
Common sources of zinc
A
- cold relief
- batteries
- paint
- zippers
- jewelry
- supplements
- sunscreen
19
Q
Zinc
MOA
A
- acid liberates free zinc => zinc salts
- corrosive to stomach and intestinal mucosa
- oxidative damage leads to hemolysis
- toxicity seen in dogs and aquatic organisms
- small breed dogs overrepresented
20
Q
Zinc tox
Clinical Signs
A
- Occurs w/in a few days
- vomiting (esp w/ ointments)
- depression, anorexia
- hemolytic anemia
- jaundice
- pancreatitis
- lesions
- enteritis
- renal, hepatic, pancreatic necrosis
21
Q
Zinc tox
Clinical signs of chronic toxicity
A
- occurs most often in cattle: onset time several weeks
- signs
- PU/PD
- Diarrhea
- Anorexia
- Hemolytic anemia
- Lameness
- Lesions
- gastric ulcers, renal tubule necrosis, hepatocyte necrosis
22
Q
Zinc tox
Dx
A
- Serum levels > 10 ppm
- use blue top
- use syringes w/o rubber (zinc in the lubricant)
- liver zinc > 200 ppm
- Dec PCV, regenerative anemia, thrombocytopenia
- heinz bodies in 33% canine patients
- elevated liver, kidney, pancreatic enzymes
- hemoglobinuria
- rads for hardware dz
23
Q
Zinc tox
Tx
A
- remove foreign bodies
- emesis if not contraindicated
- Primarily symptomatic
- fluids: renal failure and dehydration
- blood products: hemolytic anemia
- PPI, omeprazole, H2 blockers
- decrease systemic absorption zinc salts
- Gi protectants for irritation/ulceration
24
Q
Household chemicals
A
4th most common group of toxins animal poison control center receives calls for
25
Liquid/bar soap, shampoo, laundry detergent, rug shampoo
* CS: vx/d
* TX: **dilution** with milk or water
* Rarely fatal
26
Scouring powder, bleach
* Toxicity due to alkalinity: corrosive to skin and MM
* causes liquefactive necrosis penetrates deep layers of MMs
* CS: vx, abdominal pain
* TX
* dilute with milk or water
* Emesis or lavage (except very caustic exposures)
* Activated charcoal and cathartic (except very caustic exposures)
27
Disinfectants
Lysol
* Phenol
* denatures and precipitates cellular proteins
* CS
* corrosive burns of oral-esophageal pathway
* vx, hypersalivation
* ataxia
* panting
* shock, cardiac arrhythmias
* methemoglobinemia
* hepatic and renal damage
* coma
* TX
* demulcents (milk or eggs)
* gastric lavage or emesis and activated charcoal (if no caustic burns)
* supportive therapy: fluids, respiratory support
* 1% methylene blue: methemoglobinemia
28
Disinfectants
Pine-sol
* Pine oils
* Directly irritating to MM
* detoxified by glucuronidation: cats more susceptible
* CS
* nausea, hypersalivation, bloody vomit, abdminal pain
* ataxia, hypotension
* respiratory depression
* acute renal faiulre
* pulmonary edema
* TX
* dilute with milk, egg white, or water
* follow with activated charcoal or cathartic
* Emesis and lavage contraindicated: aspiration pneumonia
* supportive therapy
* renal perfusion
* acid-base and electrolyte balance
29
Automatic Dishwasher detergents
Cascade, Palmolive, All, Electrasol
* Toxicity to high alkalinity (pH \> 10.5)
* CS
* vx/d, salivation, GI pain
* oral, esophageal, and gastric erosions
* TX
* dilution with milk or water
* analgesics
* steroids for inflammation
30
Toilet Bowl Cleaner
SnoBol, Lysol, Vanish, Saniflush, Lime-A-Way
* Acidic: sulfuric acid/hydrochloric acid
* CS
* vx, salivation, dysphagia, abdominal pain, GI ulceration
* dsypnea
* TX
* dilution with milk or water
* steroids if stricture is possible
* symptomatic
* **Emesis, lavage, activated charcoal contraindicated**
31
Ammonia, Oven Cleaners, Drain Cleaner
Dow Oven Cleaner, Easy-Off, Drano, Liquid Plumber
* Alkaline (pH ~ 14): cause caustic ulceration
* CS (same as toilet bowl cleaner)
* vx, salivation, dysphagia, abdominal pain, GI ulceration, dyspnea
* TX
* dilution with milk or water
* steroids if stricture possible
* symptomatic
32
Repro toxicants
Phytoestrogens: Zearalenone
* Mycotoxin
* metabolite of Fusarium spp
* often found with DON (deoxynivalenol)
* most grains can be affected
* toxin occurs primarily during storage
* head stable and resistant to most retardants
* Affects most animals (pigs, cattle, sheep)
* chickens are resistant
33
Zearalenone
MOA
* **causes hyperestrogen syndrome: vulvovaginitis and estrogenic resp swine**
* Estrogen receptor agonist
* Alpha-zearanol has higher affinity for estrogen receptor
* Rapid detection kits available
34
Zearalenone
Clinical Signs
* In ferrets and pigs symptoms depend on sex and maturity
* Males
* decreased libido
* infertility
* immunosuppression
* liver damage
* necrosis, redding of tail
* Female
* dec litter size and birth weights
* enlarged, swollen uteri
* shrunken, cystic ovaries
* vulva swelling and reddening
* vaginal and rectal prolapse
* Cattle/sheep
* similar signs
* regressed testis and feminization
* abortions/pseudopregnancy
35
Zearalenone
DX and TX
* presense of \>1-2 ppm zearalenone in swine feed
* reversal of symptoms when feed changed
* can take 7-10 days
* activated charcoal or high fiber may reduce elimination times b/c extensive enterohepatic recycling
