Acute Poisoning

Question 1

How does ricin toxin target poisoning

Answer 1

Ingested
GI upset
Targets organs kidney liver and pancreas

Question 2

What is cholinergic toxidrome

Answer 2

organ phosphate/nerve agent poisoining

Question 3

How does cholinergic toxidrome

Answer 3

OP/nerve agent bind to acetylcholinesterase
acetylcholine is not broken down after release into synapse
there is sustained cholinergic activity

Question 4

Role of atropine

Answer 4

Reduces muscarinic effects, e.g bronchorrheoa but not paralysis

Question 5

Role of pralidoxime

Answer 5

Regenerates acetylcholinesterase - if given early enough

Question 6

Examples of common toxic syndromes

Answer 6

XS sedative/stimulant 
Sympathetic syndrome 
Salicylism 
anticholinergic syndrome 
cholinergic syndrome 
serotonin syndrome 
opiates narcosis 
sympathomimetic syndrome

Question 7

What investigations would you carry out for acute poisoning

Answer 7

FBCs
U+Es
LFT 
glucose/plasma osmolality 
urine toxicology

Question 8

What happens when someone take XS paracetamol

Answer 8

Usual conjugated pathways become overwhelmed and remaining paracetamol is oxidised to the toxic metabolite NAPBQI

Question 9

What is the antidote for XS paracetamol

Answer 9

N-acetylcysteine - IVI

Question 10

How does opioid poisoning work

Answer 10

Specific competitive antagonist at opiate receptor -> naloxone

Question 11

When might repeated doses/ infusion be necessary

Answer 11

When there is a shorter duration of action than many opiates