Approach to a Poisoned Pet Flashcards

1
Q

What are the top 10 toxins?

A

OTC meds
Food
Human prescription meds
Chocolate
Plants
Household toxins
Veterinary products
Rodenticides
Insecticides
Recreational Drugs

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2
Q

5 main areas of acute management of intoxication

A

ABCDs (airway, breathing, circulatory)
Control hemorrhage, seizures and muscle tremors
Assess metabolic and medical abnorms/ plan for tx
GI contamination
Supportive care

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3
Q

Decontamination

A

Ocular decontamination (flush with water)
Dermal decon (PPE, soap)
GI decon
Ion exchange resins
Cathartics
Activated charcoal

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4
Q

GI contamination

A

Purpose: ↓ absorption
Emesis, gastric lavage and whole bowel irrigation

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5
Q

Contraindications to emesis

A

Going up hurts like going down
Oil/ petroleum
↑ chance of aspiration
Seizing, sedated animal

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6
Q

Home use emetics

A

7% syrup Ipecac
3% peroxide (NOT CATS)
Table salt
Liquid dishwashing liquids

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7
Q

Veterinary use emetics

A

Apomorphine (conjunctiva)→ reversal: naloxone
Xylazine (limited effectiveness in cats)
Dexmetatomidine (cats) → reversal: atipamazole
Ropinirole

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8
Q

Gastric lavage

A

For large quantities of toxins that sit on the stomach (kitty litter) or have a narrow safety index (organophosphate, seizures, comatose)
15-20 L of fluid

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9
Q

Whole bowel irrigation

A

Indication: sustained release tablets
Clears the entire GI
Contra: obstruction

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10
Q

Ion exchange resins

A

Binds toxin to carrier → traps in stool → excretion
Ex: cholestyramine

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11
Q

Osmotic cathartics

A

↓ the time allowed for toxin to absorb (speed transit time)
Two forms: saline (Na sulfate, Mg sulfate, Mg citrate) and saccharide (sorbitol)

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12
Q

Activated charcoal

A

Universal antidote that absorbs the toxin
Used with cathartic (sorbitol)
Enterohepatic circulation
Hydration and multiple doses

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13
Q

Contraindications for activated charcoal

A

Toxicants that don’t bind: EG, xylitol and heavy metals
Hypernatremia, Gi obstruction/ perforation, CNS depression

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14
Q

Other forms of decontamination

A

Forced diuresis
Ion trapping (changes in urine pH)
Lipid emulsion (lipid sink- fat soluble compounds- ivermectins, weed, permethrin)

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15
Q

Therapeutic plasma exchange (TPE)

A

Apheresis tx
Plasma component of blood removed and replaced with solution (crystalloid/ colloid)

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16
Q

What is TPE used for?

A

Drugs with small volumes of distribution and highly protein bound
Ex: NSAIDs