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GIR Test 3 > B5.055 Prework 2: Adverse Drug Reactions > Flashcards

B5.055 Prework 2: Adverse Drug Reactions Flashcards

1
Q

organophosphates

A 
irreversible cholinesterase inhibiting insecticides
parathion
malathion
sarin
soman
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2
Q

carbamates

A 
irreversible cholinesterase inhibiting insecticides
carbaryl
aldicarb
carbofuran
aminocarb
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3
Q

insecticide toxidrome

A

SLUD

salivation, lacrimation, urination, defecation

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4
Q

mild insecticide poisoning symptoms

A

anorexia, headache, dizziness, nausea

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5
Q

moderate insecticide poisoning symptoms

A

excessive sweating, vomiting, abdominal cramps

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6
Q

severe insecticide poisoning symptoms

A

pinpoint and nonresponsive pupils
heart block
coma

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7
Q

serum cholinesterase levels following exposure

A

levels are low

measured as a confirmatory test

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8
Q

treatment of insecticide poisoning

A

atropine: small dose to block cholinergic effects, increase as needed
2-PAM to reactivate acetylcholinesterase enzyme prior to aging (only use for organophosphates, not carbamates)

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9
Q

mechanism of methemoglobin inducing agents

A 
oxidize hemoglobin (fe2+) to methemoglobin (fe3+) which is incapable of carrying oxygen
nitrates
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10
Q

carbon monoxide effects on heme protein

A

binds to hemoglobin to produce carboxyhemoglobin

binds much tighter than O2 and inhibits O2 carrying

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11
Q

cyanide effects on heme protein

A

inhibits cytochrome c oxidase, enzyme in electron transport chain
blocks oxidative phosphorylation and respiration
extremely rapid action

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12
Q

symptoms of nitrate induced methemoglobinemia

A

chocolate colored blood
hypotension, hypoxia, cyanosis
convulsions, coma, resp failure

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13
Q

treatment of methemoglobinemia

A

only needed when 35% or more hemoglobin is oxidized

methylene blue will convert methemoglobin back to hemoglobin

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14
Q

normal carboxyhemoglobin levels

A

non smokers = 1%
smokers = 5-10%
auto exhausts = 4-7%

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15
Q

symptoms of CO poisoning

A

headache, dizziness and stupor due to brain anoxia

cherry red blood

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16
Q

treatment of CO poisoning

A

terminate exposure
administer O2
avoid respiration stimulating drugs
hyperbaric O2 if severe

17
Q

symptoms of cyanide poisoning

A

RAPID

dizziness, headache, hypotension, unconsciousness, convulsions, resp failure

18
Q

treatment of cyanide poisoning

A

induce methemoglobinemia bc methemoglobin competes for cyanide ion with cytochrome oxidase
hydroxocobalamin- binds to CN- to form cyanocobalamin which is excreted in urine

19
Q

arsenic

A

naturally occurring

most widespread and common environmental metal contaminant

20
Q

lead

A

anthropogenic, accumulates in body, differential effects in adults and children

21
Q

mercury

A

biomagnification issue

22
Q

cadmium

A

multiorgan carcinogen, no chelator

23
Q

manganese

A

parkinsons like symptoms, no chelator

24
Q

mechanism of arsenic toxicity

A

binds to sulfhydryl groups on enzymes and interferes with cellular metabolism
organic &laquo_space;As5+ &laquo_space;As3+ &laquo_space;arsine

25
Q

acute arsenic poisoning

A 
hemolysis and hemoglobinurea
GI disturbances
ventricular arrhythmias
vasodilation
hyperpigmentation of skin
kidney tubular damage
26
Q

chronic arsenic poisoning

A

nephritis
dermatitis
cancer of multiple tissues (bladder, liver)

27
Q

treatment for arsenic toxicity

A

remove ingested arsenic by lavage or emesis
dimercaprol is preferred for acute poisoning
succimer is preferred for chronic poisoning

28
Q

routes of lead toxicity

A

anthropogenic

exposure via smoke, smog, old paint

29
Q

acute lead effects

A

kidney damage, GI irritation

30
Q

chronic lead effects

A

interference with heme biosynthesis leading to microcytic anemia
constipation and abdominal pain
neurological damage

31
Q

symptoms of lead poisoning in children

A

developmental deficits
low IQ
growth retardation
irritability

32
Q

symptoms of lead poisoning in adults

A

hypertension
cholic
anemia

33
Q

treatments of lead toxicity

A

remove unabsorbed lead by gastric lavage
calcium gluconate for GI effects
chelation therapy: Ca Na2EDTA, BAL (dimercaprol), penacillamine (oral), succimer (oral)

34
Q

when is treatment for lead toxicity in children recommended

A

> 5 micrograms/dL

GIR Test 3 (19 decks)

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