Boots Final stuff Flashcards
What are the vitamin K dependent coag factors?
X, IX, VII, II (1972)
Which of the following are 1st generation (before 1970) anticoagulant rodenticides? Which are second generation?
Chlorphacinone Brodifacoum Bromodialone Warfarin Diphacinone Pindone
1st gen: Warfarin, Pindone (W-P pre ‘70)
2nd: Brodifacoum, Bromdialone (B’s are 2nd)
Arftoo-D2 has ingested anticoagulant rodenticide, his PCV is 18%, he is bleeding, but otherwise stable. How do you treat?
Start vit K therapy and monitor closely
Give FFP +/- FWB
Which rodenticide causes cerebral edema and diffuse white matter vacuolization throughout the CNS?
Bromethalin
T/F Anticoagulant rodenticides have a pungent smell and degrade in the environment over about 1 week.
False, they are odorless and tasteless and resistant in the environment for weeks.
Your patient, Captain Sniffy, ingests a small amount (less than 1g) of an anticoagulant rodenticide. His owner is not sure whether what he ingested is Warfarin or Brodifacoum, but she is certain it is one of these. Do you treat Captain Sniffy either way or do you need to try to figure out which of these he ate? Why?
Need to investigate further - Warfarin is 1st gen and a single dose (especially as low as 1 gram) may not cause any symptoms.
Brodifacoum is 2nd gen and is toxic after a single dose. The LD50 for a dog is 0.2-4mg/kg so depending on how much the Captain weighs it might kill him.
What is the mechanism of action for bromethalin?
Uncoupling of oxidative phosphorylation (leading to inadequate ATP to power Na+/K+ pump)
T/F Administering phenobarbitol reduces the metabolism of warfarin because it is an enzyme inhibitor. This enhances the toxicity.
False
Phenobarb is an enzyme INDUCER and would DECREASE toxicity
Cimetidine is an enzyme inhibitor
Which of the following enhance the toxicity anticoagulant rodenticides?
Cimetidine Estrogen Certain sulfonamides Enzyme inducers Vitamin K Hemorrhage Phenylbutazone Corticosteroids Salicylates
Cimetidine (also other enzyme inhibitors, like grapefruit juice)
Certain sulfonamides (antibiotics)
Hemorrhage (all things that cause blood loss, anemia, or hemolysis)
Phenylbutazone
Corticosteroids
Salicylates
T/F Blood levels of anticoagulant rodenticides reflect clinical signs. Peak levels in blood coincide with the most severe clinical signs.
False, peak blood levels occur in 6-12 hours but it can take days for clinical signs to develop
What are the targets for bromethalin that rely heavily on oxidative phosphorylation?
Brain
Spinal cord
The plasma half-life for ___generation anticoagulant rodenticides is several hours, the half life for ___generation is several days.
1st
(Warfarin=19hrs)
2nd
(Brodifacoum=6 days)
What enzyme do anticoagulant rodenticides inhibit? What does that enzyme do?
Vitamin K epoxide reductase
It converts vit K epoxide to its reduced form which is needed for the formation of clotting factors.
Which vitamin K-dependent coagulation factor has the shortest half-life? Which pathway is this factor in?
VII
Extrinsic
T/F All animals poisoned with anticoagulant rodenticides will show external evidence of bleeding, especially if they are going to succumb.
False in all ways, if the bleeding was in the brain or heart the animal will probably die but may not bleed externally.
A cattle farmer found out that he the hay he just fed his cows was contaminated with brodifacoum. Why may his pregnant cows abort?
Placental hemorrhage
Which of the following clotting tests reflect the extrinsic pathway? aPTT PIVKA PT ACT
PT
PIVKA
Which clotting test is not available cage-side, is not highly specific, but will become abnormal first in case of anticoagulant rodenticide toxicity?
PIVKA
Which form of vitamin K is used to treat anticoagulant rodenticide toxicity? How is it administered?
Vitmine K1 (phytonadione)
Given orally
Which of the following may reduce the effectiveness of vitamin K therapy? Kidney failure Liver failure Pneumonia Fatty meals
Liver failure
You have given activated charcoal to a dog that has very recently ingested an anticoagulant rodenticide. The coag factors are in the normal range but on the low end so you want to give vitamin K. Which of these is the best course of action?
Start oral vitamin K1 supplementation immediately.
Give IV vitamin K now and send home oral vitamin K1.
Send the patient home with vitamin K1 and recheck coags in 72 hours.
Give FFP and IV fluids that contain potassium.
Send the patient home with vitamin K1 and recheck coags in 72 hours.
You cannot start oral vit K immediately, must wait for the charcoal to wear off
IV vit K is counter-indicated
Potassium (K) is not the same thing as vitamin K
Which of the following species are most susceptible to anticoagulant rodenticides? Which is most sensitive? Pig Cat Dog Ruminant Horse Chicken
Dogs are most susceptible
Pigs are most sensitive
Obi Wag Kenobi has ingested anticoagulant rodenticide, his PCV is 13%, he is bleeding and very weak. How do you treat?
Give FWB or FFP + packed RBCs
Give IVF and provide other supportive care
Start vitamin K and monitor closely
Treatment for warfin ingestion is indicated for ____, while treatment for brodifacoum ingestion is indicated for _____. If the rodenticide is unknown, treat for ____.
1 week
4 weeks
3-4 weeks
Quintox, Rampage, Ortho Mouse-B-Gone or Rat-B-Gone, and Muritan cause vitamin D toxicosis. What type of rodenticide are these?
Cholecalciferol
What do Cestrum diurnum (day-blooming jasmine) and Solanum torvum (turkey berry) both contain?
Vitamin D analogs
Some rodenticides when consumed by the target animal in sublethal doses can cause the animal to learn to avoid the poison. This does not occur with cholecalciferol. What property am I describing?
Bait shyness
No bait shyness with cholecalicerol or bromethalin rodenticides.
T/F Swine, dogs and cats can be poisoned by relay toxicosis by anticoagulant rodenticides.
True
This means they (a non-target species) eat a mouse or other target animal that has been poisoned
What organ will you find the highest concentration of anticoagulant rodenticides?
Liver
T/F Cats are more susceptible to cholecalciferol rodenticides than dogs.
True
Which is correct in terms of the order of potency (most to least):
Ergocalciferol»Dihydrotachysterol»Calcitriol
Calcitriol»Dihydrotachysterol»Ergocalciferol
Dihydrotachysterol»Ergocalciferol» Calcitriol
Calcitriol»Dihydrotachysterol»Ergocalciferol
Cholecalciferol is absorbed from which of the following: Liver GIT Blood Kidney
GIT
Which 2 conditions can predispose an animal to cholecalciferol toxicity?
Renal disease
Hyperparathyroidism
T/F The more bioavailable forms of cholecalciferol rodenticides are toxic are much lower doses.
True
A diet high in ___ / ___ may predispose to cholecalciferol toxicity.
Calcium
Phosphorous
Cholecalciferol is metabolized to calcidiol in the ____ and to calcitriol in the ____.
_____ is the main form in circulation.
Liver
Kidney
Calcidiol
Cholecalciferol rodenticide toxicity causes ____calcemia and ____phosphatemia. It causes ___ PTH levels.
Hyper
Hyper
Low
Which rodenticide can be excreted in high levels in milk?
Cholecalciferol
Name one gastrointestinal, one renal, one cardiovascular and one neurological clinical sign that can occur with cholecalciferol toxicity.
GI: anorexia, vomiting (+/- hematemesis), abdominal pain, constipation (+/- melena)
Renal: PU, PD, hyposthenuria
CV: arrhythmia, hypertension
Neuro: depression, weakness, muscle twitching, seizures, coma/death in days
What does “GUP” stand for?
General Use Pesticide
What methylxanthine alkaloid is found in cacao beans?
Theobromine
T/F Cats are more sensitive than dogs to bromathalin.
True
Bromathalin is metabolized by N-demethylation in the liver to the metabolite desmethylbromethalin, which is more toxic. What is this term describes this process?
Lethal synthesis
T/F: Acute signs such, as CNS excitation, occur with supralethal doses of bromethalin.
Subacute signs, such as CNS depression, are more common.
True
Anticoagulant rodenticides from which generation take over a week to act?
1st generation
For which rodenticide is Ginko biloba used?
Bromethalin
Why must we be cautious when using human oral hygiene products extra-label in canines?
It may contain xylitol, which may not be listed as an active ingredient
T/F Cats are most susceptible to xylitol toxicity.
False, dogs
Xylitol is absorbed readily but incompletely from the GIT. Approximately how long after ingestion do plasma levels peak?
30 minutes
T/F Dogs who develop hypoglycemia due to xylitol ingestion will eventually develop liver failure.
False.
What are the three main methylxanthine alkaloids causing toxicity in dogs and cats?
Caffeine
Theobromine
Theophylline
T/F Decontamination by inducing vomiting is counterindicated with xylitol ingestion, activated charcoal is a better option.
False, it is indicated and activated charcoal is ineffective because it is an alcohol
Which organ is responsible for most of the metabolization of xylitol?
Liver (80%)
What methylxanthine alkaloid can be found in tea and asthma medications?
Theophylline
Xylitol is a potent promoter of the release of which substance in some species. What does this cause?
Insulin
Hypoglycemia
In large doses, liver failure
Oral feeding of a diet high in what is indicated for xylitol toxicity treatment?
Carbohydrates
Which animals are resistant to bromathalin toxicity?
Guinea pigs
Which liver enzyme should be monitored with xylitol toxicity?
ALT
T/F Dogs are most susceptible to methylxanthine toxicity?
True
Methylxanthines inhibit which enzyme and antagonize which receptor?.
Phophodiesterases
Adenosine receptors
Which causes greater cardiac stimulation: caffeine, theobromine or theophylline?
Theobromine
Which causes GI symptoms including nausea, vomiting and abdominal pain: caffeine, theobromine or theophylline?
Theophylline
How long to clinical signs of methylxanthine toxicity generally last?
12-72 hours, depending on the dose ingested
T/F: The LD50 for caffeine is higher than that for theobromine in cats and dogs.
False, caffeine has a lower LD50 in both species.
T/F Activated charcoal is indicated in the treatment of methylxanthine toxicosis.
True
Also, repeat for up to 36-72 hours
Which causes catecholamine release: caffeine, theobromine or theophylline?
Caffeine
T/F Methylxanthine undergoes lethal synthesis in the liver.
False, it does undergo enterohepatic recycling though
T/F Seizures and arrhythmias are common with methylxanthine toxicosis and do not factor into prognosis.
False, they indicate a poor prognosis
