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605 Toxicology > CNS Stimulants > Flashcards

CNS Stimulants Flashcards

1
Q

Which two toxins cause intermittent seizures?

A
  1. Lead
  2. 1080
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2
Q

1080

A

a rodenticide not available in the US, and also found in some Australian plants

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3
Q

Are seizing animals an emergency?

A

yes

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4
Q

Strychnine

A

below ground use restricted pesticide; also found in herbal medications

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5
Q

Strychnine MOA

A

competitive and reversible inhibition of NT glycine (which would normally open chloride channels) and hyperpolarizes neurons, so the animal has uncontrolled reflex activity especially concerning extensor muscles –> RIGIDITY

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6
Q

Strychnine Clinical Signs

A

anxiety, violent tetanic (only rigidity) seizures, death d/t respiratory inhibition (can’t expand chest) so they suffocate

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7
Q

Strychnine Tx

A

no emesis (rapid onset) but can lavage, IV fluids + electrolytes, control seizures, poor prognosis
may also administer lipid therapy

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8
Q

lipid therapy

A

can be given to fat soluble toxins to keep them BOUND in circulation (remember only free is a problem)

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9
Q

Pros of Lipid Therapy

A

faster recovery time, can be administered via peripheral catheters (inc. availability beyond ERs), inexpensive with a good shelf life

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10
Q

Cons of Lipid Therapy

A

must be refrigerated, can have a number of complications (lipemia, pancreatitis, inc. liver enzymes, organ failure, binds other important drugs like diazepam)

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11
Q

Toxins that can be treated with Lipid Therapy

A

Most common: Marijuana!!
but also ivermectin, Ca channel blockers, permethrin, antidepressants, muscle relaxers

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12
Q

Water Hemlock

A

one of the most toxic plants in the US (toxin concentrated in root chambers in stem), grows in waterways

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13
Q

Water Hemlock Clinical Signs

A

rapid onset violent seizures with a similar MOA to strychnine; salivation, muscle twitching, and death

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14
Q

Water Hemlock Tx

A

not often done because usually animal is found dead, but can use AC and even rumenotomies

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15
Q

Mycotoxin

A

toxins produced by a fungus, often found on stressed or poorly stored crops

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16
Q

Tremorgenic Mycotoxin Grasses (3)

A
  1. Bermuda
  2. Dallis
  3. Perennial Rye Grass
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17
Q

Large Animal Tremorgenic Mycotoxin Clinical Signs

A

“staggers” appear after ~7 days of grazing, fine muscle tremors of head and neck, stiffness

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18
Q

Large Animal Tremorgenic Mycotoxin MOA

A

reduces GABA and glycine concentrations, and likely cerebral vasoconstriction

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19
Q

Large Animal Tremorgenic Mycotoxin Tx

A

remove from source, provide supportive care, good prognosis with recovery in 3-7 days

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20
Q

Small Animal Tremorgenic Mycotoxin Sources

A

“garbage toxicosis” so garbage, compost, indole alkaloids (penicillium spp)

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21
Q

Small Animal Tremorgenic Mycotoxin MOA

A

inhibits glycine, GABA, and possible increase in Ach

22
Q

Small Animal Tremorgenic Mycotoxin Clinical Signs

A

hyperactivity, tremors, seizures (w/in 30-120minutes) with varying severity

23
Q

Small Animal Tremorgenic Mycotoxin Tx

A

emesis, maybe AC, seizure and tremor control (via methocarbamol!), supportive care and fluids

24
Q

Methocarbamol

A

centrally acting skeletal muscle relaxant

25
Q

Should you ever induce emesis in a seizing animal?

A

NO omg please no

26
Q

3 Ways to Get Hypernatremia

A
  1. Ingestion
  2. Dehydration
  3. Substances that Cause Fluid Shifts (Osmotic Shifts)
27
Q

Substances that may DIRECTLY cause Salt Toxicosis

A

salt (duh), brine, feed mixing errors, rock salt, ice melt, ocean water, bouillon, homemade playdoh

28
Q

INDIRECT causes of Salt Toxicosis

A

lack of water (frozen, overcrowded trough, gross, etc), osmotic agents, paintballs, activated charcoal, high fructose corn syrup

29
Q

Acute Salt Toxicosis MOA

A

sudden increase in plasma Na and water is pulled out of the brain causing cerebral vascular damage and hemorrhage

30
Q

Chronic Salt Toxicosis MOA

A

Na diffuses into brain to protect from dehydration d/t water loss, so glycolysis is inhibited which dec ATP because the Na pump stops working (leads to vomiting, lethargy, ataxia, tremors, seizures)

31
Q

Is it important to know whether salt toxicosis is acute or chronic?

A

yes, we don’t want to correct it too quickly, otherwise can cause cerebral edema

32
Q

Idiogenic osmoles

A

produced if elevations of Na in the brain are elevated for more than 24 hours in order to counteract the osmotic pull of water out of the brain

33
Q

This is a pathognomonic lesion of acute salt toxicosis in what species?

A

SWINE; these are eosinophilic cuffs around blood vessels and are only seen on histopath within the first 48 hours

34
Q

Acute Salt Toxicosis Tx

A

low sodium IV fluids given quickly, also plain water enemas

35
Q

Chronic Salt Toxicosis Tx

A

slowly drop sodium levels, so administer hypertonic saline (match serum Na levels) over a long period of time and DO NOT ALLOW FREE CHOICE WATER

36
Q

Amphetamines

A

many derivatives, available as Rx/OTC/illegal; low margin of safety and have rapid absorption over the blood-brain-barrier

37
Q

Amphetamine Clinical Signs

A

agitation, tachycardia with reflex bradycardia, hypertension, hyperthermia, seizures, death

38
Q

Amphetamine Tx

A

DO NOT GIVE BENZODIAZAPINES
GIVE ACEPROMAZINE (a lot)
support cardiovascular system (fluids) and acidify the urine to promote excretion

39
Q

Serotonergic Drugs

A

increases levels of serotonin in the CNS; found in SSRIs, SNRIs, MAOIs, TCAs and other antidepressants

40
Q

Serotonin Syndrome

A

complex combination of clinical signs resulting from the overstimulation of serotonin receptors

41
Q

Serotonin Syndrome Prognosis in Humans

A

poor

42
Q

Serotonin Syndrome Prognosis in Pets

A

good

43
Q

3 Main Signs of Serotonin Syndrome

A
  1. CNS Effects (agitation, seizures)
  2. Autonomic Effects (hypersalivation, vomiting, diarrhea, fever)
  3. Neuromuscular Effects (rigidity, tremors)
44
Q

mydriasis

A

dilated pupils

45
Q

Serotonin Syndrome Tx

A

acepromazine and cyproheptadine (plus other supportive care, AC charcoal can be given if found soon enough)

46
Q

Methylxanthine Sources

A

caffeine, chocolate, tea, coffee

47
Q

Why does chocolate have a longer time to peak plasma levels?

A

chocolate increases pyloric sphincter tone, so it doesn’t get into intestines as quickly!

48
Q

Methylxanthines Clinical Signs

A

GI/Cardiac/Neuro stimulatory signs

bloating, vomit/diarrhea, hyperactivity, tachyarrhythmias, tremors and seizures

49
Q

How to determine dose ingested?

A

add caffeine and theobromine concentrations (mg/oz) together

50
Q

Methylxanthine Tx

A

emesis for chocolate and AC if over lethal dose, otherwise supportive care for symptoms

605 Toxicology (9 decks)

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