Common Household Products Flashcards
Describe the toxicokinetics of Ethanol/Methanol
- readily absorbed orally
- widely distributed in CNS
- ethanol is metabolized by hepatic alcohol dehydrogenase to acetaldehyde, which is then converted to acetate
Describe the mechanism of action of/what is caused by Ethanol/Methanol
- irritation of mucus membranes
- CNS depression
- acetaldehyde causes vasodilation and induces vomiting
- acetate causes metabolic acidosis
- ethanol inhibits ADH
What are the clinical signs of acute ethanol/methanol toxicosis?
- rapid onset of CNS depression
- abnormal behavior
- vomiting and breath odor
- hypothermia, tremors, and ataxia
- congested mucus membranes
- polydipsia and dehydration
- death from respiratory failure
What are the clinical signs of chronic ethanol/methanol toxicosis?
kidney and liver damage
What lesions are seen with ethanol/methanol toxicosis?
GI mucosa, liver, kidney, and lung congestion
What are treatments for ethanol/methanol toxicosis?
- emetics in recent ingestion and gastric lavage
- charcoal not effective
- supportive care
Describe the toxicokinetcs of propylene glycol toxicosis
- rapidly absorbed from GI tract and by inhalation
- metabolized in liver to lactaldehyde, then lactic acid, then pyruvic acid
- partly excreted unchanged in urine
What are the clinical signs of propylene glycol toxicosis?
- ataxia and CNS depression
- heinz body anemia in cats
- osmotic diuresis
- muscle twitching seen in cats
- metabolic acidosis
What are the treatments for propylene glycol toxicosis?
- emesis and activated charcoal
- IV fluids and bicarbonate therapy
Describe the toxicokinetics of ethylene glycol toxicosis
- rapidly absorbed from GIT
- peak plasma level in 2 hours
- metabolized to toxic metabolites in liver
- oxalic acid binds to serum Ca to form insoluble Ca oxalate crystals and hypcalemia
Describe the mechanism of action of/what is caused by ethylene glycol toxicosis
- direct GI irritation, increased serum osmolality, and CNS depression
- metabolite causes metabolic acidosis and acute renal failure
- CNS damage
What are the early signs of ethylene glycol toxicosis?
- nausea/vomiting, anorexia, CNS depression, ataxia, hypothermia, muscle fasciculations, tachycardia, tachypnea, PU/PD, coma, death
What are the later signs of ethylene glycol toxicosis?
- oliguric renal failure
- vomiting, anorexia, depression, lethargy, coma, seizures, oliguria, renal pain
What lesions are seen with ethylene glycol toxicosis?
- hemorrhagic gastroenteritis
- pulmonary edema
- pale and swollen kidneys with grey or yellow streaks
- yellow, birefringent rosette-shaped calcium oxalate crystals in kidney or urine
Treatments of ethylene glycol toxicosis
- activated charcoal within 4 hours
- inhibitors of alcohol dehydrogenase (Fomepizole, Ethanol)
- fluid therapy and bicarbonate
What are the laboratory findings of ethanol/methanol toxicosis?
blood alcohol levels > 1-1.5
hypoglycemia
What are the laboratory findings of propylene glycol toxicosis?
- metabolic acidosis
- hyperosmolarity
- increased anion gap
- hypoglycemia
- low urine SG
- heinz bodies in cats
What are the laboratory findings of ethylene glycol toxicosis?
- increased serum osmolality
- increased anion gap
- low urine SG
- hypocalcemia
- hyperglycemia
- increased CREA and BUN
- hyperphosphatemia, hyperkalemia
- increased PCV and TP
Describe the toxicokinetics of D-Limonene and other essential oils
- absorbed through GI and skin
- max blood concentration in 10 minutes
- metabolized by liver and excreted in urine
What are the clinical signs of D-Limonene/Essential oil toxicosis?
- ataxia, weakness, paralysis
- CNS depression, hypothermia, and hypotension
- patient smells like lemons
What are the treatments for D-Limonene/Essential oil toxicosis?
- shampoo with mild dish soap
- monitor temperature
- supportive care
Describe the mechanism of action of/what is caused by detergents and phenols
- direct irritation of skin and mucus membranes
- phenols denature and lead to direct irritation causing coagulative necrosis
What are the clinical signs of detergent and phenol toxicosis?
- ingestion causes nausea, vomiting, diarrhea, and colic
- phenols may cause respiratory stimulation, ataxia, weakness, etc.
- dermal exposure causes irritation
What lesions are found with detergent and phenol toxicosis?
- ulceration and necrosis of GI mucosa and skin
- liver and kidney changes (necrosis)
What are the laboratory findings of detergents and phenol toxicosis?
- hemolysis/methemoglobin
- respiratory alkalosis
- proteinuria and hematuria
- elevated serum liver enzymes
What are the treatments for detergent toxicosis?
- non-ionic: rinse with water
- anionic: water/milk for ingestion, activated charcoal, bathing for dermal
- cationic: water/milk/egg white/charcoal, wash with soap and water
What are the treatments for phenol toxicosis?
- milk, egg whites followed by activated charcoal and saline cathartics
- supportive care
Describe the mechanism of action of bleach toxicosis
- in stomach acid, forms hypochlorus acid which penetrates mucus membranes
- gas causes severe respiratory and eye irritation
- concentrated solutions are corrosive
What are the treatments of bleach toxicosis?
- milk, water, or Mg to neutralize stomach acid
- wash with soap and water
- supportive care
Describe the toxicokinetics of xylitol toxicosis
- absorbed incompletely from GIT
- peak plasma levels 30 minutes
- can be converted to glucose then glycogen by liver
Describe the mechanism of action of xylitol toxicosis
- promotes insulin release resulting in severe hypoglycemia
- large doses can cause liver failure
What are the clinical signs of xylitol toxicosis?
- hypoglycemia: weakness, ataxia, seizures
- lethargy, vomiting, liver failure, coagulopathy
What are the laboratory findings of xylitol toxicosis?
- hypoglycemia
- ALT elevation
- ALP, bilirubin, prolonged PT/PTT, thrombocytopenia, and hyperphosphatemia
What are the treatments for xylitol toxicosis?
- induce vomiting
- 50% dextrose IV follow by infusion
- high carbohydrate diet
- fluid therapy
Describe the toxicokinetics of methylxanthines
- absorbed from GIT
- widely distributed
- metabolized by liver and undergo enterohepatic recycling
- excreted in urine
Describe the mechanism of action of/what is caused by methylxanthine toxicosis
- inhibit phosphodiesterases and antagonize adenosine receptors
- caffeine stimulates release of catecholamines
- theobromine: greater cardiac stimulation
What are the clinical signs of theophylline toxicosis?
- nausea, vomiting, abdominal pain, mild acidosis, and tachycardia
What are the clinical signs of caffeine/theobromine toxicosis?
- restlessness, hyperactivity, vomiting
- tachycardia, weakness, ataxia, diarrhea, muscle tremors
- convulsions, arrhythmias, muscle rigidity, seizures, death
What are the treatments of methylxanthine toxicosis?
- induce vomiting if early
- activate charcoal
- IV fluid therapy
- meds for tremors and seizures
- beta blockers for arrhythmias
