Decontamination + Zersen Cases

Question 1

best drugs for dogs to induce emesis

Answer 1

apomorphine
dexmedetomidine
hydromorphone
ropinirole/clevor

Question 1

best drugs for cats to induce emesis

Answer 1

dexmedetomidine
hydromorphone

Question 2

when would you want to induce emesis at home with 3% hydrogen peroxide?

Answer 2

if the animal ingested antifreeze/ethylene glycol and you cannot get to a vet quickly

Question 3

when would you use a gastric lavage

Answer 3

if emesis is contraindicated (e.g. acids/bases or essential oils/potpourri)
methylxanthine large ingestion and symptomatic

Question 4

what medication should you pair with giving activated charcoal

Answer 4

antiemetic & cathartic

Question 5

what toxins do you NOT use activated charcoal for

Answer 5

alcohols (ethylene glycol, ethanol), xylitol, heavy metals

Question 6

what decontamination can you do for lipid soluble toxins such as (bupivacaine, lidocaine, propranolol, verapamil, diltiazem, CCB, clomipramine, chlorpromazine, lamotrigine, pyrethrins, baclofen, moxidectin, ivermectin, NSAIDs, THC, bromethalin)

Answer 6

intralipid emulsion (ILE) via IV

Question 7

the triage exam includes

Answer 7

CABCDE
catastrophic bleeding
airway
breathing
circulation
disability (neuro)
exposure (open wounds)

Question 8

seizure medications

Answer 8

midazolam or diazepam

Question 9

diuresis is recommended when?

Answer 9

if drug is excreted via the kidney

Question 10

medications for agitation, hyperactivity

Answer 10

acepromazine, midazolam, cyproheptadine

Question 11

antiemetic example

Answer 11

maropitant + ondansetron

Question 12

pro kinetic example

Answer 12

metoclopramide

Question 13

proton pump inhibitor example
when would you use this?

Answer 13

prantoprazole/omeprazole
gastric ulcers or esophagitis

Question 14

what are the 3 classes of antidotes

Answer 14

1. chemical or causal antidotes
2. functional antidotes
3. pharmacological or physiological antidotes

Question 15

examples of chemical or causal antidotes

Answer 15

chelating agents for heavy metals
immunotherapies
activated charcoal

Question 16

examples of functional antidotes

Answer 16

midazolam for seizures
atropine for organophosphatases and carbamates
prednisone for hypercalcemia

Question 17

pharmacological or physiological antidote examples for opioid toxicity and ethylene glycol

Answer 17

opioid toxicity - naloxone
ethylene glycol - fomepizole

Question 18

Marijuana
excreted?
enterohepatic recirculation?
clinical signs?

Answer 18

excretion: bile, feces
enterohepatic recirculation: yes
clinical signs: lethargy, ataxia, incontinence/dribbling urine

Question 19

do human drug screens detect marijuana ingestion in dogs

Answer 19

NO

Question 20

how rapidly is ethylene glycol absorbed from GI tract

Answer 20

very rapid – minutes-2 hours

Question 21

diagnostics for ethylene glycol toxicity

Answer 21

history
clinical signs
venous or arterial blood gas
blood concentration of EG
urinalysis
osmolarity
wood’s lamp

Question 22

treatment for ethylene glycol toxicity

Answer 22

hemodialysis is BEST
antidote - fomepizole
can give ethanol
IV fluids, GI support, urinary catheter

Question 23

systems most affected by NSAIDs toxicity

Answer 23

GI
renal
CNS

Question 24

vitamin D toxicity
excreted by?
enterohepatic recirculation?
clinical signs
antidote?

Answer 24

excretion: bile, feces
enteroheptatic recirculation: yes
clinical signs: PUPD, vomit, anorexia, hemorrhagic diarrhea
no antidote

Question 25

most common complication of vitamin D toxicity

Answer 25

hypercalcemia

Question 26

treatment for vitamin D toxicity

what about if the patient is hypercalcemia

Answer 26

0.9% NaCl IV fluids
maropitant
phosphate binders

IF HYPERCALCEMIC - diuretics (furosemide), dexamethasone SP, bisphosphate, urinary catheter