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Toxicology (Spring 2017) > Ethylene Glycol and Methylxanthines > Flashcards

Ethylene Glycol and Methylxanthines Flashcards

1
Q

When are the most toxicities associated with ethylene glycol seen?

A

When in highest use (fall and winter)

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2
Q

What is the death rate associated with ethylene glycol?

A

75%

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3
Q

True or False: Malicious poisoning associated with ethylene glycol is increasing.

A

TRUE

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4
Q

True or False: Ethylene glycol has a bitter taste.

A

FALSE: sweet taste

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5
Q

Ethylene glycol is absorbed intact, and then when would you see peak blood levels reached?

A

1 - 4 hours

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6
Q

Ethylene glycol is associated with a mild CNS depression or excitation?

A

CNS depression

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7
Q

Ethylene glycol is rapidly metabolized by the liver enzyme ____ ____.

A

Alcohol dehydrogenase

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8
Q

Metabolism of ethylene glycol to toxic organic acids by alcohol dehydrogenase in the liver causes what?

A

An acidosis

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9
Q

10% of ethylene glycol is excreted unchanged in the urine. The remainder is metabolized to what?

A

Oxalic acid

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10
Q

Oxalic acid kelates calcium to form what?

A

Calcium oxalate

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11
Q

Current therapeutic response is to prevent metabolism of the ethylene glycol to ______.

A

Oxalic acid

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12
Q

In addition to 10% of the ethylene glycol, what other substance is excreted in the urine?

A

Hippuric acid

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13
Q

With ethylene glycol toxicity, was is expired?

A

CO2

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14
Q

What is the half life of ethylene glycol?

A

3 hours

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15
Q

How long is the acute stage of ethylene glycol toxicity?

A

30 minutes - 12 hours

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16
Q

What 4 clinical signs are associated with the acute stage of ethylene glycol toxicity?

A
  1. PU/PD
  2. Ataxia
  3. Vomiting
  4. Depression
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17
Q

How long is the 2nd stage (renal stage) of ethylene glycol toxicity?

A

12 - 72 hours

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18
Q

What type of clinical effects are associated with the 2nd stage of ethylene glycol toxicity?

A
  1. Vomiting
  2. Acidosis
  3. Isosthenuria
  4. Miosis
  5. Coma
  6. Seizures
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19
Q

What is the clinical pathology change associated with ethylene glycol toxicity?

A

Hypocalcemia

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20
Q

What is the 3rd stage of ethylene glycol toxicity associated with?

A

Oliguric renal failure

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21
Q

What would you see on a CBC with ethylene glycol toxicity?

A
  1. Increased PCV
  2. Increased serum protein
  3. Stress leukogram
22
Q

How does ethylene glycol make an animal want to drink more?

A

Increases the osmolarity of the blood, is passed in the urine, causes diuresis, and results in PU/PD

23
Q

With ethylene glycol toxicity, what is seen on the stress leukogram?

A
  1. Neutrophilia

2. Lymphopenia

24
Q

Which 3 systems does ethylene glycol target?

A
  1. CNS
  2. GI
  3. Kidney
25
What would you see on serum chemistry with ethylene glycol toxicity?
1. Hypocalcemia 2. Hyperglycemia 3. Hyperkalemia 4. Increased BUN 5. Increased creatinine 6. Increased phosphorus
26
What would you see on urinalysis with ethylene glycol toxicity?
1. Low USG | 2. Urine pH < 6.5
27
What type of crystalluira is associated with ethylene glycol toxicity?
Calcium oxalate crystalluria
28
How might one diagnose an ethylene glycol toxicity?
1. Calcium oxalate nephrosis 2. Detection of EG in serum (test kit) 3. GC/MS (analysis of serum or urine)
29
True or False: The Ethylene Glycol Test Kits are specific for ethylene glycol.
FALSE: The test kits cross react with other compounds (propylene glycol, glycerol) that may cause a false positive.
30
How might one treat an ethylene glycol toxicity?
1. Reduce absorption: emetics, AC, cathartics 2. Increase excretion: IV fluids 3. Combat acidosis: Na bicarb 4. 4-MP, ethanol 5. Hemodialysis
31
How much time post exposure could you utilize emetics, AC, or cathartics with EG?
1 - 2 hours
32
How much time post exposure could you utilize 4-MP or ethanol to treat EG toxicity?
2 hours
33
What does 4-MP stand for?
4-methyl pyrazole
34
Which is the preferred antidote for EG, 4-MP or ethanol?
4-MP
35
How long does 4-MP need to be administered?
At least 50 hours
36
What are the 3 methylxanthine alkaloids?
1. Caffeine 2. Theobromine 3. Theophylline
37
What is the MOA of the methylxanthines?
Competitive antagonism of adenosine on adenosine receptors
38
What are the 4 effects of antagonizing adenosine on adenosine receptors?
1. Bronchodilation 2. Vasoconstriction 3. CNS stimulation 4. Tachycardia
39
Methylxanthines also increase what intracellularly?
Calcium
40
Methylxanthines stimulate the parasympathetic or sympathetic nervous system?
Sympathetic nervous system
41
How do methylxanthines lead to the release of catecholamines?
Inhibit phosphodiesterase --> increase cAMP
42
What would be the clinical effects associated with methylxanthine alkaloids?
1. Tachycardia 2. Vomiting/diarrhea 3. Polyuria 4. Hyperactivity/agitation/seizures
43
Are the methylxanthine alkaloids diuretics or anti-diuretics?
Diuretics
44
What is the most common methylxanthine intoxication, caffeine, theobromine, or theophylline?
Theobromine
45
What are 2 sources of theobromine?
1. Chocolate | 2. Cocoa mulch
46
Chocolate products often contain ___ - ___ mg caffeine / oz.
2 - 40 mg / oz
47
Which of the chocolate products has the most theobromine content?
Baking chocolate
48
Which of the chocolate products contains the least amount of theobromine?
White chocolate
49
Dogs excrete what compound extremely slowly?
Theobromine
50
What is the half life of theobromine in the dog?
18 hours
51
Which samples could you use to detect a methylxanthine intoxication?
1. Urine 2. Serum 3. Stomach contents 4. Liver
52
How would one treat a methylxanthine alkaloid intoxication?
1. Artificial respiration 2. Emetics, lavage, AC 3. Control seizures 4. Lidocaine for VPCs 5. Fluids

Toxicology (Spring 2017) (15 decks)

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