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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
Q

What would you see on serum chemistry with ethylene glycol toxicity?

A
  1. Hypocalcemia
  2. Hyperglycemia
  3. Hyperkalemia
  4. Increased BUN
  5. Increased creatinine
  6. Increased phosphorus
26
Q

What would you see on urinalysis with ethylene glycol toxicity?

A
  1. Low USG

2. Urine pH < 6.5

27
Q

What type of crystalluira is associated with ethylene glycol toxicity?

A

Calcium oxalate crystalluria

28
Q

How might one diagnose an ethylene glycol toxicity?

A
  1. Calcium oxalate nephrosis
  2. Detection of EG in serum (test kit)
  3. GC/MS (analysis of serum or urine)
29
Q

True or False: The Ethylene Glycol Test Kits are specific for ethylene glycol.

A

FALSE: The test kits cross react with other compounds (propylene glycol, glycerol) that may cause a false positive.

30
Q

How might one treat an ethylene glycol toxicity?

A
  1. Reduce absorption: emetics, AC, cathartics
  2. Increase excretion: IV fluids
  3. Combat acidosis: Na bicarb
  4. 4-MP, ethanol
  5. Hemodialysis
31
Q

How much time post exposure could you utilize emetics, AC, or cathartics with EG?

A

1 - 2 hours

32
Q

How much time post exposure could you utilize 4-MP or ethanol to treat EG toxicity?

33
Q

What does 4-MP stand for?

A

4-methyl pyrazole

34
Q

Which is the preferred antidote for EG, 4-MP or ethanol?

35
Q

How long does 4-MP need to be administered?

A

At least 50 hours

36
Q

What are the 3 methylxanthine alkaloids?

A
  1. Caffeine
  2. Theobromine
  3. Theophylline
37
Q

What is the MOA of the methylxanthines?

A

Competitive antagonism of adenosine on adenosine receptors

38
Q

What are the 4 effects of antagonizing adenosine on adenosine receptors?

A
  1. Bronchodilation
  2. Vasoconstriction
  3. CNS stimulation
  4. Tachycardia
39
Q

Methylxanthines also increase what intracellularly?

40
Q

Methylxanthines stimulate the parasympathetic or sympathetic nervous system?

A

Sympathetic nervous system

41
Q

How do methylxanthines lead to the release of catecholamines?

A

Inhibit phosphodiesterase –> increase cAMP

42
Q

What would be the clinical effects associated with methylxanthine alkaloids?

A
  1. Tachycardia
  2. Vomiting/diarrhea
  3. Polyuria
  4. Hyperactivity/agitation/seizures
43
Q

Are the methylxanthine alkaloids diuretics or anti-diuretics?

44
Q

What is the most common methylxanthine intoxication, caffeine, theobromine, or theophylline?

A

Theobromine

45
Q

What are 2 sources of theobromine?

A
  1. Chocolate

2. Cocoa mulch

46
Q

Chocolate products often contain ___ - ___ mg caffeine / oz.

A

2 - 40 mg / oz

47
Q

Which of the chocolate products has the most theobromine content?

A

Baking chocolate

48
Q

Which of the chocolate products contains the least amount of theobromine?

A

White chocolate

49
Q

Dogs excrete what compound extremely slowly?

A

Theobromine

50
Q

What is the half life of theobromine in the dog?

51
Q

Which samples could you use to detect a methylxanthine intoxication?

A
  1. Urine
  2. Serum
  3. Stomach contents
  4. Liver
52
Q

How would one treat a methylxanthine alkaloid intoxication?

A
  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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