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Pharmacology > EXAM #5: INTRODUCTION TO TOXICOLOGY > Flashcards

EXAM #5: INTRODUCTION TO TOXICOLOGY Flashcards

1
Q

What is toxicology?

A

Subtopic of pharm concentrating on the effects and properties of toxic substances

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2
Q

What does it mean that poisoning if situational and quantitative in nature?

A

Any substance at the right DOSE and for the right amount of TIME can be a poison

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3
Q

Why do we study toxicology?

A

1) Protect us from adverse effects of toxicants

2) To develop improved toxicants

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4
Q

What is the definition of the LD50?

A

Dose at which 50% of animals die

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5
Q

What is the definition of the TI i.e. how do you calculate the TI?

A

LD50/ED50

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6
Q

What does a big TI indicate?

A

Safe drug

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7
Q

What is the ALD?

A

Average Lethal Dose

*Note that this is estimated from accidental deaths in humans

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8
Q

What is the primary determinant of toxicity?

A

Dose–you want to know:

  • How much?
  • When?
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9
Q

How do you clinically manage poisoning?

A

1) Support patient’s vitals:
- ABCs
2) Reduce or remove drug

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10
Q

What are two treatments that can be considered for an “unconscious for unknown reason” type patient?

A

1) Glucose

2) Naloxone

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11
Q

What is a toxidrome?

A

Group of signs and symptoms constituting the basis for the diagnosis of poisoning

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12
Q

What are two emesis inducers?

A

1) Apomorphine

2) Syrup of Ipecac

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13
Q

What are the contraindications to emesis inducers?

A
  • Chemical pneumonitis e.g. WD40

- Acid or alkali agents

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14
Q

What is the MOA of activated charcoal?

A

Very large SA that binds to toxic agent

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15
Q

When should charcoal be administered?

A

Within 30 min. or ingestion

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16
Q

What cross reaction do you need to remember about activated charcoal?

A

Efficacy of other medications will decrease with charcoal administration

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17
Q

What is the antidote to organophosphate poisonin e.g. Sarin, insecticide bomb…etc?

A

Pralidoxime or 2-PAM
- Binds organophosphate

Atropine= blocks muscarinic effects

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18
Q

What is the MOA of cyanide poisoning?

A

Deactivation of cytochrome C in mitochondrial membrane

CNS and cardiac tissue most affected

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19
Q

What is the antidote for cyanide poisoning?

A

Amyl nitrite
Sodium nitrite
Sodium thiosulfate

*All with O2

20
Q

What is the most potent poison known to man?

A

Botulinum toxin (prevents ACh release from nerve terminal)

21
Q

What are BAL, EDTA, DMSA, DMPS, calcium EDTA, and deferoxamine used to treat?

A

Heavy metal poisoning

22
Q

What is DMSA specifically indicated for?

A

Treatment of:

  • Arsenic
  • Mercury
  • Lead poisoning
23
Q

How is DMSA dosed?

A

10mg/kg PO for 5x days if OVER 12

- Under 12, add an additional 14 days for 19 total days of treatment

24
Q

What is the antidote for Botulinsm toxin?

A

Antibody for Botulism A, B, and E

25
Q

What is the MOA of the drugs used to treat cyanide poisoning?

A

1) Oxidize Hb to methemoglobin
2) Binds cyanide to make cyanmethemoglobin

ADD Sodium thiosulfate
3) Cyanmethemoglobin–>thiocyanate and Hb

26
Q

How can ethylene glycol/methanol/isopropyl alcohol poisoning be treated without an antidote?

A

Ethanol that will competitively inhibit alcohol dehydrogenase

27
Q

What is the antidote for ethylene glycol/ methanol/ isopropyl alcohol poisoning?

A

Fomepizole

28
Q

What is the MOA of Fomepizole?

A

Blocks alcohol dehydrogenase from making toxic metabolites

29
Q

How does the affinity of CO for Hb compare to O2?

A

CO has 210x greater affinity

30
Q

What is the treatment for CO poisoning?

A

Hyperbaric O2

31
Q

What is the classic appearance of CO poisoning?

A

Cherry red lips/gums

32
Q

How does an overdose of Warfarin present?

A

Excessive bleeding e.g:

  • Hemoptysis
  • Bruising
  • Bleeding from nose or gums
  • Blood in the urine/stool
33
Q

What is the antidote for Warfarin?

A

Vitamin K

34
Q

What are the antidotes for opoid overdose? What is the difference?

A

Naloxone= acute OD b/c of short half-life

Naltrexone= longer duration of action

35
Q

What is methemoglobinemia?

A

Heme iron is in the Fe3+ state that cannot bind O2

36
Q

What is the antidote for methemoglobinemia?

A

Methylene Blue

37
Q

What is the MOA of Methylene Blue for Methemoglobinemia?

A

Direction chemical reduction of methemoglobin back to Hb

38
Q

List the signs/ sx associated with a sympathomimetic toxidrome.

A

Mydriasis
HTN
Tremor
Hyperthermia

39
Q

What are the drugs associated with sympathomimetic toxidromes?

A

Cocaine
Amphetamines
PCP

40
Q

List the signs/ sx associated with a sedative/hypnotic toxidrome.

A

Coma
Decreased respiratory drive
Miosis or mydriasis
Hypotension

41
Q

What are the common drugs that lead to a sedative/hypnotic toxidrome?

A

Alcohol
Barbiturates
Benzodiazepines

42
Q

List the signs/ sx associated with a opiate toxidrome.

A

Coma
Respiratory depression
Miosis

43
Q

List the signs/ sx associated with an anticholinergic toxidrome.

A

CNS agitation
Mydriasis

Fever
Dry skin
Flushing
Urinary retention

Remember, “Hot Dry Red Mad and Blind”

44
Q

What is the mnemonic to remember the toxidrome associated with Cholinergic agents?

A

SLUDGE

Salivation 
Lacrimation 
Urination 
Diaphoresis 
GI Upset 
Emesis
45
Q

List the signs/ sx associated with a TCA toxidrome.

A 
Agitation-->coma
Mydriasis 
Dysrhythmia
Convulsions 
Hypotension
46
Q

List the signs/ sx associated with a salicylate/aspirin toxidrome.

A 
Increased respirations
Diaphoresis 
Tinnitus 
Agitation 
Hyperpyrexia

Pharmacology (64 decks)

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