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Pharmacology > Exam3Lec2Toxicology > Flashcards

Exam3Lec2Toxicology Flashcards

1
Q

What are the toxic gases?

A

CO and HCN

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2
Q

Carbon Monoxide (CO)
A. Features
B. Exposure
C. MOA
D. Clinical presenations
E. Treatment

A

A. Features:Colorless, odorless, tasteless
B. Exposure: combusion from cars, fireplaces, furnaces, charcoal
C. MOA: CO binds to hemoblogin lowering unloading of O2 to other tissues and incr O2 affinity at other sites
D. Clinical presentations: hypoxia, lethargy dyspnea, confusion, coma/death
E. Treatment: remove CO source and give 100% O2 via hyperbaric chamber

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3
Q

Cyanide (HCN)
A. Exposure
B. MOA
C. Treatment

A

A. Exposure: burning of plastics , wool, apple, peach, apricot, cassava “APAC”
B. MOA: Inhibits Cytochrome A3 mediated electron transfer, preventing oxidative phosphyrolation and ATP production.
C. Treatment: Sodium nitrate, Sodium thiosulfate, Hydroxocobalamin(Vitamin B12)

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4
Q

How does treatment work forSodium nitrate, Sodium Thiosulfate, and Hydroxocobalamin?

A

sodum nitrate or amyl nitrate converts hemoglobin into methmoglobin which binds to cyanide with high affinity to produce cyanmethemoglobin

sodium thiosulfate converts cyanide into less toxic thiocynate

Hydroxocobalmin converts CN to cyanocobalamin which is renally excreted.

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5
Q

A 3 year old boy ingests 30 ferrous sulfate tablets. Which of the following most likely will develop signs of acute toxicity?
A. stomach
B. liver
C. kidney
D. Pancreas

A

A. stomach

b/c gastroenteritis

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6
Q

What are the toxic inhaled particles?

A

silica and asbestos

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7
Q

Silica
A. Exposure
B. Toxicity
C. Prevention

A

A. Exposure: mines, construction sites, stone cutters
B. Toxicity: Silicosis: progressive lung disease that can result in fibrosis and emphysema
C. Prevention: minimize exposiure (no cure)

silica-stones=sites (3 s)

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8
Q

Asbestos
A. Exposure
B. Toxicity
C. Treatment

A

A. Exposure: inhalation of fibers damage the lungs
B. Toxicity: can cause abestosis, mesothelioma, cancer.
C. Treatment: Prevention and supportive treatment

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9
Q

Rare cancer of the chest wall of peritoneum

A

Mesothelioma

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10
Q

Interstitial and pleural fibrosis and calcifications

A

Asbestosis

clinical presenations: SOB, severe coigh and chest pains, progressive disease, no specific treatment.

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11
Q

What are the toxic drugs

A

1.Methylenedioxymethamphetamine (MDMA)
2.Gamma-hydroxybutyrate (GHB)
3.Acetaminophen
4.Benzodiazepines
5.Opiods
6.Tricyclic Antidepressants

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12
Q

Methylenedioxymethamphetamine (MDMA)
A. Other names
B. MOA
C. Cardiopulmonary effects
D. Neurologic effects
E. Psychologic effects
F. Musculoskelets effects
G. Additional effects

A

A. Other names: street drug, ecstasy
B. MOA: Causes the release of serotonin (5-HT) and inhibits uptake and synthesis of 5-HT (see incr accumulation of 5-HT in synaptic cleft)
C. Cardiopulmonary effects: tachy and HTN
D. Neurologic effects: Hyperthermia, seizures
E. Psychologic effects: Euphoria, anxiety
F. Musculoskelets effects: teeth grinding, rhabdomyolysis
G. Additional effects: hyponatremia

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13
Q

Treatment of Methylenedioxymethamphetamine (MDMA)

A
  • Hyponatremia: fluid restriction
  • Refractory HTN: nitroprusside or phentolamine
  • Hyperthermia: aggressive external cooling with ice
  • Anxiety and seizures: diazepam
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14
Q

Gamma-hydroxybutyrate (GHB)
A. Exposure
B. MOA
C. Cardiopulmonary effects
D. CNS effects
E. Additional effects

A

A. Exposure: raves, rape drug
B. MOA: GABAb receptor agonist, incr dopaminergic activity, onset is 15 min
C. Cardiopulmonary effects: hypoxia, brady, hypotension
D. CNS effects: euphoria, deep sleep, coma, hallucination
E. Additional effects: salivation vomitting, hypthermia

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15
Q

Gamma-hydroxybutyrate (GHB) treatment

A

Bradycardia treament with atropine
Severe withdrawal treatment with pentobarbital

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16
Q

Acetaminophen
A. Toxicity
C. Treatment

A

A. Toxicity: high amounts can cause liver damage by CYP mediated bioactivation
C. Treatment: N-acetylcysteine is antidote for acetaminophen overdose
* inactivates metabolities
* administer within 8-10 hours to be most effective

can wait longer to administer it b/c the liver and kidney would be damaged

17
Q

MOA (bioactivation) for Acetaminophen

A
  1. Acetominophen can under 2 bioactivation pathways, 1. glucourination and 2. sulfation which both produce non-toxic metabolites of acetominophen
  2. With overdose of acetominophen, it can undergo bioactivation through CYP enzyme creating NAPQI intermediate
  3. This intermediate is very electrophilic and interacts with the nucleophiles on the liver and kidney, which can then lead to liver cell death
18
Q

Benzodiazepines (Diazepam, Chlorodiazepoxide)
A. Toxicity
B. High toxicity
C. Treatment

A

A. Toxicity: Incr in GABA activity at GABAa receptor, leads to CNS and Resp depression
B. High toxicity : with ETOH, short acting benzos (midazolam), opiods
C. Treatment: supportive, Flumanezil (GABAa antag), Activated charcoal (adsorption)

death is rare
NOT GABAb

19
Q

Opiods (morphine, heroin, oxycodone, fentanyl, carfentanil)
A. Toxicity
B. Treatment

A

A. Toxicity: mu receptor agonist causes CNS and Resp depression
B. Treatment: supportive, Naloxone/Naltrexone (mu antags), Activated charcoal

20
Q

Tricylic Antidepressants (TCA): Amitriptyline, Desiprammine -ine)
A. Toxicity
B. Treatment

A

A. Toxicity: Incr in norepi and serotonin in synapti cleft, alpha recepetor antag and Na+ channel blocker, tachy
B. Treatment: supportive, sodium bicarbonate (reverse sodium channel blockage), activated charcoal

think “anti-sodium”

21
Q

A MSP3 student who began interviewing at several prestigious medical schools is studying the effects of toxicants on human neuronal cell lines at the MCOM. Which of the following NT does methylenedioxymethamohetamine incr the most?
A. Glutamate
B. GABA
C. Serotonin
D. Dopamnine

A

C.Serotonin

22
Q

A child takes too many iron tablets and is given a chelator to treat his symptoms. He subsequently develops acute respiratory distress. Which of the following was he likely giving?
A. Dimercaprol
B. Penicillamine
C. Succimer
D. Deferoxamine

A

D. Deferoxamine

23
Q

The burning of plastics and wool can lead to which of the following toxicities?
A. HCN
B. CO
C. CHCl3
D. CCl4

A

A. HCN

24
Q

Which of the following is a GABA receptor agonist?
A. MDMA
B. GHB
C. Morphine
D. TCA

A

B. GHB

GHB-GABAb

25
Q

Intermittent phlebotomy is a treatment for chronic toxicity of which of the following?
A. Fe
B. Pb
C. Hg
D. Cu

A

A. Fe

Pharmacology (26 decks)

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