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Toxicology (Spring 2017) > Final Exam: OTC Analgesics and Other Medications > Flashcards

Final Exam: OTC Analgesics and Other Medications Flashcards

1
Q

In cats, Acetaminophen is safe up to what dose?

A

NO DOSE IN SAFE

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2
Q

Acetaminophen causes what clinical effects in cats?

A
  1. Methemoglobinemia
  2. Anemia
  3. Hematuria
  4. Hemoglobinuria
  5. Edema of face and paws
  6. Anorexia
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3
Q

Acetaminophen mainly affect which 2 systems in the cat?

A
  1. Cardiovascular

2. Metabolic

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4
Q

Acetaminophen mainly affects which 2 systems in the dog?

A
  1. GI

2. Liver

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5
Q

Acetaminophen causes what clinical effects in the dog?

A
  1. Icterus
  2. Hemolysis
  3. Elevated liver enzyems
  4. Elevated bilirubin
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6
Q

What is the antidote to acetaminophen?

A

N-acetylcysteine

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7
Q

What are your options for supportive care associated with acetaminophen toxicity?

A
  1. SAMe
  2. Ascorbic acid
  3. Methylene blue
  4. RBC or oxyglobin if methemogloinemia or anemia)
  5. Cimetidine to block metabolism of APAP
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8
Q

What is the half life of aspirin in the cat?

A

38-45 hours

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9
Q

What is the half life of aspirin in the dog?

A

7-8 hours

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10
Q

Like aspirin, what else contains salicylate acid and is toxic to dogs and cats?

A

Pepto bismol

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11
Q

What is the MOA of aspirin?

A

COX-inhibitor that reduces thromboxane and prostaglandin

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12
Q

What are the clinical signs associated with aspirin ingestion?

A
  1. Emesis
  2. Fever
  3. Hyperventilation
  4. Liver failure
  5. Anorexia/depression
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13
Q

Does aspirin cause hypokalemia or hyperkalemia?

A

Hypokalemia

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14
Q

Does aspirin cause hyponatremia or hypernatremia?

A

Hypernatremia

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15
Q

Would aspirin cause a metabolic acidosis or metabolic alkalosis?

A

Metabolic acidosis

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16
Q

How would you treat an aspirin intoxication?

A

Supportive care: emesis, AC, cathartics, IV fluids, Na bicarb, blood transfusions, sucralfate, cimetidine, ranitidine.

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17
Q

What is the active ingredient in “children’s tylenol”?

A

Acetaminophen

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18
Q

Which is more susceptible to acetaminophen intoxication, dogs or cats?

A

Cats

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19
Q

True or False: Acetaminophen is still toxic if not metabolized.

A

FALSE

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20
Q

With acetaminophen, would serum APAP be increased or decreased?

A

Increased

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21
Q

With acetaminophen, would blood glutathione be increased or decreased?

A

Decreased

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22
Q

How does N-acetylcysteine work?

A

Provides the sulfydryl groups to bind acetaminophen metabolites and encourage their excretion

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23
Q

When would you use cimetidine with acetaminophen toxicity?

A

ONLY in dogs

24
Q

What is cimetidine?

A

Cytochrome p450 inhibitor

25
What might you use to treat acetaminophen toxicity if there are no other choices?
Methylene blue
26
What is the active ingredient in aspirin?
Acetylsalisylic acid
27
True or False: Ibuprofen has a wide margin of safety.
FALSE: Ibuprofen has a narrow margin of safety.
28
NSAIDs, such as Ibuprofen, have a high ____-binding capacity.
Protein-binding
29
What is 5-fluorouracil used to treat in humans?
Basal cell carcinomas
30
Which are more sensitive to 5-fluorouracil, dogs or cats?
Cats
31
With 5-fluorouracil toxicity, is death prolonged or rapid?
Rapid, within 7 hours
32
What are the clinical signs associated with 5-fluorouracil toxicity?
1. Sloughing of GIT (bloody vomitus/feces) 2. CNS signs (tremors, seizures) 3. Bone marrow suppression
33
True or False: 5-Fluorouracil toxicity is not necessarily an emergency.
FALSE
34
How might one treat a 5-fluorouracil intoxication?
1. IV fluids 2. Colloids 3. Blood prodcuts 4. Anti-emetics 5. GI protectants (famotidine, ranitidine, cimetidine, omeprazole) 6. Seizure control 7. Antibiotics if leukopenic 8. Neupogen
35
What does Neupogen do?
Stimulate the bone marrow
36
What does SSRI stand for?
Serotonin re-uptake inhibitors
37
What is the MOA of SSRIs?
Inhibit uptake of serotonin at pre-synaptic membranes.
38
True or False: SSRIs, like Ibuprofen, have a narrow safety margin.
TRUE
39
What is serotonin syndrome?
Drug-induced syndrome due to elevated serotonin levels in the CNS
40
Which species is most susceptible to serotonin syndrome?
Canine
41
There are 4 causes of serotonin syndrome, what ar they?
1. Increased synthesis of serotonin 2. Decreased breakdown of serotonin 3. Blocked re-uptake of serotonin 4. Serotonin agonists
42
Name a drug that increases synthesis of serotonin.
Griffonia seed extract
43
Name a drug that decreases breakdown of serotonin.
MAOIs
44
Name a drug that blocks re-uptake of serotonin.
SSRIs
45
Name a drug that acts as a serotonin agonist.
LSD, Imitrex
46
What 4 systems does serotonin syndrome affect?
1. CNS 2. GI 3. Neuromuscular 4. Cardiovascular
47
What are the clinical signs of serotonin syndrome?
1. CNS: agitation, vocalization, seizures 2. GI: vomiting, diarrhea 3. Neuromuscular: tremors, ataxia 4. Cardiovascular: tachycardia, hypertension 5. HYPERTHERMIA
48
What can be used to diagnosis of serotonin syndrome?
GC/MS in blood
49
How would one treat serotonin syndrome?
1. Symptomatic/supportive care 2. Phenobarbital for seizures 3. Cyproheptadine 4. IV fluids 5. Anti-emetics
50
What is cyproheptadine?
Serotonin antagonist
51
What is the MOA of TCAs?
Inhibit reuptake of norepinephrine and serotonin in the CNS
52
What type of antagonists are TCAs?
Alpha-1 adrenergic antagonists
53
TCAs have an affinity for which 2 receptors?
1. Muscarinic receptors | 2. Histamine (H1) receptors
54
What are the clinical effects associated with TCAs?
1. Sedation 2. Seizures 3. Cardiac arrhythmias 4. CV collapse 5. Anticholinergic effects: mydriasis, blurred vision, dry mouth, tachycardia, urinary retention, slowed GI transit time
55
How might one treat a TCA intoxication?
1. Emesis, gastric lavage, AC 2. Monitor EKG 3. Keep blood pH above 7.6 4. Control seizures

Toxicology (Spring 2017) (15 decks)

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