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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
Q

What might you use to treat acetaminophen toxicity if there are no other choices?

A

Methylene blue

26
Q

What is the active ingredient in aspirin?

A

Acetylsalisylic acid

27
Q

True or False: Ibuprofen has a wide margin of safety.

A

FALSE: Ibuprofen has a narrow margin of safety.

28
Q

NSAIDs, such as Ibuprofen, have a high ____-binding capacity.

A

Protein-binding

29
Q

What is 5-fluorouracil used to treat in humans?

A

Basal cell carcinomas

30
Q

Which are more sensitive to 5-fluorouracil, dogs or cats?

31
Q

With 5-fluorouracil toxicity, is death prolonged or rapid?

A

Rapid, within 7 hours

32
Q

What are the clinical signs associated with 5-fluorouracil toxicity?

A
  1. Sloughing of GIT (bloody vomitus/feces)
  2. CNS signs (tremors, seizures)
  3. Bone marrow suppression
33
Q

True or False: 5-Fluorouracil toxicity is not necessarily an emergency.

34
Q

How might one treat a 5-fluorouracil intoxication?

A
  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
Q

What does Neupogen do?

A

Stimulate the bone marrow

36
Q

What does SSRI stand for?

A

Serotonin re-uptake inhibitors

37
Q

What is the MOA of SSRIs?

A

Inhibit uptake of serotonin at pre-synaptic membranes.

38
Q

True or False: SSRIs, like Ibuprofen, have a narrow safety margin.

39
Q

What is serotonin syndrome?

A

Drug-induced syndrome due to elevated serotonin levels in the CNS

40
Q

Which species is most susceptible to serotonin syndrome?

41
Q

There are 4 causes of serotonin syndrome, what ar they?

A
  1. Increased synthesis of serotonin
  2. Decreased breakdown of serotonin
  3. Blocked re-uptake of serotonin
  4. Serotonin agonists
42
Q

Name a drug that increases synthesis of serotonin.

A

Griffonia seed extract

43
Q

Name a drug that decreases breakdown of serotonin.

44
Q

Name a drug that blocks re-uptake of serotonin.

45
Q

Name a drug that acts as a serotonin agonist.

A

LSD, Imitrex

46
Q

What 4 systems does serotonin syndrome affect?

A
  1. CNS
  2. GI
  3. Neuromuscular
  4. Cardiovascular
47
Q

What are the clinical signs of serotonin syndrome?

A
  1. CNS: agitation, vocalization, seizures
  2. GI: vomiting, diarrhea
  3. Neuromuscular: tremors, ataxia
  4. Cardiovascular: tachycardia, hypertension
  5. HYPERTHERMIA
48
Q

What can be used to diagnosis of serotonin syndrome?

A

GC/MS in blood

49
Q

How would one treat serotonin syndrome?

A
  1. Symptomatic/supportive care
  2. Phenobarbital for seizures
  3. Cyproheptadine
  4. IV fluids
  5. Anti-emetics
50
Q

What is cyproheptadine?

A

Serotonin antagonist

51
Q

What is the MOA of TCAs?

A

Inhibit reuptake of norepinephrine and serotonin in the CNS

52
Q

What type of antagonists are TCAs?

A

Alpha-1 adrenergic antagonists

53
Q

TCAs have an affinity for which 2 receptors?

A
  1. Muscarinic receptors

2. Histamine (H1) receptors

54
Q

What are the clinical effects associated with TCAs?

A
  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
Q

How might one treat a TCA intoxication?

A
  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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