FMS III therapy for toxic agents

Question 1

carbon monoxide

Answer 1

high affinity binding to hemoglobin, decrease transport of O2 by preventing its bending to Hb
-txt with oxygen

Question 2

cyanide

Answer 2

binds to ferric iron of cytochrome oxidase. stops election transport. Death due to respiratory failure.
tx: sodium nitrate, sodium thiosulfate, hydroxocobalamine

Question 3

lead

Answer 3

inhibits delta-aminolevulinic acid (ALA) dehydratase and ferrochelatase

• tx: calcium disodium EDTA, dimercaprol
• succimer for kids

Question 4

Iron

Answer 4

induces lipid peroxidation in mitochondria and inhibits electron transport.
tx: deferoxamine

Question 5

dioxin or chlorinated aromatic hydrocarbon

Answer 5

• indirect action by inducing transcription via Ah receptor
• induction of enzymes ALA synthase and Ah hydroxylase
• no specific antidote, cholestyramine

Question 6

Paraquat

Answer 6

• induces ROS

- tx: serial activated charcoal and antioxidants

Question 7

Warfarin

Answer 7

blocks vitamin K epoxide

-treat with vitamin K or fresh frozen plasma for severe cases