General kinds of poison (A-E) Flashcards
Used in anti-freeze preparation
Ethylene glycol
Ethylene glycol is excreted by __?
Kidney
Ethylene glycol causes ___?
Drunken state, severe high anion gap metabolic acidosis, acute renal failure
Ethylene glycol MOA
Oxidation
Ethylene glycol -> glycolaldehyde -> glycolic acid -> formic acid, glycine, oxalic acid -> CAUSES BLINDNESS
Ethylene glycol metabolites
Glycol aldehyde, Glycolic acid, Glyoxylic acid
Ethylene glycol toxic metabolite
Oxalic acid, formic acid
Acute renal failure seizure can be treated with
Diazepam
These enzymes converts alcohol to oxalic acid
alcohol dehydrogenase
Inhibit alcohol dehydrogenase
Fomipazole
Formic acid -> Co2
Leucorin
Systemic alkalizer
Hemodialysis + Sodium bicarbonate
For hypocalcemia
Ca gluconate
AKA wood alcohol
Methanol
Denaturant, pain remover, solvent
Methanol
Methanol MOA
Formaldehyde -> Formic acid (Blindness)
Methanol metabolites
Formaldehyde, Formic acid
Methanol treatment
Ethanol & Fomipazole
Sodium bicarbonate
Lethal dose of methanol
10 mL
Median lethal dose of methanol
100 mL
More toxic than ethanol but less toxic than methanol
Isopropyl alcohol
Crude oil alcohol
Isopropyl alcohol
Isopropyl alcohol contains __% of alcohol
70%
Isopropyl alcohol can lead to ___
Ketosis
Isopropyl alcohol treatment
Hemodialysis + gastric lavage
Aldehydes aka
Formaldehyde
Formaldehyde contains __% of aldehyde
35-50%
Formaldehyde common name
Formalin, formol
Embalming fluid
Formaldehyde
Similar in presentation to methanol toxicity
Formaldehyde
Signs and symptoms of formaldehyde local
Mucosal irritation
Signs and symptoms of formaldehyde systemic
CNS depression, coma, metabolic acidosis
Treatment for aldehyde
Ammonia + sodium bicarbonate
This is responsible for hangover
Formaldehyde
Formaldehyde aka
ethanal or acetaldehyde
Treatment for aldehydes
Hemodialysis + sodium bicarbonate
100% formalin contains
40% formaldehyde by volume and 37% by mass
It is an electrolyte disorder and imbalance of acid and base
Metabolic acidosis
Not highly toxic except unsaturated
Ketone/ Acetone
Simplest ketone
Acetone
Unsaturated ketone that is toxic
Methyl vinyl ketone
Ld50 of ketone, methyl vinyl chloride
7 mg/kg
Treatment for ketone
Neutralization -> Milk + H2o
Mostly derived from petroleum distillates
Hydrocarbon
Petroleum distillates –>
Kerosene
Signs and symptoms of for hydrocarbon
Lung aspiration
Treatment for hydrocarbon
Mineral oil
This is used to increased the viscosity of toxicant
Mineral oil
Benzene can cause __.
Megaloblastic leukemia, aplastic anemia
Most important toxidrome of acute exposure to benzene
CNS depression
The most significant serious toxic effect of chronic exposure to benzene - manifesting as aplastic anemia, agranulocytosis, and risk for the development of leukemia
Bone marrow injury
Treatment for hydrocarbon/ benzene
Ventilatory support + 100% O2
Meat preservatives
Inorganic nitrates
Chile saltpeter
Sodium Nitrate - NaNO3
Saltpeter
Potassium nitrate - KNO3
Treatment for angina pectoris
organic nitrates
ISMO
ISND
Imdur
Isordil
Vasodilator; Monday’s disease
Organic nitrates
Treatment for methomeglobinemia
Inorganic nitrites
Has antioxidant properties
Organic nitrites
Signs and symptoms of organic nitrites
Lightheadedness, headache, nausea and vomiting, diarrhea, abdominal pain
Treatment for organic nitrites
Methylene blue (1-2 mg/kg)
Low dose = ___
High dose = ___
Treatment
Can cause also MetHgb
Can cause silicosis
Silica
Sign and symptoms of silicosis
Lung fibrosis & Bcronchogenic cancer
Treatment for silica
Alumina
Asbetos causes
Asbestosis
Signs and symptoms of asbestosis
Lung cancer
Treatment for asbestos
Decontamination
used in non-flammable cleaning fluids and fire extinguishers
Carbon tetrachloride
Metabolites of carbon tetrachloride
Epoxide, Phosgene
War weapon
Phosgene
Hepatorenal toxin
Poison gas
Sign and symptoms of carbon tetrachloride
Difficulty in breathing, nausea & vomiting, Pulmonary edema and skin lesions
Treatment for carbon tetrachloride
Ventilatory support
Bleaches
Sodium hypochlorite
Sign and symptoms for bleaches
Esophageal irritation, GI discomfort
Treatment for bleaches
Gastric lavage
Metal cleaners and mat removers
Oxalic acid
Signs and symptoms of oxalic acid
Metabolic acidosis, seizures and hypocalcemia
Treatment for oxalic acid
Ca gluconate -> hypocalcemia
Shaver’s disease
Aluminum
3rd most abundant element; most abundant metal
Aluminum
Aluminum has __ effects
Constipating and astringent
Used in the galvanizing of iron and container for battery cells
Zinc
Defiency cause by zinc__
Parakeratosis
Toxicity for zinc
Metal fume fever
Treatment for zinc
Aspirin +bed rest
For hair removal
Depilatories
Depilatories contains __
Sulfides, thioglycolates
Signs and syptoms for depilatories
Local irritation
In milk production
Chloramine T
Signs and symptoms and treatment for Chloramine T
Transform in CN
Sodium thiosulfate; Sodium nitrate
FD & C no. 5
Tartrazine
Signs and symptoms of Tartrazine
Anaphylaxis in an allergic reaction
Signs and symptoms of MSG
Lightheadedness, tightness of the feet, seizure
Treatment for MSG
Lessen MSG in foods
Artificial sweeteners
Saccharin and aspartame
Signs and symptoms for artificial sweeteners
Diarrhea, abdominal pain, nausea, pain
Aspartame
Aspartic acid, Phenylalanine
Artificial sweetener causes
Phenylketonuria
Median lethal dose of MSG
15-18 mg/kg
Moth balls and coal tar
Napthalene
Causes coagulative necrosis
Acids
Causes Liquefactive necrosis
Alkali
Treatment for alkali
Dilutional therapy (a large amount of water + milk)
Sp treatment for alkali poisoning
Vinegar, fruit juice
Sp treatment for acid poisoning
Antacid (can be diluted with water except sodium hydroxide)
Acid and alkali are CI in
Gastric lavage, do not neutralize, emetic, cathartics
Source of hydrogen fluoride
Fluorinated water
Signs and symptoms of HF and treatment
Hypocalcemia, Ca gluconate
Agriculture; Weed killer
Paraquat
Is known to accumulate slowly in the lungs by an active process and causes lung edema, alveolitis, and progressive pulmonary fibrosis days to weeks after an acute exposure
Paraquat
Signs and symptoms of paraquat
Pulmonary edema, pulmonary fibrosis, alveolitis
MOA of paraquat
Inhibit superoxide dismutase
Strong oxidizing agent
Permanganate
Permanganate can cause
Methomoglobin
Other names of carbolic acid and discover by
Phenol; Joseph lister
MOA of phenol
Protein denaturation
Signs and symptoms of phenol- Local
Mucosal/ Local irritation, Redness of skin, corrosive
Signs and symptoms of phenol- Systemic
Seizure, Coma, Liver damage, Kidney damage
Diagnosis for phenol
Chemical evidence = Phenol + Iron chlorine -> Blue violet
Treatment for phenol
Castor oil
Cathartic
Resinoleic acid
Luminous vomitus
Phosphorous
Odor of phosphorous
Garlic odor
Treatment for phosphorus
Copper sulfate
Types of phosphorus
Red- granular, non-toxic, matches
Yellow/white- toxic’ can be seen in pyrotechnics and fireworks
Signs and symptoms of this toxicity is hepatic injury
Picric acid and tannic acid
Sources of cyanide
Prunus species
MOA of cyanide
Inhibits cytochrome c oxidase, oxygen consumption
Signs and symptoms of cyanide
CNS/CV disturbances, Seizure, Respiratory depression, death, odor of bitter almonds, cherry red blood
Treatment of cyanide
Sodium nitrite
Amyl nitrite (inhalation)
Methylene blue
Sodium thiosulfate
Alternative tx for cyanide
Dicobalt edentate (Kelocyanor)
Hydroxycobalamin -> Vitamin b12
A result of incomplete combustion
Carbon monoxide
Carbon monoxide is secondary to __
smoking
A most common cause of air pollution
Carbon monoxide
MOA of carbon monoxide
CO -> Hg _ carboxyhemogloginemia -> 200x nonbinding capacity than hg
Signs and symptoms of CO
Cherry red color of the blood
Hypoxia -> anoxia -> death
Psychomotor impairment-> headache -> confusion -> tachycardia -> coma
Tx for CO
100% O2
Hyperbaric o2 -> revives dead tissue
Artificial air -> 80% helium + 20% oxygen
Hyperbaric oxygen supplementation
This may be a necessary intervention if no response is seen with 100% oxygen supplementation in cases of poisoning with MO and cyanide
Hyperbaric oxygen supplementation
Hydrogen sulfide odor
Rotten egg odor
Hydrogen sulfide MOA
Binds with hemoglobin to form another abnormal form of hemoglobin with sulfhemoglobinemia
Hydrogen sulfide signs and symptoms
Dyspnea, Decreased O2 consumption
