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Toxicology > Introduction to Clinical Toxicology > Flashcards

Introduction to Clinical Toxicology Flashcards

1
Q

What are some toxin sources?

A

Pesticides, drugs, chemicals, toxins (bacterial, fungal, plant, animal), feed additives, poisonous gaases

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2
Q

What is toxicology?

A

Study of poisons

Includes identification, chemical properties, biologic effects, and treatment of conditions

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3
Q

What is poison synonymous with?

A

Toxin or toxicant

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4
Q

What is a xenobiotic?

A

Foreign drug or chemical in body (harmful or not)

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5
Q

What is toxicity?

A

Refers to the amount of poison or potency (mg/kg)

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6
Q

What is dose response?

A

Greater the dose, the greater the respons

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7
Q

What is threshold dose?

A

Dose = no detrimental effects measured

Most toxic responses increase in severity with increasing amounts of toxicants

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8
Q

What is a lethal dose?

A

Potential of drug or chemical to cause death

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9
Q

What is LD50?

A

The dosage lethal to 50% of animals eposed

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10
Q

What is LC50?

A

Concentration of xenobiotic in water lethal to 50% of animals exposed

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11
Q

What is the dose-response relationship?

A

Xenobiotic interacts with molecular receptor site to produce response
Degree of response is correlated to xenobiotic concetration at receptor site
Xenobiotic concentration at receptor site is related to dose received

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12
Q

What is a target organ?

A

Area of the body most often affected by xenobiotic

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13
Q

What are the routes of toxicant exposure?

A 
Ingestion
Cutaneous
Inhalation
Injection
Ocular
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14
Q

What are factors that affect toxicant intake orally?

A

Weight of exposed animal
Percent body weight of toxicant consumed
Concentration of xenobiotics

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15
Q

What is the average water intake?

A

2-3 L of water/kg of dry feed consumed

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16
Q

What is 1 ppm equal to?

A

1 mg/kg
1 μg/g
1 mg/L

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17
Q

How many ppm is a 1% solution?

A

10,000 ppm

Move decimal 4 places to the right for percent to ppm

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18
Q

What are the 4 events that occur with post-xenobiotic exposure?

A

Aborption
Distribution within the body
Metabolism
Excretion

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19
Q

What is absorption?

A

Movement of xenobiotic from site of administration into the blood

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20
Q

What is the rate of xenobiotic diffusion across a membrane proportional to?

A

Concentration across membrane, lipid/water partition coefficient, and diffusion coefficient

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21
Q

What does toxicant transportation by blood depend on?

A

Physiochemical properties
Concentration gradient between blood and tissue
Ratio of blood flow to tissue mass
Affinity of xenobiotic for tissue

22
Q

What is the distribution of toxins associated with?

A

Site with susceptible receptors where reaction can occur

Inert site without receptors or effect

23
Q

What is the most metabolically active organ?

A

Liver

24
Q

What is the goal of biotransformation?

A

Make xenobiotic more water soluble

25
Q

What is the most common route of excretion?

A

Renal excretion (glomerular filtration or active tubular secretion)

26
Q

How can diagnostic evaluation help with toxicology?

A

Determine cause or source of intoxication
Enable specific therapy with specific antidotes/prevention
Protect public health
Determine liability

27
Q

What does a confirmed toxicology diagnosis test rest upon?

A 
History
Clinical signs
Lesions
Clinical tests
Animal tissue samples
Environmental samples
Chemical analysis
Bioassays
28
Q

True or False: treat the patient, not the poison

A

True

29
Q

How can you treat the patient?

A 
Telephone instructions
Remove from source
Label (amount, toxic ingredients, antidotes)
Time of exposure
Vomiting
Emergency
30
Q

What are the goals for therapy of an intoxicated patient?

A 
Stabilize vital signs
Clinical evaluation
Prevent continued exposure
Facilitate removal of absorbed toxicant
Antidote
Supportive therpay
31
Q

How do you stabilize vital signs?

A 
Ensure patent airway
Make sure patient is breathing
Prevent aspiration of vomitus
Maintain cardiovascular function
Control CNS stimulation
Control body temperature
32
Q

When is emergency intervention necessary?

A

Respiratory depression or failure
Manage cardiac arrhythmias
Shock-sequela to toxicants that cause fluid loss, vomiting, diarrhea, blood loss, or cardiomyopathy
CNS emergency

33
Q

How can shock-sequela be treated?

A

Fluids
Blood
Monitor CVP
Blood gas

34
Q

What is used to treat seizures?

A

Diazepam
Phenobarbital
Pentobarbital

35
Q

How do you treat hyperthermia?

A

Cold baths
Ice packs
Cooled IV fluids

36
Q

How do you treat hypothermia?

A

Blankets
Hot water bottles
Heating pads

37
Q

How can you prevent continued absorption?

A

Emesis

38
Q

How much can emesis remove?

A

60% of ingesta

39
Q

True or False: emesis is still effective 2-4 hours after ingestion

A

False

40
Q

What is emesis not used in? Why?

A

Rodents, rabbits, horses, or ruminants

They cannot vomit safely or effectively

41
Q

When is emesis contraindicated?

A

When an animal is unconscious, depressed, seizuring, or suspect corrosive or caustic volatile materials

42
Q

What is used when emesis is ineffective or contraindicated?

A

Gastric lavage

43
Q

What is the purpose of an endotracheal tube for gastric lavage?

A

Prevent aspiration of stomach contents

44
Q

How is lavage fluid administered for gastric lavage?

A

Gently by gravity flow at 10 ml/kg

45
Q

What is an enterogastric lavage?

A

Gastric lavage and retrograde high enema give with the gastric tube and endotracheal tube still in place

46
Q

How does adsorption with activated charcoal work?

A

Physical binding of toxicant with charcoal (unabsorbable) eliminated in feces

47
Q

What is charcoal usually administered with and why?

A

Cathartic (sodium sulfate orally)

Hastens removal of toxicant-charcoal complex and removes constipation from charcoal

48
Q

When is gastrotomy, rumenotomy, and endoscopy used?

A

Refractory cases
Foreign bodies
Toxic oils, tars

49
Q

What is used in the case of dermal exposure?

A

Wash with warm water and soap or mild detergent

Clip long haired animals

50
Q

What is used in the case of icular exposure?

A

Immediate flush with water or physiological saline

51
Q

How can you facilitate removal of absorbed toxicant?

A

Activated charcoal

Diuresis

52
Q

What do patients often benefit from?

A

Supportive and symptomatic therapy which offset toxic effects

Toxicology (4 decks)

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