Lec 4 Flashcards
What are pesticides?
Compounds designed to eradicate undesirable pests
Includes insecticides and rodenticides
List the types of insecticides.
- Organophosphorus
- Carbamate
- Organochlorine
- Pyrethroids
- Naphthalene
- Inorganic insecticides (e.g. Lead hydrogen arsenate)
Organophosphorus and carbamate are common categories
What types of rodenticides are mentioned?
- Anticoagulants
- Zinc phosphide
- Strychnine
- Naphthylthiourea agents
- Fluorinated agents
These are used to control rodent populations
What are the conditions of pesticide exposure?
- Accidental
- Occupational
- Suicidal
- Homicidal
Accidental exposure is common, especially in children
What is the mechanism of action of organophosphorus insecticides?
Inhibit cholinesterase, leading to accumulation of acetylcholine
This causes stimulation followed by depression of nicotinic and muscarinic receptors
What are the clinical manifestations of organophosphorus insecticide poisoning?
- CNS stimulation: anxiety, irritability, convulsions
- CNS depression: coma, respiratory & cardiovascular depression
- Muscarinic effects: DUMBELS
- Nicotinic effects: muscular fasciculation then weakness
DUMBELS stands for Diarrhea, Urination, Miosis, Bradycardia, bronchorrhea, bronchospasm, Emesis, Lacrimation, Salivation
What is the fatal dose of parathion?
0.02-0.1 g orally
This is a common organophosphate insecticide
What are the late sequelae of organophosphorus insecticide poisoning?
- Intermediate syndrome: paralysis of proximal muscles
- Delayed peripheral neuropathy: paresthesia and weakness
Intermediate syndrome begins 3 days after exposure; delayed neuropathy begins after 3 weeks
What is the role of atropine in organophosphorus insecticide poisoning?
Antagonizes muscarinic action
It is part of the antidotal treatment
How do carbamates differ from organophosphates?
- Reversible cholinesterase inhibitors
- Shorter duration of toxicity
- No long-term sequelae
Carbamates have a rapid onset and do not cause CNS effects
What are the uses of naphthalene?
- Moth repellents
- Toilet bowl deodorizers
Naphthalene is toxic and may cause hemolysis
What is the clinical picture of naphthalene poisoning?
- Hemolysis
- GIT symptoms: nausea, vomiting, diarrhea
- CNS symptoms: coma, convulsions
- Renal failure
G6PD deficiency increases the risk of hemolysis
What is the treatment for naphthalene poisoning?
- Supportive treatment
- GIT decontamination
- Symptomatic treatment
Blood transfusion may be necessary in severe hemolysis
What are the clinical effects of pyrethrins/pyrethroids?
- Skin irritation
- Respiratory irritation
- GIT symptoms
- CNS effects
Severe toxicity can affect the CNS
What is the mechanism of toxic action of zinc phosphide?
Hydrolysis to phosphine gas, causing gastrointestinal and pulmonary irritation
Phosphine is a cytochrome C oxidase inhibitor
What is the treatment for zinc phosphide poisoning?
- Supportive treatment
- GIT decontamination
- Symptomatic treatment
Inhalation may require 100% humidified oxygen
What is the mechanism of action of warfarin?
Blocks the vitamin K cycle, impairing the production of blood-clotting factors
This leads to gradual development of bleeding
What are the signs of warfarin overdose?
- Hematuria
- Blood in stool
- Epistaxis
- Bruising
Severe cases can lead to intracranial hemorrhage
What is the antidote for warfarin poisoning?
Vitamin K1
Takes several hours to activate enough factors to reverse coagulopathy
Define drug dependence.
Chronic intoxication characterized by physical dependence and tolerance
Results in detrimental effects to the individual and community
What are the four main classes of abused drugs?
- Depressants
- Stimulants
- Hallucinogens
- Others
Each class has distinct effects and risks
What are the withdrawal manifestations of opiates?
- Craving for the drug
- Generalized aches
- Irritability and insomnia
- Increased secretions
- Dilated pupils
Withdrawal typically starts 15 hours after stopping
When does withdrawal typically start after stopping the drug?
15 hours after stopping the drug.
What is the peak time for withdrawal symptoms?
48 hours.
How long does withdrawal typically subside?
Over 7 days.
What are common withdrawal manifestations?
- Craving for the drug
- Generalized aches
- Irritability and insomnia
- Nausea & vomiting
- Increased secretions
- Yawning
- Dilated pupils
- Tachycardia & hypertension
What is the treatment for opiate withdrawal?
- Hospitalization
- Gradual reduction of opiate
- Substitution by Methadone or Buprenorphine
What are the physical symptoms associated with Tramadol?
- Similar to opiate with higher incidence of nausea
- Dizziness
- Loss of appetite
- Convulsions
What mental symptoms are associated with Tramadol use?
- Aggressive behavior
- Suicidal thoughts
- Mood swings
What are the withdrawal symptoms of SSRI?
- Numbness
- Tingling
- Paresthesia
- Tinnitus
- Hallucinations
- Paranoia
- Extreme anxiety
- Panic attacks
- Confusion
What is the role of Clonidine in Tramadol treatment?
It is an alpha-adrenergic receptor stimulant that decreases all withdrawal symptoms.
What are common treatment methods for cocaine use?
- Hospitalization
- Barbiturates or Diazepam for anxiety or convulsions
- Good nutrition
- Vitamins
- Physical exercise
- Psychological and religious rehabilitation
What physical symptoms are associated with cocaine use?
- Facial pallor
- Dilated pupils
- Crack keratitis
- Euphoria
- Hallucinations
- Cocaine bugs
What are the withdrawal symptoms of cocaine?
- Irritability
- Neurological pain in arms and legs
- Tendency to violence
What are the names of some new designer drugs?
- Bath salts
- Flakka
- Voodoo
- Strox
- Shabu
What are Bath Salts derived from?
Khat plant containing natural cathinone.
What are the clinical manifestations of Bath Salts?
- Strong stimulant effects
- Addictive properties
What supportive measures are used for Bath Salts treatment?
- ABC Supportive measures
- GIT decontamination
- Symptomatic treatment
What is the mechanism of action of Flakka?
Potent re-uptake inhibitor of dopamine and norepinephrine.
What are the physical effects of Flakka?
- Insensitivity to pain
- Tachyarrhythmias
- Hypertension
- Hyperthermia
- Respiratory distress
- Excessive sweating
- Seizures
- Cerebral edema
- Stroke
- Rhabdomyolysis
- Renal failure
What psychological effects are associated with Flakka?
- Loss of awareness
- Euphoria
- Anxiety
- Aggression
- Self-mutilation
- Panic attacks
What is Voodoo in the context of drugs?
Herbs sprayed with synthetic cannabinoids.
How do synthetic cannabinoids compare to THC?
- Up to 800 times more active
- Full agonists compared to THC’s partial agonist properties
What are the severe effects of synthetic cannabinoids?
- Hypertension
- Dysrhythmias
- Agitation
- Hallucinations
- Delusions
- Seizures
- Coma
- Rhabdomyolysis
- Acute kidney failure
What is Strox in drug terms?
A newer drug similar to Voodoo, with additional ingredients like atropine and hyoscine.
What are the clinical manifestations of Shabu?
- Fast heart rate
- Dilated pupils
- Toxic psychosis
- Confusion
- Hallucinations
- Seizures or coma
What are the dangers associated with Shabu?
- Rapid addictiveness
- Strokes
- Kidney and liver damage
- CNS destruction
- Auditory and visual hallucinations
- Complete loss of memory and vision
