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Year 4 - Toxicology > Lecture 19 - Poisons > Flashcards

Lecture 19 - Poisons Flashcards

1
Q

Describe carbon monoxide

A
  • gas
  • colorness
  • odorless
  • tastless
  • slightly lighter than hair
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2
Q

sources of carbon monoxide

A
  • endogenous
  • incomplete combustion of fossil fuels and carbon-containing compounds (car exhaust from older cars or fires)
  • exposure to methyl chloride (solvent in paint stripper)
  • some drug therapy (phenobarbital)
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3
Q

metabolism/elimination of carbon monoxide

A

primarily eliminated unchanged by the lungs

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4
Q

carbon monoxide poisoning causes ____ ______

A

tissue hypoxia

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5
Q

Describe carbon monoxide levels (percent saturation)

A

1-10%: no detrimental effect (common esp if you live in urban centre)

5-9%: smoker level

10-20%: slight headache

20-30%: throbbing temples

30-40%: severe headache, weakness, dizziness, n/v, collapse

40-50%: retinal hemorrhages, increased respiration

Over 50%: convulsions, coma, death

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6
Q

What 3 spots are most sensitive to oxygen deprivation?

A

CNS, brain, lungs

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7
Q

Who is most susceptible to CO poisoning?

A
  • infants
  • those with lung disease
  • those with CV disease
  • elderly
  • those with anemia
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8
Q

What is the treatment of carbon monoxide poisoning?

A
  • remove person from source of carbon monoxide
  • hyperbaric oxygen
    • 100% oxygen, their CO2 level will drop by 1/2 within 40 minutes
    • Air has 20% oxygen - will take about 4 hours to get the level to drop by 1/2
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9
Q

What can we use for analysis of carbon monoxide?

A

whole blood: need RBC’s

liver or kidney can also be used bc they have hemoglobin

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10
Q

What is the lethal dose of cyanide?

A

2mg/kg

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11
Q

What forms does cyanide come in?

A
  • Hydrogen cyanide (HCN)
    • colorless gas or blue-white liquid
  • Cyanide salts ex. KCN, NaCN
    • white crystalline powder
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12
Q

sources of cyanide?

A
  • normal metabolism
  • cigarette smoking
  • fumigants, insecticides
  • electroplating industry
  • dying, printing, photography
  • combustion of N-containing compounds
  • cyanogenic glycosides
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13
Q

Describe the toxicity of cyanide

A
  • an enzymatic poison
  • attacks the cytochrome system
  • prevents oxygen utilization at the cellular level (cytotoxic anoxia)
  • results in metabolic asphyxiation
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14
Q

Describe the symptoms of acute toxicity of cyanide

A
  • giddiness
  • stiffness in lower jaw
  • rapid, slow, irregular breathing
  • muscle twitching
  • palpitations
  • cyanosis
  • convulsions
  • coma
  • death due to respiratory arrest
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15
Q

____ and ____ are most sensitive to cyanide toxicity

A

brain and heart

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16
Q

Describe the chronic toxicity of cyanide

A
  • dizziness
  • weakness
  • congestion of lungs
  • conjunctivitis
  • loss of appetite
  • weight loss
  • mental deterioration
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17
Q

Describe the max ppm of cyanide that you can get in an 8 hour work day and the ppm’s that cause death

A

Max 10 ppm over an 8 hour day

110 ppm = death in 1 hour
135 ppm = death in 30 min
180 ppm = death in 10 min
270 ppm = immediately fatal

18
Q

Ingestion of cyanide: death may be delayed as long as ___ hour

A

1

19
Q

What is the treatment for cyanide poisoning?

A
  • Body can detoxify CN on it’s own
  • Cn –> SCN- (via the rhodanese enzyme)
  • cyanide –> thiocyanide
  • this is an inefficient system; can be sped up by adding an exogenous source of sulfur
  • 3 agents used: amyl nitrite; sodium nitrite; sodium thiosulfate
  • thiocynate is water soluble and excreted in urine
20
Q

if a house fire happens, what produces CO2 and what produces cyanide

A

wood: CO2

synthetic furniture: cyanide

21
Q

What do we need to interpret cyanide?

A

-whole blood

22
Q

What are inhalants?

What does that include?

A

defined as breathable chemical vapours that produce psychoactive (mind altering) effects

Includes:
1-volatile solvents
2-aerosols
3-anesthetics
4-volatile nitrates
23
Q

What are some examples of volatile solvents?

Common sources?

A
  • toluene
  • methylethyl ketone
  • acetone
  • benzene
  • naptha
  • trichloroethane
  • methylene chloride

Common sources:

  • paint or paint thinner
  • cement/glue
  • lacquer thinner
  • nailpolish remover
  • lighter fluid
  • dry cleaning fluids
  • gasoline
24
Q

Examples of aerosols and common sources

A

Ex. fluorocarbons

Common sources:

  • hairspray
  • cooking spray
  • deodorant sprays
  • glass chillers
  • spray paint
25
Q

Examples and sources of anaesthetics

A
  • nitrous oxide
  • ether
  • chloroform
  • halothane

Sources:

  • propellant in whip cream containers
  • anaesthetic used in dentristry and surgery
  • solvent
26
Q

Examples and sources of volatile nitrites

A

ex. amyl nitrite, butyl nitrite, isobutylene nitrite

sources:
- room odorizers
- tape head cleaner (past)
- used medically to dilate blood vessels

27
Q

street names for inhalants

A
  • sniff
  • amys
  • head cleaner
  • hippie crack
28
Q

What are the two ways to get exposure to inhalants

A
  • intentional abuse

- occupational exposure

29
Q

what are methods of exposure of inhalants

A
  • inhalant (most common)
  • oral ingestion or liquid
  • skin contact
30
Q

Sniffing

A

directly inhaling from container or heated pan or from piece of clothing soaked with solvent

31
Q

Huffing

A

holding solvent soaked rag over face and breathing in through mouth

32
Q

Bagging

A

spraying or pouring the solvent into a plastic bag, holding over mouth and nose and inhaling from the bag

33
Q

Describe the stimulant phase of sniffing

A
  • euphoria
  • excitement
  • release of inhibitions
  • floating sensations
  • delusions of grandeur and invincibility
34
Q

How long does stimulant phase last for

A

15-30 mins typically but may be up to 1 hour depending on the agent used

35
Q

Describe the depressant phase of sniffing

A
  • drowsiness
  • slowed reflexes
  • stupor
  • bizarre thoughts
  • visual/auditory hallucinations
  • inebriation similar to alcohol intoxication
36
Q

How long does depressant phase last for?

A

up to 1-2 hours after cessation of sniffing

37
Q

What are some general indicators of inhalant use?

A
  • odor on breath or clothing
  • excessive nasal secretions
  • red watery eyes
  • dilated pupils
  • rapid involuntary eye movements
  • complains of double vision, ringing in the ears, vivid dreams, hallucinations
  • slow, slurred speech
  • overall intoxicated appearance, confused, disoriented
  • white powdery ring of dried glue around mouth, lmao obviously
  • drooling, sores around mouth
  • paraphenalia such as glue tubes, balloons and plastic bags with traces of glue or paint on them
38
Q

Describe the pharmacokinetics (ADME) of inhalants

A
  • inhaled vapours enter the bloodstream directly from the lungs
  • rapidly distributed to the brain and liver
  • some inhalants are metabolized and excreted by the kidneys; others are eliminated unchanged via the lungs
  • stored in the fat tissues and slowly released back into the blood
39
Q

long term effects of sniffing

A
  • fatigue
  • chronic headache
  • dizziness, depression
  • irritability
  • loss of concentration and memory
  • loss of appetite
  • tremor

-liver, kidney, and brain damage

40
Q

Tolerance of sniffing?

A

yes

41
Q

Dependence of sniffing?

A

psychological dependence only

42
Q

What is sudden sniffing death?

A
  • Also called “sudden cardiac death”
  • typically follows strenuous exercise or undue stress after several deep inhalations of “sniff”
  • is caused by heart failure resulting from severely irregular heartbeat
  • associated with halogenated hydrocarbons (ex. Freons)

Year 4 - Toxicology (24 decks)

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