Lecture 2 - Decontamination Cont’d (Exam 2 Material)

Question 1

When considering a necropsy, what essential equipment is required for it?

Answer 1

Fill in

Question 2

It is never too late to ?

Answer 2

Answer is decontaminate

Question 3

When considering the big D, what is the first and second big D?

Answer 3

The first big D is dose while the second big D is decontaminate

Question 4

For decontamination, what method you choose will depend on what?

Answer 4

1) exposure route(s)
2) nature of toxicant
3) clinical presentation
4) time interval
5) Pre existing health risks

Question 5

For decontamination, what method you choose will depend on what?

Answer 5

1) exposure route(s)
2) nature of toxicant
3) clinical presentation
4) time interval
5) Pre existing health risks

Question 6

What is the main goal for topical exposures? What are the indications?

Answer 6

The main goal is to stop dermal absorption
Indications: corrosives (if the pH is less than 3 or greater than 11, then you must worry about corrosion (corrosive issues); also know that if something is systematically absorbed, then it will have systemic effects

Indications continued: corrosives include dish washer/laundry detergents (with pH less than 3 or greater than 11), cleaning solutions, nothing that can be systemically absorbed, essential oils like potpourri, anything that can cause paresthesia (sensation of tingling or burning) like pyrethrins or pyrethroids

First question you should have is: is this dry or wet compound?
If dry: brush, vccum, shove; follow with a bath (2-3 times), using mild liquid dish detergent and rinse with room temperature water then make sure animal is dry to prevent hypothermia

If liquid: first consider if it is 1) fat soluble (use mechanics hand degreaser —> then bathe with mild liquid dish detergent, do it 2-3 times, then rinse and dry) or 2 water soluble (bath with room temperature water, use mild liquid dish detergent 2 - 3 times, then rinse and dry the animal.

Also the other main point is you need to consider oral and ocular exposures

Question 7

Discuss the oral (inhalant) and ocular exposures in regards to topical dermal exposures; discuss the indications of inhalant and ocular corrosives

Answer 7

Know that ocular exposures to hand in hand with dermal exposures meaning that dermal exposure typically lead to an ocular exposure:

Indications of ocular exposures: irritants, corrosives from dermal exposures: from skin to eye; flush up to 15 - 20 minutes (commercial eye wash, tap water) - sedation is often required for a topical anesthetic
- monitor for pawing, rubbing at eyes, redness, lacrimation, blinking, squinting, (known as signs of blufferspam)

Indications of inhalant exposures: irritants, corrosives, gas, smoke inhalation, CO
- remove from environment
- potent airway/adequate respiration/bronchoconstrictuon - brinchospams
- endotracheal tube/oxygen anti inflammatory
- ex apples include anhydrous ammonia, phosphine gas, and house fires
- for BIRDS, you need to know that birds have a very sensitive respiratory system, therefore if you see a bird with respiratory signs, you want to ask a lot of questions about the nvironment

Question 8

Discuss the most common options for treatment of oral exposures (regarding irritants and corrosives)

Answer 8

Option #1) dilution —> A) use this for when pH is less than 3 or greater than 11 and for concentration (when it is above 3 - 5 %) for corrosives, cleaning agents, and dish washer plus laundry detergents, pot pourri, and essential oils B) water/milk/raw egg whites C) follow up with a GI protectant like omeprazole for 2 weeks or sucralfate

Question 9

Explain why milk/raw egg whites are used in relation to dilution of corrosive agents (instead of water). Also explain what else is given with oral exposures of corrosive agents?

Answer 9

• water works great for dilution but when compared to milk/raw egg whites, they have proteins in them which our water does NOT and these proteins are useful because they like to grab onto loose acids/bases however the problem with milk/raw egg whites is that they can cause vomiting and diahhrea, therefore administer an anti emetic (to prevent vomiting) to prevent further irritation of the GI system.

Regarding the second part of the question, give an antiemetic (to prevent further vomiting and upset of the GI tract) and then switch the water. Also be sure and follow up with GI protectants such as omeprazole and sucralfate

Question 10

——— is the solution to pollution

Answer 10

Dilution is the solution to pollution

Question 11

How do omeprazole and sucralfate work

Answer 11

Omeprazole is a proton pump inhibitor and this will act to reduce any acid pollution that may be occurring. sucralfate coats the GI tract and it soothes any ulceration that may be present

Question 12

In general, discuss emetics. Then discuss the difference between dogs and cats

Answer 12

Emesis is the action of vomiting. The chemoreceptor trigger zone is in the medulla oblongata and it contains dopamine 2, nuerokinin, 5-hydroxytryptamine, acetylcholine, andrenergic, and histamine receptors that respond to substances circulating in the blood.

Dogs have a significant number of dopaminergic receptors while cats have a significant number of alpha 2-andrenergic receptors.

Question 13

Discuss when emetics should not be used (the contraindications of emetics)

Answer 13

1) don’t give to rabbits, rodents, birds, horses, and ruminants
2) when it is too late (when vomiting has already occurred, stomach is empty, or risk of aspiration pneumonia)
3) with ingestion of strong acids (pH < 3) or alkalis (pH > 11) or ingestion of volatile hydrocarbons
4) don’t give to symptomatic (hypoxia, seizing, etc) or anatomic anaomalies (brachycephalic breeds)
5) in cases where antimetics medications (antihistamines, narcotics, antidepressants, benzodiazepines) have been ingested, emetics might not be useful

Question 14

Discuss option 2 of oral exposures

Answer 14

Option 2 = Emetics
Gaol = remove material from the stomach
- NOT All comes up/some never vomit
- Choice, route of emetic, may delay administering activated charcoal (AC) (45 min or longer)/give an emetic, once emesis has occurred (or not occurred), then give an anti emetic or a pro kinetic (metaclopramide - dopaminergic receptor, maropitant - NK receptor, ondansetron or dolasetron - serotonin 5-HT receptor) and then give AC - YES

Indications (benefits):
- asymptomatic
- within 1-2 hours up to 4 hours - not cut in stone (delays in gastric emptying; coins; grapes)
- time dependent ( up to 75% is removed)
- save: look at it, test it, freeze it

Question 15

Discuss apomorphine hydrochloride (in clinic)

Answer 15

Apomorphine hydrochloride in clinic:
- Dogs - dopaminergic receptors of the chemoreceptor trigger zone of the area postrema of the medulla (CRTZ) which result in the dog vomiting
- Effective (> 90%) IV
- Usually post IV, immediate and short duration
- second dose generally not recommended (after 30 min - 2 hr due to tolerance)
Side effects: prolonged vomiting, persistent signs of nausea (lip licking, salivation) - control with metoclopramide, maropitant, odansetron or dolasetron, etc. reddened eyes (conjunctival sac)
- serious side effects/overdose (CNS/respiratory depression) may be reversed with naloxone - mechanism unclear (competitive antagonist?)