Lecture 21: Toxicology

Question 1

Rapid Evaluation and Identification of a Poison of Alcohols (ethanol, methanol) and Salicylates

Answer 1

-Anion Gap:
Drug-induced metabolic acidosis.
Elevated: e.g. alcohols, salicylates poisoning

Question 2

Competitive inhibition of a Poison of Alcohols (ethanol, methanol)

Answer 2

-Enzyme competitors:
E.g. ethanol competes with methanol for alcohol dehydrogenase (ethanol used to treat methanol poisoning by inhibiting formation of toxic methanol metabolites)

Question 3

Another method of elimination of a Poison of Alcohols (ethanol, methanol)

Answer 3

Hemodialysis (HD) is used to enhance the removal of alcohols.

Question 4

Dextrose

Answer 4

Stabilization and Supportive Care: (D-50%) - For comatose patients.

Question 5

Another method of elimination of a Poison of Salicylates

Answer 5

Hemodialysis (HD) is used to enhance the removal of salicylates

Question 6

Gastrointestinal Decontamination of Syrup of ipecac

Answer 6

-Induction of Emesis: Syrup of ipecac (apomorphine
parenterally preferred)
● Contraindications:
1) Unconscious patients, convulsions
2) Corrosives
3) Agents causing rapid loss of consciousness

Question 7

Eimination of N-acetylcysteine

Answer 7

-Enhance elimination by enhancing metabolism:

Used for acetaminophen (Panadol) poisoning (enhances the metabolism of toxic metabolite).

Question 8

Elimination of Sodium bicarbonate

Answer 8

1) Enhance elimination of poison by enhancement of urinary excretion.
2)Alkaline diuresis for acidic drugs: enhance excretion of acidic
drugs e.g. salicylates (pH of urine 7.3-8.5)