Medical Toxicology Flashcards
what is the most common cause of poisoning among adults?
opioid overdose
branch of toxicology that does therapeutic drug monitoring, and emergency toxicology
medical toxicology
which branch of toxicology is patient consent not required?
medical toxicology
branch of toxicology that does performance testing, workplace drug testing, and postmortem drug analysis
forensic toxicology
in which branch of toxicology does the subject have to consent to be tested?
forensic toxicology
in which branch of toxicology is the identity of the specimen presumed?
medical toxicology
in which branch of toxicology must the identity of the specimen be proven?
forensic toxicology
the material may be fatal if it comes in contact with the skin, is inhaled, or ingested
acute toxicity
what is the most common metallic poisoning in children younger than 6 years?
iron
a patient presents with nausea, vomiting, diarrhea, abdominal pain, metabolic acidosis, sepsis, shock, drowsiness, coma, respiratory failure, and hepato/nephrotoxicity. what are they likely experiencing?
iron poisoning
what is a complication of iron poisoning?
GI corrosive damage
what is the cause of an iron overdose in adults?
suicide attempt
what is the treatment of an iron overdose?
deferoxamine (chelation therapy)
what is the most common adverse effect of taking iron?
constipation
what should be given with an iron prescription?
stool softener
what is the most important environmental health problem for children younger than 6 years?
lead poisoning
a patient presents with developmental/learning delays, irritability, muscle cramps, nausea, vomiting, and pica. what are they experiencing?
lead poisoning
what is the complication of lead poisoning?
slow absorption
what is the most serious metallic poisoning?
lead
when are kids screened for lead?
1 and 2 years old
what is the treatment for lead poisoning?
chelation therapy
binds to protein sulfhydryl groups and the inorganic compounds it contains is highly toxic and linked to cancer
arsenic
substance that is dubbed “inheritance powder”
arsenic
where is the highest concentration of arsenic located?
in seafood and contaminated water
what 3 specimen are used to test for arsenic?
urine
hair
nails
what is the treatment for arsenic poisoning?
chelation therapy
what is the most common cause of gaseous poisoning?
carbon monoxide
substance that is colorless, tasteless, and non-irritating
carbon monoxide
substance that replaces O2 in Hb and may bind to myoglobin and other heme containing enzymes
carbon monoxide
what are the 2 primary toxic effects of carbon monoxide?
cellular hypoxia
anoxia
a patient presents with cyanosis, hyperventilation, increased heart rate, decreased mental status. what are the experiencing?
carbon monoxide poisoning
what happens to the patient if there is 60-70% saturation of carboxyhemoglobin?
patient is comatose
what happens to the patient if there is 70-80% saturation of carboxyhemoglobin?
respiratory failure and death
what is the treatment for carbon monoxide poisoning?
100% O2 to increase PO2 and displace CO from Hgb
what is the specimen of choice to test for carbon monoxide poisoning?
whole blood (okay if clotted)
CNS depressant that is the #1 date rape drug
alcohol
what is the most commonly abused drug?
alcohol
what should we worry about during a detox of alcohol?
seizures
% ethanol equation
proof / 2
what are the signs and symptoms of alcohol overdose?
Mental confusion
Unresponsive
Snoring
Throwing up
Hypothermia
Erratic breathing
Loss of consciousness
Paleness of skin
what 3 specimens can be used for an alcohol assay?
serum
plasma
whole blood
what is the ideal method of an alcohol assay?
gas chromatography
what should be avoided when getting a blood sample of an alcohol assay?
alcohol wipes
alcohol assay that is used to monitor an alcoholic’s long-term compliance
GGT
alcohol assay that is converted to blood alcohol concentration
breathalyzer
strong minerals that produce chemical burn on contact and do not vaporize quickly
acids and bases
where does acid ingestion cause superficial necrosis?
esophagus
why is the esophagus epithelium resistant to acid?
has slightly alkaline pH
what is the site of major injuries of acid ingestion?
stomach
why is the stomach the site of major injury in acid ingestions?
gastric juices cannot neutralize acids
where are the 2 sites of major injury for alkali ingestion?
esophagus
oropharynx
what type of ingestion produces deep tissue injuries?
alkali ingestion
what is the management for aspirin toxicity?
correct metabolic acidosis
when can activated charcoal be used in aspirin toxicity?
if exposure occurred less than 1 hour ago
what is the treatment for acetaminophen toxicity?
mucomyst (n-acetylcysteine)
what is the 2nd most common cause of liver failure, requiring transplantation?
acetaminophen toxicity
a patient presents with abdominal pain, nausea, vomiting, and diarrhea. what are they likely experiencing?
acetaminophen poisoning
what would liver enzymes look like 24-48 hours after an acetaminophen poisoning?
elevated
what occurs 3-5 days after an acetaminophen poisoning? (3)
liver failure, coma, and death
when is therapeutic drug monitoring useful? (2)
drugs with narrow TI
drugs taken on chronic basis
what the body does to the drug
pharmacokinetics
what occurs to the drug if pH > pK?
reabsorbed
what occurs to the drug if pH < pK?
excreted
