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Pharm Block 6 > Occupational and Environmental poisons > Flashcards

Occupational and Environmental poisons Flashcards

1
Q

What size of particles get deposited in nasopharynx?

A

5-30 microns - these can’t make sharp turns

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2
Q

What size of particles get deposited in trachea/bronchi?

A

1-5 microns, sedimentation

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3
Q

What size particles get deposited in alveoli?

A

under 1 micron, diffusion

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4
Q

What are the three determinents of depositon of particles?

A

size, air velocity, directional chance

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5
Q

How are toxins removed?

A

blow nose, cough, ciliary movement, phagocytosis, absorption

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6
Q

What are the differences between gases, vapors, and aerosols?

A

gases - toxic agents in gaseous state at room temp and pressure. Vapors- vaporize under room temp, aerosols include solid particles and liquid droplets.

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7
Q

Carbon monoxide poisoning symptoms?

A

headache, dizziness, N/V, visual disturbances, Cheyne-stokes respiration, cherry red blood and skin.

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8
Q

What is mechanism of CO poisoning

A

prevents Oxygen binding and lowers ability of oxygen to dissociate from hemogblobin

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9
Q

Treatment for CO poisoning

A

remove from exposure, rest, Oxygen

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10
Q

What are lab findings for CO poisoning

A

Low chloride, low bicarb, low pH, low pCo2, normal pO2.

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11
Q

What is the mechanism for cyanide poisoning?

A

complexes with Fe3+ in cytochromic oxidases. Activates chemoreceptors leading to increased RR. Death is due to resp. arrest and pulmonary edema

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12
Q

What is the TX for CN poisoning

A

O2, lavage with charcoal if PO,
amyl nitrate + sodium nitrate IV – produce methemoglobinemia to bind to CN, only soon after exposure. If too long, give bicarb to temper acidosis.
Sodium thiosulfate produces thiocynate, which is excreted in urine.

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13
Q

What are the symptoms and labs of CN poisoning?

A

cyanosis, vomiting, high BP, RR increased, lactic acidosis, elevated keto acids: beta hydroxybutyrate and acetoacetic acid, lactic acid. Increased anion gap. Low pCO2, high PO2, high glucose.

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14
Q

Gasoline, kerosene, naphtha (lighter fluid) cause what symptoms?

A

CNS depression, sensitizes myocardium to epi causing arrhythmias. Increased RR, bloody sputum, diffuse pulmonary infiltrates. Organic chemicals cause reduces surfactant production and increased permeability of capillary beds.

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15
Q

Formaldehyde poisoning has what presentation?

A

Highly reactive with most cellular components thus causes coagulative necrosis, metabolic acidosis, CNS depression.

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16
Q

Labs with formaldehyde poisoning?

A

very low pH, low Cl-, very low sodium, very high LDH and AST indicating organ damage

17
Q

What is lethal dose of formaldehyde?

A

30 mL

18
Q

Treatment of formaldehyde poisoning

A

control of acidosis with bicarb, maintain BP with dopamine, lactated Ringers solution and 5% dextrose in water

19
Q

Methanol toxicity SE

A

formic acid acidosis, retinal damage, CNS depression, “whiteness” to vision, increased RR

20
Q

Labs for methanol toxicity

A

low bicarb, increased osmolality, low pH, low pCO2, high PO2

21
Q

How do you tx methanol poisoning

A

ethanol, fomepizole, dialysis

22
Q

When do you hemodialysis for ethanol?

A

blood alcohol > 450

23
Q

What are the symptoms when you get TRASHED with ethanol?

A

Temp decrease, Respiration increase, Acidosis, Sedation, Hypovolemia, Electrolyte disturbance, Dialysis

24
Q

How does ethylene glycol cause damage?

A

metabolized to oxalate which precipitates in kidneys causing tubular damage. Treat with ethanol or fomepizole.

25
Q

What are SE of benzene poisoning?

A

CNS depression, blood dyscrasias

26
Q

What do you give milk when kids consume liquid bleach?

A

hope HCl saponifies milk instead of tissue

27
Q

What are effects of liquid bleach consumption

A

severe irritation of mucus membranes, eyes; pain and vomiting, decreased BP, coma

28
Q

What are effects of volatile bleach (gas) exposure

A

Lacrimation, mucous membrane irritaiton, edema, resp. issues

29
Q

Treatment for volatile bleach exposure

A

oxygen, morphine to reduce pulmonary pressure, furosemide IV to treat pulmonary edema

30
Q

What are effects of Borax poisoning

A

erythematous rash, CNS depression, CV collapse, delayed hepatic/renal failure

Pharm Block 6 (11 decks)

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