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Toxicology Final > Poisoning Presentation > Flashcards

Poisoning Presentation Flashcards

1
Q

What are the properties of CO?

A
  • gas
  • colorless
  • odorless
  • tasteless
  • slightly higher than air
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2
Q

What are common sources of CO poisoning?

A
  • endogenous
  • incomplete combustion of fossil fuels and carbon containing compounds
  • exposure to methylene chloride
  • some drug therapy
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3
Q

How is CO metabolized and eliminated?

A
  • eliminated primarily unchanged by the lungs
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4
Q

What percent saturation of CO causes coma and death?

A

over 50%

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5
Q

What are s/s that will be experienced by patients when their CO % saturation goes over 10%?

A
  • slight headache
  • throbbing temples
  • severe headache, weakness, dizziness, n/v, collapse
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6
Q

What groups of people are the most susceptible to CO poisoning?

A
  • infants
  • those with lung disease
  • those with CVD
  • elderly
  • those with anemia
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7
Q

What is the treatment of CO poisoning?

A
  • remove person from source of CO

- hyperbaric O2

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8
Q

What about putrefaction will interfere with the interpretation of CO in the blood?

A
  • putrefactive by products with interfere with the CO because they have the same UV spectra
  • this can be an issue with fire victims as well
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9
Q

What are the forms that cyanide comes in?

A
  • hydrogen cyanide (HCN) (colourless gas or blue-white liquid)
  • cyanide salts eg: KCN, NaCK (white crystalline powder)
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10
Q

What chemical smells like burnt almonds?

A
  • CYANIDE
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11
Q

What are the sources of cyanide?

A
  • normal metabolism
  • cigarette smoking
  • fumigants, insecticides
  • electroplating industry
  • dyeing, printing, photography
  • combustion of N containing compounds
  • cyanogenic glycosides
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12
Q

What are N containing compounds?

A
  • plastics, polyurethane bedding, carpets, insulin, etc
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13
Q

Cyanide attacks the ______ system

A

cytochrome

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14
Q

What does attack on the cytochrome system lead to?

A
  • preventing oxygen utilization at the cellular level (cytotoxic anoxia)
  • results in metabolic asphyxiation
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15
Q

What are the s/s associated with acute toxicity of cyanide?

A
  • giddiness
  • stiff lower jaw
  • rapid, slow, irregular breathing
  • muscle twitching
  • palpitations
  • cyanosis
  • convulsions
  • coma
  • death due to respiratory arrest
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16
Q

What organs are most sensitive to CNS toxicity?

A
  • brain and heart
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17
Q

What s/s are associated with chronic toxicity of cyanide?

A
  • dizziness
  • weakness
  • congestion of lungs
  • conjunctivitis
  • loss of appetite
  • weight loss
  • mental deterioration
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18
Q

When does death usually occur with cyanide?

A
  • death may be delayed for as long as 1 hour
19
Q

What is the tx of cyanide poisoning?

A
  • body can detoxify CN on its own
  • CN -> SCN- (via rhodanese enzyme)
  • but an inefficient system; can be speeded up by adding an exogenous source of sulfur
  • 3 agents used: amyl nitrate, sodium nitrite, sodium thiosulfate
20
Q

What is the most beneficial treatment for cyanide poisoning?

A

-sodium thiosulfate is the most beneficial tx - non-toxic, water soluble, economical to give- only limitation is that it has a longer DOA by a little bit

21
Q

What fluid is cyanide best detected in?

A
  • analytical whole blood
22
Q

Enzymes in the blood will produce ____ when someone dies

A

CN

23
Q

What can you add to blood to stop CN from being produced?

A

can produce NaCl

24
Q

What are inhalants

A

breathable chemical vapours that produce psychoactive effects

25
Q

What is included in the category of inhalants

A

volatile solvents
aerosols
anaesthetics
volatile nitrates

26
Q

What is the most common volatile solvent?

A

toluene

27
Q

What are the most common sources of volatile solvents?

A
  • paint
  • paint thinner
  • household cement and glue
  • lacquer thinner
  • lighter fluid
  • gasoline
    etc
28
Q

What are some of the chemicals that are involved in anaesthetic?

A
  • NO, ether, chloroform, halothane
29
Q

What are the most common sources of volatile nitrites?

A
  • room odorizers
  • tape head cleaner
  • used medically to dilate blood vessels
30
Q

What is “sniffing”

A
  • directly inhaling from container or heated pan or from piece of clothing soaked in a solvent
31
Q

What is “huffing”

A
  • holding solvent soaked rag over face and breathing in through mouth
32
Q

What is “bagging”

A
  • spraying or pouring the solvent into a plastic bag holding over mouth and nose and inhaling from the bag
33
Q

What is the typical inhalant user?

A
  • young men
  • low socioeconomic status
  • poor student with high rate of absenteeism
34
Q

What is the stimulant phase of sniffing?

A
  • euphoria
  • excitement
  • release of inhibitions
  • floating sensations
  • delusions of gradeur
35
Q

How long does the stimulant phase of sniffing last?

A

15-30 minutes (up to 1 hour)

36
Q

What is the depressant phase?

A
  • drowsiness
  • slowed reflexes
  • stupor
  • bizarre thoughts
  • visual/auditory hallucinations
  • inebriation similar to alcohol intoxication
37
Q

How long does the depressant phase last?

A
  • lasts up to 1-2 hours after cessation of sniffing
38
Q

What are the general indicators of inhalant use?

A
  • pungent chemical door on breath or clothing
  • excessive nasal secretions
  • red, watery eyes, dilated pupils, rapid involuntary eye movements
  • complaints of double vision, ringing in the ears, vivid dreams, hallucinations
  • slow, slurred speech
  • overall intoxication
  • drooling, mouth sores
39
Q

How fast are inhalants absorbed?

A
  • immediately absorbed directly from lungs
40
Q

Inhalants are then rapidly distributed to what organs?

A
  • to the brain and liver
41
Q

What are the long term effects of sniffing?

A
  • fatigue
  • chronic headache
  • dizziness, depression
  • irritability
  • loss of concentration and memory
  • loss of appetite
  • tremor
42
Q

Does sniffing cause psychological and physiological dependence?

A
  • psych: YES

- phys: NO - but sometimes some tremors, irritability when they stop

43
Q

What is sudden sniffing death?

A

aka sudden cardiac death

  • typically follows strenuous exercise or undue stress after several deep inhalations or sniff
  • caused by heart failure resulting from irregular heartbeat
  • associated with halogenated hydrocarbons

Toxicology Final (14 decks)

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