Poisons and Antidotes

Question 1

Herbicide that causes fatal pulmonary fibrosis

Answer 1

Paraquat

Question 2

Parathione (insecticide) that is metabolized to paraoxon which inactivates acetylcholinesterase. Increased ACh causes a cholinergic crisis.

Answer 2

Organophosphates/Carbamates

Question 3

Antidote: Oxygen at High partial pressure (hyperbaric oxygen) will displace the CO from Hgb

Answer 3

Poison: Carbon Monoxide (CO)

Question 4

Antidote: methylene blue (acts as an electron donor and reduces Fe+++(ferric) to Fe++ (ferrous)

Answer 4

Poisons: Methemoglobinemia Inducers (nitrates, aromatic amines, nitro compounds, abx, local anesthetics

Question 5

Antidote: Two step process. Amyl/Sodium nitrites which generate methemoglobin. Hydroxycobalamin which binds CN forming cyanocobalamin. Sodium Thiosulfate which forms SCN. Cyanogenic glycosides (taken within minutes to hours)

Answer 5

Poison: Cyanide (binds to and inhibits cytochrome oxidase and blocks aerobic respiration.)

Question 6

Antidote: Chelation with deferoxamine

Answer 6

Iron (metals)

Question 7

Antidote: Chelation with dimercaprol or dimercaptopropane sulfate. Succimer/DMSA, DMPS, N-acetylcysteine.

Answer 7

Mercury (metals)

Question 8

Antidote: chelation with Calcium disodium, dimercaprol or penicillamine. EDTA, BAL, Succimer (DMSA)

Answer 8

Lead (metals)

Question 9

Antidote: chelation with penicillamine

Answer 9

Copper (metals)

Question 10

Antidote: chelation with dimercaprol, dimercaptopropane sulfate or penicillamine.

Answer 10

Arsenic (metals)

Question 11

Dioxin/aryl hydrocarbon receptor ,polychlorinated biphenyls/estrogen receptor

Answer 11

receptor-ligand interactions

Question 12

Solvents disrupt membrane fluidity (i.e. ETOH), inhibition of Na channels

Answer 12

Perturbation of membrane function, permeability

Question 13

CN, Hydrogen sulfide act on cytochrome oxidase

Answer 13

Interference with ATP generation

Question 14

CO binding to Hgb Fe++, metals and sulfhydryl groups, lipid peroxidation, DNA damage, protein damage

Answer 14

Interaction with macromolecules

Question 15

Induce Ca++ influx into cytoplasm (gluatmate- excitotoxins), foxglove/digoxin

Answer 15

Alteration Calcium homeostasis

Question 16

Increase generation of ROS and/or decrease anti-oxidant capacity, can be related to drug metabolism.

Answer 16

Generation of Oxygen radicals/Oxidative stress

Question 17

Oxidized to a hydroxyl radical, causes cell death by lipid peroxidation

Answer 17

Paraquat

Question 18

Poison- Parathione

Answer 18

Antidote- Atropine Sulfate or Pralidoxime

Question 19

Poison causes death by:

i.e. alcohol an barbiturates

Answer 19

CNS depression- decreased consciousness, coma, loss of airway protective reflexes, respiratory arrest, aspiration of gastric contents.

Question 20

Poison causes death by:

i.e. cocaine/ephedrine

Answer 20

Cardiovascular toxicity: HoTN due to decreased contractility peripheral vascular collapse, fluid loss. Arrhythmias.

Question 21

Poison causes death by:

i.e. CO, HCN, H2S

Answer 21

Cellular Hypoxia: Interference with O2 transport, delayed organ damage.

Question 22

Poison causes death by:

Illicit drugs

Answer 22

Traumatic injury resulting from behavioral effects.