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Pharm > Principles of Clinical Toxicology and Treatment of Acute Poisoning > Flashcards

Principles of Clinical Toxicology and Treatment of Acute Poisoning Flashcards

1
Q

ED50

A

Effective dose: concentration that produces half of the maximum effect

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2
Q

LD50

A

Dose that kills half of the subjects exposed

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3
Q

TD50

A

Dose that produces the half maximum toxicity

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4
Q

Therapeutic index

A

LD50/ED50

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5
Q

Threshold (non-toxic) dose)

A

No observed adverse effects below this line

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6
Q

Carcinogenesis

A

Metabolically activated: Aromatic amines, nitrosamies, PAHs, Aflatoxin
Alkylating agents: cyclophosphamide, melphalan

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7
Q

Teratogenicity Category A

A

Animal negative/human negative

SAFE

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8
Q

Teratogenicity Category B

A

Animal negative/human not available OR animal adverse/human negative
Presumed to be safe

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9
Q

Teratogenicity Category C

A

Animal adverse/human not available OR animal and human not available
Give only if potential benefit justifies risk
Dangerous in 1st trimester

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10
Q

Teratogenicity Category D

A

Human risk, but benefits to mom may be acceptable in a life threatening/serious disorder

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11
Q

Teratogenicity Category X

A

Risk of the drug clearly outweighs possible benefit

Contraindicated in women who are or who may become pregnant

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12
Q

Cholinergic or anticholinesterase syndrome- MOA

A

Organophosphate and carbamate insecticides > inhibition of cholinesterase and accumulation of acetylcholine

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13
Q

Cholinergic or anticholinesterase syndrome symptoms

A

Muscarinic: sweating, miosis, lacrimation, abdominal cramps, vomiting, diarrhea, bradycardia, hypotension
Nicotinic: Fasiculations, cramps, weakness, paralysis, respiratory compromise
Central: Anxiety, restlessness, coma

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14
Q

Cholinergic or anticholinesterase syndrome treatment

A

Atropine

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15
Q

Anticholinergic Syndrome MOA

A

Atropine, scopolamine, tricyclic antidepressants, antihistamines, jimson weed
Too little acetylcholine at the muscarinic receptor site

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16
Q

Anticholinergic Syndrome SE

A

dry mouth, dysphagia, mydriasis, tachycardia, hyperthermia, dry skin, flushing, lethargy, seizures, confusion, respiratory failure

17
Q

Anticholinergic Syndrome Treatment

A

Physostigmine

18
Q

Hemoglobinopathy Syndromes

A

Carboxyhemoglobinemia (CO)
Methemoglobinemia (sulfonamides)
Hypoxia, headache, disorientation, cardiac dysfunction, acidosis, death

19
Q

Narcotic Overdose MOA

A

Heroin, oxycodone, Morphine, Meperidine

20
Q

Narcotic Overdose Symptoms

A

respiratory depression, hypotension, pinpoint pupils

21
Q

Sympathomimetic excess MOA

A

Cocaine, amphetamines, MAOIs > too much NE

22
Q

Sympathomimetic excess symptoms

A

Diaphoresis/dehydration, nervousness, tremor, CNS excitation, hypertension, tachycardia, seizures

23
Q

Withdrawal syndrome (opiate vs. non-opiate symptoms)

A

Opiate withdrawal: mydriasis, piloerection, rhinorrhea, lacrimation (no seizures)
NON-opiate CNS depressants: hallucinations, tachycardia, hyperpyrexia, SEIZURES

24
Q

Cardiac conduction/rhythm problems (AV block, brady, tachy)

A

AV block: digitalis
Sinus brady: digitalis, beta-blockers, ca channel blockers
Sinus tachy: cocaine, amphetamines

25
Q

Metabolic acidosis

A

Aspirin, methanol and ethylene glycol

26
Q

GI dysfunction

A

Cholinergic syndrome: cramping, n/v

Iron poisoning: bloody diarrhea

27
Q

Seizures cause

A

Intoxication, withdrawal

28
Q

Seizure treatment

A

Diazepam/lorazepam: acute control

Phenobarbital: long term

29
Q 
Antidotes:
Iron-
Acetaminophen-
Organophosphate-
Anticholinergic-
Methanol and ethylene glycol-
Digitalis-
A 
Iron- Deferoxamine
Acetaminophen- Acetylcystine
Organophosphate- 2-PAM or atropine
Anticholinergic- Physostigmine
Methanol and ethylene glycol- Ethanol
Digitalis- Digitalis Antibodies
30
Q

Indications for elimination of absorbed substances

A

Severe poisoning that does not respond to supportive therapy
Deterioration despite full supportive care
Overwhelming dose of a chemical
Impairment of normal excretory routes
Severe disease that precludes tolerance of supportive care

Pharm (20 decks)

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