Principles of Treatment of Toxicoses

Question 1

T/F: an acutely poisoned animal is an emergency

Answer 1

true

Question 2

Respiration symptomatic treatment

Answer 2

• tracheostomy under local anesthesia
• cuffed ETT if unconscious
• artificial respiration
• bronchodilators (aminophylline)
• resp analeptics (doxapram IV)

Question 3

Cardiovascular symptomatic treatment

Answer 3

• ensure adequate circulatory volume (fluid or blood therapy)
• cardiac massage
• cardiac stimulants (10% Ca gluconate IV, glucagon IV< digoxin IV)
• hypotension (fluid therapy, sympathomimetics)

Question 4

Body temperature symptomatic treatment

Answer 4

Hypothermia - blanket or warm pads

Hyperthermia - ice bags, cold water, bath, cold water enema)

Question 5

CNS symptomatic treatment

Answer 5

CNS depression - artificial respiration

CNS stimulation - anticonvulsants

Question 6

Acid-base symptomatic treatment

Answer 6

acidosis - sodium bicarb IV every 15 mins, 1/6 molar sodium lactate, lactated ringers
alkalosis - normal saline IV followed by PO ammonium chloride

Question 7

pain treatment

Answer 7

opioids

Question 8

4 important aspects of removing the poison

Answer 8

• remove suspected source
• remove poison from site of absorption
• decrease rate of absorption
• enhance elimination of the poison

Question 9

List methods of removing poison from site of absorption (decontamination)

Answer 9

emetics, gastric lavage, rumenotomy, purgatives, skin and MM

Question 10

Contraindications of using emetics?

Answer 10

unconsciousness, corrosives, petroleum products, dehydration, animals showing convulsions, severely ill, unknown toxicants

Question 11

What is the time line of using an emetic in a dog or cat?

Answer 11

1-2h from ingestion time

Question 12

What is the emetic choice in dogs?

Answer 12

apomorphine

Question 13

Which is FALSE regarding apomorphine?
A) toxicity includes vomiting and respiratory depression
B) can be given IV, IM, SC or in conjunctival sac
C) antidotes are naloxone or levallorphan IV
D) emetic of choice in cats

Answer 13

D - it is the emetic of choice in dogs

Question 14

What is the emetic of choice in cats?

Answer 14

xylazine

Question 15

A client calls you because her dog ate something poisonous. An emetic is indicated in this case. What are some household items she can use to make her dog vomit?

Answer 15

hydrogen peroxide, fresh ground mustard, diluted dishwashing fluid, saturated NaCl solution

Question 16

3 methods of decreasing rate of absorption

Answer 16

precipitation, adsorption, ion trapping

Question 17

decrease rate of absorption by giving chemicals that bind the toxicant

Answer 17

precipitation

Question 18

physical binding of the toxicant to reduce absorption

Answer 18

adsorption

Question 19

adsorbent of choice is

Answer 19

activated charcoal

Question 20

when is charcoal not an effective adsorbent?

Answer 20

ammonia, cyanide, heavy metal salts, nitrate and nitrite, fluoride, sodium chloride, ethanol, methanol, iodides, bleach, fertilizer

Question 21

T/F: ion trapping is very effective in decreasing absorption

Answer 21

false it is not

Question 22

4 ways to enhance elimination

Answer 22

fluid therapy and diuretics
urine pH modifiers
peritoneal dialysis
hemodialysis

Question 23

2 most common diuretics used in poisoning

Answer 23

mannitol and furosemide

Question 24

Describe the effects of urinary acidifiers

Answer 24

urinary acidifiers (ammonium chloride or methionine) enhance renal excretion of weak basic drugs (alkaloids, amphetamines)

Question 25

describe the effects of urinary alkalinizers

Answer 25

urinary alkalinizes (sodium bicarb) enhance renal excretion of weak acidic drugs (NSAIDs or phenobarbital)

Question 26

When is peritoneal dialysis used?

Answer 26

when animal is suffering from oliguria or anuria