Recreational Drugs

Question 1

What is the MOA of marijuana? why is it more toxic in dogs?

Answer 1

interact with CB1 (brain) and CB2 (peripheral)

dogs have more CB1 receptors

Question 2

What are the clinical signs of marijuana toxicity? What is the duration and the peak?

Answer 2

effects in 30-60min
peak in 2-3h

depression, sleepy, disorientation, mydriasis, vomiting, hypothermia, incoordination/ataxia, hyperesthesia, urinary incontinence, bradycardia

lessoften:
apprehension, hyperexcitability, tremors, seizures, tachycardia, hyperthermia, vocalize, severe depression, hypoventillation, stupor/coma

Question 3

What is the Dx for marijuana toxicity?

Answer 3

no specific lab test

• human dipstick unreliable
• clin signs and Hx

Question 4

What is the treatment for marijuana toxicity?

Answer 4

emesis, AC
monitor vitals (CV and resp)
S&S care
Iv fluids, electrolytes
lipid emulsion
antiemetics
sedation (diazapam)
keep warm and quiet

Question 5

What is the Px for marijuana toxicity?

Answer 5

good with recovery in 24 to 5 days

Question 6

What are the therapeutic uses of marijuana?

Answer 6

anxiety, pain, nausea

Question 7

What are the problems with marijuana use in pets today?

Answer 7

there is no quality control

little THC could be a lot

Question 8

What are methylaxanthines?

Answer 8

alkaloids

caffeine
theophylline (tea)
theobromine (chocolate)

Question 9

how toxic is caffeine (generally)?

Answer 9

around 10 pills - LD50

1/2tsp = LD50 for 40lb dog

Question 10

How do chocolate types rank in toxicity? what else affects toxicity?

Answer 10

baking > dark > milk > white

size of the dog

Question 11

Whats the rule of thumb for chocolate toxicity?

Answer 11

1 oz (30g) / lb body weight for milk chocolate

10% of that for baking
30% of that for dark

Question 12

Whats the LD50 for chocolate orally? in mg/kg?

Answer 12

250-500mg theobromine/kg

Question 13

What are the general clinical effects of chocolate poisoning?

Answer 13

main:

• cerebral and cortical stim
• myocardial contraction
• smooth muscle relaxation

Question 14

What are the clinical affects of chocolate at 1-4 hours?

Answer 14

hyperactive, pacing, panting, tremors, vomit and diarrhea, urination, tachycardia, hypertension and hyperthermia

Question 15

What are the clinical signs chocolate at the hours following 1-4?

Answer 15

cardiac arrhythmias, muscle rigidity and ataxia, hyperreflexia and CNS excitation

Question 16

What are the critical signs and at what time period does this occur?

Answer 16

coma, terminal seizures

death in 18 hours - 3-4d from cardiac or resp failure

Question 17

What is the treatment for chocolate poisoning? prognosis?

Answer 17

decontam
- emesis or GL
- AC
- IV fluids
S&S care
- control seizures and excitation
- monitor HR, BP, resp function

signs persist 12-36h

prognosis: good if caught early

Question 18

How does nicotine products vary in nicotine content?

Answer 18

cigarettes (10-30mg)
cigars (100-450 mg)
chew (13-17mg/gram)
patch (1-120mg)
gum (2-4)

Question 19

What is the mechanism of action of nicotine poisoning?

Answer 19

mimic acetylcholine –> stim post synaptic nicotinic receptors in CNS. auto NS and NMJ

high dose:
- persistant stim –> persistant depolarization of nerves and muscles with exhaustion and failure

Question 20

About how many nicotine “products” are toxic for 40lb dog?

Answer 20

2 cigars
< 1 pack
20g chew
patches cause prolonged exposure (not usually lethal)

Question 21

how is nicotine absorbed/excreted?

Answer 21

MM, skin rapidly

renal

Question 22

What are the initial clinical signs of nicotine?

Answer 22

GI effects (salivation, vomiting, diarrhea)

Question 23

What CV affects are seen with nicotine poisoning?

Answer 23

mixed

activation of sym and parasym systems

Question 24

What are the general clinical signs of nicotine poisoning?

Answer 24

CNS stim/ecitation
- tremors, agitation, incoordination, seizures)
followed by CNS depres
- depolarizing block of NMJ leading to weaknes and paralysis

Question 25

What causes death and how long does it take?

Answer 25

18-24h or faster

death from cardiac arrest or resp paralysis

Question 26

What is the Tx and Px of nicotine poisoning?

Answer 26

decomtam

• emesis/GL
• AC
• cathartic
• IV, increase urinary excretion
• endoscopic removal of patch

monitor heart rate and BP, seizure control, resp support

prognosis poor for high doses if not stabilized within 4h