Recreational Toxicology Flashcards

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1
Q

Ricin structure

A

A chain + B chain

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2
Q

Ricin MOA

A

Breaks down proteins

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3
Q

Ricin poisoning management

A

Nothing to do in acute phase
Supportive treatment

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4
Q

LD50

A

Lethal dose that kills 50% of the population

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5
Q

What state are most nerve agents in at room temp

A

Liquid, then evaporate into gas

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6
Q

What type of agent is Sarin

A

Organophosphate

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7
Q

2 pneumonics for symptoms of organophosphate poisoning/ cholinergic crisis

A

DUMBELLS -
diarrhoea
Urination
Myosis
Bronchorrhea
Bradycardia
Emesis
Lacrimation
Lethargy
Salivation/Sweating / Seizures

SLUDGE
Sweating/ Salivation / Seizures
Lacrimation
Urination
Diarrhoea
GI cramps + pain
Emesis

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8
Q

Organophosphate poisoning red flags

A

Secretions + Seizures

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9
Q

Main nerve agent antidote

A

Atropine - dries up secretions

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10
Q

Most ‘problematic’ cholinergic sx

A

Bronchorrhea

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11
Q

Which services carry atropine

A

Ambulances carry 4 self help packs
Large volumes carried by specialist providers

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12
Q

Cholinergics

A

Compounds that mimic the action of acetylcholine +/or butyrylcholine

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13
Q

Muscarinic

A

Type of ACH receptor involved in parasympathetic nervous system
Decreases HR, GI muscle contraction, incr GI secretions, incr gland secretion, urine release, contracts eye muscles, erections

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14
Q

Nicotinic

A

Type of ACH receptor
Involved in neuro transmission, neuro modulation, cognitive function, and voluntary motor control, adrenaline+noradrenaline release + sympathetic nervous system activation

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15
Q

Anticholinergic

A

Class of drugs that block ACH
Reduce secretions, have many side effects
Used for allergic and inflam disease, Parkinson’s, overactive bladder, and motion sickness

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16
Q

Acetylcholine

A

Excitatory Neurotransmitter that acts on muscarinic and Nicotinic receptors

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17
Q

Cholinesterase

A

Enzyme present in the CNS that catalyses hydrolysis of ACH into acetic acid and choline

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18
Q

Anticholinesterase

A

Class of drugs that inhibit breakdown of ACh
Used for Alzheimer’s and myasthenia Gravis
Novichok, organophosphate

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19
Q

Ageing

A

biochemical process by which the agent-enzyme complex becomes completely resistant to oxime reactivation
Makes binding irreversible

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20
Q

Cyanide toxicity treatment

A

1) nitrates 2) methylene blue

Cyanide + nitrate -> methylHb
MethylHb + methylene blue -> Hb

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21
Q

Crack lung

A

Form of COPD caused by crack use
Forms soaces in the lungs

22
Q

Major vascular risk from crack use

A

Aortic dissection

23
Q

Why is it difficult to make antidotes for drugs

A

Often have multiple MOAs

24
Q

Why do people use crack

A

Powerful stimulant
Highly addictive
Numbs feelings

25
Q

Crack

A

Crystal form of cocaine that can be smoked to get a 5-10 min high

26
Q

How does crack cause harm

A

Overdose
Incr risk of heart attack, stroke, aortic dissection
Paranoia, disruption of personal relationships
Addiction
Effects amount of glutamate in brain affecting cognition and memory
Increases sensitivity to stress

27
Q

Crack/cocaine OD

A

Tachycardia
Hypertension
Diaphoresis
Mydriasis
Seizures
Hallucination
Delirium
Violent behaviour
Hyperthermia
Arrhythmia
Chest pain
DIB
Haemoptysis

28
Q

Crack/cocaine OD PH tx

A

Rapid cooling for hyperthermia
Benzodiazepines
Supportive tx

29
Q

Why do people take MDMA

A

Happy
‘Loved up’
Energised

30
Q

Effects of MDMA

A

Nausea
Muscle cramps
Gurning / jaw tightening
Blurred vision
Chills
Hyperthermia
Sweating
Tachycardia
Hypertension
Hyperactivity
Bruxism
Restlessness
Insomnia
Concentration difficulty

31
Q

MDMA

A

Synthetic psychoactive drug
Powder, crystal, or in pills
Class A
Stimulant

32
Q

How does MDMA cause harm

A

Increased risk of unsafe sex
Serotonin syndrome
Dehydration, hyperthermia, HF, kidney failure
Depression, aggression, impulsiveness, anxiety
Sleep problems
Liver failure
Repeated use depletes serotonin - depression and anxiety

33
Q

MDMA MOA

A

Increases concentration of noradrenaline, dopamine, and serotonin in the synaptic cleft
- inhibits serotonin and dopamine reuptake
- stimulates serotonin and dopamine release
- Inhibits monoamine oxidase activity
Effects Thermoregulation and autonomic nervous system
Increases ADH levels

34
Q

MDMA OD

A

Tachycardia
Hypertension
Dysrhythmia
Anxiety + agitation
Hallucination
Seizures
Mydriasis
Diaphoresis
Hyperthermia
Serotonin syndrome
Rhabdomyolysis
DIC

35
Q

Serotonin syndrome

A

Hyperpyrexia, muscle rigidity, breathing difficulty

Tx - cyproheptadind, ventilation, supportive

36
Q

PH tx of mdma OD

A

Rapid cooling
Benzodiazepines- psychomotor agitation and shivering
Cyproheptadine - serotonin syndromeABCDE
cardiac monitoring

37
Q

Effects of MDMA on water balance

A

Decreases ADH
Incr thirst (hyperthermia)
Sweating
Hot clubs,Dancing

38
Q

GHB

A
39
Q

Why do people use GHB

A
40
Q

GHB MOA

A
41
Q

GHB signs and sx

A
42
Q

GHB OD

A
43
Q

GHB PH tx

A
44
Q

What causes Hyperpyrexia

A

Muscle contractions and rigidity

45
Q

Spice

A
46
Q

Spice MOA

A
47
Q

Why people use spice

A
48
Q

Spice signs and sx

A
49
Q

Spice OD

A
50
Q

Spice PH tx

A
51
Q

How spice causes harm

A
52
Q

Cocaine/crack MOA

A