Recreational Toxicology Flashcards
Ricin structure
A chain + B chain
Ricin MOA
Breaks down proteins
Ricin poisoning management
Nothing to do in acute phase
Supportive treatment
LD50
Lethal dose that kills 50% of the population
What state are most nerve agents in at room temp
Liquid, then evaporate into gas
What type of agent is Sarin
Organophosphate
2 pneumonics for symptoms of organophosphate poisoning/ cholinergic crisis
DUMBELLS -
diarrhoea
Urination
Myosis
Bronchorrhea
Bradycardia
Emesis
Lacrimation
Lethargy
Salivation/Sweating / Seizures
SLUDGE
Sweating/ Salivation / Seizures
Lacrimation
Urination
Diarrhoea
GI cramps + pain
Emesis
Organophosphate poisoning red flags
Secretions + Seizures
Main nerve agent antidote
Atropine - dries up secretions
Most ‘problematic’ cholinergic sx
Bronchorrhea
Which services carry atropine
Ambulances carry 4 self help packs
Large volumes carried by specialist providers
Cholinergics
Compounds that mimic the action of acetylcholine +/or butyrylcholine
Muscarinic
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
Nicotinic
Type of ACH receptor
Involved in neuro transmission, neuro modulation, cognitive function, and voluntary motor control, adrenaline+noradrenaline release + sympathetic nervous system activation
Anticholinergic
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
Acetylcholine
Excitatory Neurotransmitter that acts on muscarinic and Nicotinic receptors
Cholinesterase
Enzyme present in the CNS that catalyses hydrolysis of ACH into acetic acid and choline
Anticholinesterase
Class of drugs that inhibit breakdown of ACh
Used for Alzheimer’s and myasthenia Gravis
Novichok, organophosphate
Ageing
biochemical process by which the agent-enzyme complex becomes completely resistant to oxime reactivation
Makes binding irreversible
Cyanide toxicity treatment
1) nitrates 2) methylene blue
Cyanide + nitrate -> methylHb
MethylHb + methylene blue -> Hb
Crack lung
Form of COPD caused by crack use
Forms soaces in the lungs
Major vascular risk from crack use
Aortic dissection
Why is it difficult to make antidotes for drugs
Often have multiple MOAs
Why do people use crack
Powerful stimulant
Highly addictive
Numbs feelings
Crack
Crystal form of cocaine that can be smoked to get a 5-10 min high
How does crack cause harm
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
Crack/cocaine OD
Tachycardia
Hypertension
Diaphoresis
Mydriasis
Seizures
Hallucination
Delirium
Violent behaviour
Hyperthermia
Arrhythmia
Chest pain
DIB
Haemoptysis
Crack/cocaine OD PH tx
Rapid cooling for hyperthermia
Benzodiazepines
Supportive tx
Why do people take MDMA
Happy
‘Loved up’
Energised
Effects of MDMA
Nausea
Muscle cramps
Gurning / jaw tightening
Blurred vision
Chills
Hyperthermia
Sweating
Tachycardia
Hypertension
Hyperactivity
Bruxism
Restlessness
Insomnia
Concentration difficulty
MDMA
Synthetic psychoactive drug
Powder, crystal, or in pills
Class A
Stimulant
How does MDMA cause harm
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
MDMA MOA
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
MDMA OD
Tachycardia
Hypertension
Dysrhythmia
Anxiety + agitation
Hallucination
Seizures
Mydriasis
Diaphoresis
Hyperthermia
Serotonin syndrome
Rhabdomyolysis
DIC
Serotonin syndrome
Hyperpyrexia, muscle rigidity, breathing difficulty
Tx - cyproheptadind, ventilation, supportive
PH tx of mdma OD
Rapid cooling
Benzodiazepines- psychomotor agitation and shivering
Cyproheptadine - serotonin syndromeABCDE
cardiac monitoring
Effects of MDMA on water balance
Decreases ADH
Incr thirst (hyperthermia)
Sweating
Hot clubs,Dancing
GHB
Why do people use GHB
GHB MOA
GHB signs and sx
GHB OD
GHB PH tx
What causes Hyperpyrexia
Muscle contractions and rigidity
Spice
Spice MOA
Why people use spice
Spice signs and sx
Spice OD
Spice PH tx
How spice causes harm
Cocaine/crack MOA
