SA Tox

Question 1

Serotonin (TCAs, MAO, SSRIs)

Answer 1

Altered mental status, ANS instability, neuromuscular abnormalities (seizures, clonus, etc), too much or too little catecholamines

Give ace or cyproheptadine

Multiple charcoal, ILE if severe

Question 2

Bromethalin

Answer 2

Neuro (ATPase pumps don’t work —> cells rupture —> CNS edema)

Multiple activated charcoal

Paralytic syndrome in cats, convulsant syndrome in high doses

Mannitol and steroids

Question 3

Marijuana

Answer 3

Neuro (mydriasis and dribbling urine and vomiting)

Multiple activated charcoal and ILE if severe

Question 4

OPs and carbamates

Answer 4

Neuro (inhibits acetylcholinesterase- muscarinic SLUDDE and nicotinic signs, and CNS signs)

Atropine response test- won’t respond

Atropine, glyco, 2-PAM, diphenhydramine,

Question 5

Metaldehydes (snail bait)

Answer 5

Neuro (seizures etc)

Question 6

Permethrins/pyrethroids

Answer 6

Neuro (repetitive neuron firing, seizures) and rhabdo in 🐈‍⬛

ILE

Question 7

Macrocyclic lactones

Answer 7

Neuro (dec GABA —> excitatory, blindness)

Toxic if given to MDR1 mutant or with p-gp inhibitor

Question 8

Chocolate

Answer 8

GI —> cardiac (arrhythmias) —> neuro (seizures)

Multiple activated charcoal

Can have serotonin release

Question 9

Anticoag rodenticide

Answer 9

Bleeding into cavities

Question 10

Garlic and onions

Answer 10

Anemia (Heinz bodies, methemoglobin) due to intravascular hemolysis

Charcoal not helpful

Question 11

Albuterol

Answer 11

Beta-2 agonist (activates ATPase —> hypokalemia)

Tachycardia, hypotension, altered mentation

Question 12

Cardiac glycosides

Answer 12

Inhibits ATPase —> too much Na in cell —> inc Ca in cell —> inc inotropy and cell death

GI, CV, neuro

Question 13

Xylitol

Answer 13

Liver and hypoglycemia in dogs

Question 14

Sago palm

Answer 14

Liver, GI, and Neuro, carcinogenic, mutagenic, teratogenic

Cycasin

Multi dose charcoal

Question 15

Mushroom toxicity (amanitins)

Answer 15

Liver failure, GI, and renal

False recovery between GI and liver failure

Single dose charcoal

Question 16

Aflatoxins

Answer 16

Acute fatal liver failure

Question 17

Blue green algae

Answer 17

Liver and Neuro

Acute death

Question 18

Acetaminophen toxicity

Answer 18

Liver and GI and methemoglobinemia

Especially in cats because they’re deficient in glucuronyl transferase (cp-450 detoxifies toxic metabolite called NAPQI)

Cats get edema of face and paws

Question 19

Grapes and raisins

Answer 19

AKI and GI in dogs

Question 20

Lillies

Answer 20

AKI and GI and Neuro in cats

Question 21

Ethylene glycol

Answer 21

AKI in dogs and cats

Turned into calcium oxalate by liver (this is what is toxic)

Look for calcium oxalate crystals and fluorescence on woods lamp

Drunk then false recovery then signs

Fomepizole (4-MP) and ethanol are antidote

Question 22

NSAIDs

Answer 22

GI ulcers —> AKI —> CNS (depending on dose)

Repeat charcoal and

Question 23

Cholecalciferol and calcitriol (vitamin D analogues)

Answer 23

GI —> renal (tubular necrosis and calcification)

Also CV, CNS, muscular

Repeat charcoal