SA toxicology

Question 1

what do macadamia nuts cause?

Answer 1

muscle weakness, depression, V+

1nut/kg BWt is toxic

Question 2

what do grapes cause?

Answer 2

AKI
PUPD, V+, lethargy, D+
1 grape/kg BWt

Question 3

what 2 food items cause heinz-body anaemia

Answer 3

onion
garlic
- also cause inc HR and RR, depression

Question 4

why does xylitol cause hypOglycaemia?

Answer 4

causes +++ insulin release VERY RAPIDLY

Question 5

in what time frame will emesis still be effective

Answer 5

wi 3hrs of ingestion

6hrs-aspirin and 12hrs-chocolate

Question 6

why should any topical exposure be washed with water, not detergents?

Answer 6

sometimes detergent can enhance uptake - so be safe not sorry. use oil if tar

Question 7

what agent do you use to stimulate emesis. What dose

Answer 7

apomorphine

4mg/kg i.v

Question 8

what other techn can be employed to reduce stomach/GI contents

Answer 8

gastric lavage
adsorbents 
cathartics
enema
diuretic

Question 9

Name a commonly used adsorbent and when/how it is given

Answer 9

activated charcoal
4g/kg orally with water (1g charc:10mls)
30min AFTER emesis (or it’ll just come back up…)
give half previous dose every 4-8hrs

Question 10

if the emesis doesnt stop, how can it be stopped pharaceutically?

Answer 10

naxolone (opioid antag)
4mg/kg i.v
give xylazine in cats

Question 11

briefly desc the methods of gastric lavaeg

Answer 11

cuffed ETT
head low
stomach tube w 15ml water 15 x

Question 12

what samples need to be taken?

Answer 12

EVERYTHING

Question 13

what is the action of cathartics and give some examples

Answer 13

inc GI elimination
sorbitol = may well be in charcoal mixture
sodium sulphate = 1 x dose
parrafin = 10ml/dog

Question 14

if hyperactive/seizure what 3 drugs can be used

Answer 14

diazepam = 1mg/kg. 3x in 2hrs max
propofol
phenobarbitol = 3mg/kg i.v (slowly)

Question 15

how do anticoagulant rodenticides work?

Answer 15

vit K antagonists
inhib vit K epoxide reductase
inactivates factors II, VII, IX, X

Question 16

how long until death from rodenticide poisoning?

Answer 16

1-3d

Question 17

which ‘arm’ of the coag cascade will be first t be lengthened when their are some factors inhibited? PT (ext) or APTT (int)

Answer 17

PT extrinsic as VII missing and it has the shortest half life

Question 18

how do you tx vit k1 antagonism?

Answer 18

with synthetic vit k1 = konakion
transfusion
O2
4wks of treatment

Question 19

what are the effect of ingesting too many cholecalciferols (vit D precursor)

Answer 19

hypercalcaemia from inc activation of vit D

Question 20

name some differentials which cause hypercalcaemia

Answer 20

hyperpara, addisions, renal dz, neoplastic (anal sac carcinoma)

Question 21

how to treat hypercalcaemia?

Answer 21

emesis, charcoal
saline @3x MR
calcitonin
high salt, low ca++ diet

Question 22

how long does it take for cholecalciferols to clear?

Answer 22

4-6wks

Question 23

name some cholinesterase inhibitors

Answer 23

OPs
carbamates
insecticides

Question 24

what are nicotinic effects?

Answer 24

muscle cramps
weakness
tachycardia
hypertension
mydriasis (dil)
pallor
tachy mm

Question 25

what are muscarinic effects - and the pneumonic

Answer 25

DUMBELS

D+, urination, miosis (cons), bronchospasm/constriction, bradycardia, emesis, lacrimation, salivation

Question 26

what signs follow cholinesterase inhibitor poisoning

Answer 26

nicotinic
muscarinic
and CNS signs

Question 27

how do you treat cholinesterase inhib poisoning?

Answer 27

emesis and charcoal and cathartic
atropine (anti-musc)
diazepam (prev seizures)
2-PAM (anti-nicotinic) - NB hypothermia a big risk

Question 28

what type of pyrethroid is toxic to cats?

Answer 28

permethrin

Question 29

name signs of pyrethroid poisoning

Answer 29

salivation
tremors
ataxia
depression
temp imbalance
prolongued Na+ conduction

Question 30

what dz doe paraquat tox cause

Answer 30

accumulates in lungs = pulm oedema and haemorrhage
[O] damage in alv –> MUST NOT give O2 therapy
charcoal req wi 1hr

Question 31

where are metadehydes found? what do they cause

Answer 31

slug pellets

neuro and then hepatotox

Question 32

paracetamol is most toxic to D or C?

Answer 32

cats

Question 33

why is paracetamol poisonous?

Answer 33

can glucorinidate
heinz body anaemia
mHb-aemia

Question 34

what are the signs of paracetamol OD

Answer 34

pallor
cyanosis
high HR
v+ 
hepatic failure

Question 35

How do you treat paracetamol OD

Answer 35

cimentidine (inhib cytop450 to stop being metabolised at all)
n-acetyle cysteine = antidote
ascorbic acids reduces mHb
O2
transfusion

Question 36

NSAID OD leads to Gastric ulcers, haem+, BM suppression and thrombocytopenia. what can be given to protect against GI effects?

Answer 36

sulcralfate
H2 antag (ranitidine)
PPIs
Misoprostal = synth PG to heal ulcers

Question 37

NSAID OD can also lead to hypOkalaemia, how can this be treated?

Answer 37

IVFT

give w glucose to help K+ into cells with help of insulin prod

Question 38

how can ethylene glycol lead to hypocalcaemia

Answer 38

final metabolite is oxalic acid which bind ca++ and sediments - blocking tubules. tx with Ca++

Question 39

desc the progression of ethylene glycol poisoning

Answer 39

phase 1 - ataxia, PUPD, inc HR
phase 2 - metabolic acidosis, v+, hypothermia
phase 3 - oliguric RF, seizures

Question 40

what does cannabis cause?

Answer 40

hypOthermia

Question 41

what does cocaine cause>

Answer 41

hypERthermia

Question 42

to reverse the effects of narcotics (opioids) give…

Answer 42

naloxone

Question 43

do not give diazepam if OD of…….(horse tranq)

Answer 43

amphetamines

Question 44

how should you manage chocolate poisoning

Answer 44

bladder small as methyxanthine abs thru bladder