SA toxicology Flashcards

1
Q

Within what time limit should emesis be performed whilst treating toxicosis?

A

Within 3 hours

  • 6hrs for aspirin
  • 12hrs for chocolate
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2
Q

In cases of occular contamination how long should the animals eye be irrigated?

With what?

A

Saline

20-30 minutes

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3
Q

What is the MOA of apomorphine?

What are the potential routes of administration?

A

Dopamine agonist

Can be administered parenterally or inserting a tablet into the conjunctiva until effect

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4
Q

Activated charcoal is an example of what type of substance?

What is its MOA?

A

Adsorbents

Binds the poison and prevents absorption from the GI tract.

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5
Q

If using activated charcoal to treat drug intoxication how often should the half dose be readministered?

Why?

A

Every 4-8 hrs

The substance interferes with enterohepatic circulation

eg NSAIDs, methylxanthines, ivermectin

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6
Q

What are the contraindications to emesis?

A
  • Vomiting already
  • No gag reflex
  • Central depression - unconscious, depressed
  • Seizuring
  • Corrosives, irritants or volatile products have been ingested
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7
Q

Why is apomorphine NOT used in cats?

A

The have few CNS dopamine receptors & so the drug is not effective as an emetic

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8
Q

What is a cathartic?

Give an example.

A

Speeds up defacation

eg Liquid paraffin

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9
Q

Which clotting factors are effected by vitamin K antagonism?

A

2, 7, 9, 10

Vitamin K antagonists such as warfarin competitively inhibit K1 epoxide reductase and prevent factor activation.

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10
Q

Describe the effect that vitamin K antagonists have on coagulation screening assays.

A

Initially a prolonged PT (since factor 7 has the shortest half life)

Secondly prolonged PT and APTT

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11
Q

Konakion

A

Vitamin K1

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12
Q

Cholecalciferol

A

Inactive form of vitamin D

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13
Q

What clinical signs are seen with Cholecalciferol intoxication?

A

Hypercalcaemia

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14
Q

Outline the differentials for hypercalcaemia.

A
  1. H - hyperparathyroidism
  2. A - addisons
  3. R - renal
  4. D - vitamin D toxicosis
  5. I - idiopathic
  6. O - osteolysis
  7. N - neoplasia
  8. S - spurius - dehyd/lipaemia
  9. G - granulomatous
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15
Q

What clinical signs are seen with intoxication with Cholinesterase inhibitors?

A
  1. D - diarrhoea
  2. U - urination
  3. M - miosis
  4. B - bronchoconstriction
  5. B - bradycardia
  6. E - emesis
  7. L - lacrimation
  8. S - salivation

Muscarinic, nicotinic and CNS effects

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16
Q

Examples of cholinesterase inhibitors.

A

Organophosphates

Carbamates

Insecticides/ fungicides

17
Q

What three drugs are used in treatment of cholinesterase inhibitors?

A
  1. Diazepam - reduce seizures
  2. Atropine - muscarini antagonist
  3. 2-PAM - reduce nicotinic associated muscle tremors
18
Q

Why do most pyrethroid intoxications occur?

What clinical signs are associated with intoxication?

A

Giving a dog prep to a cat - cat licks off prep whilst grooming + cutaneous absorption

  • XS salivation
  • tremors
  • ataxia
  • depression
  • hyper/hypothermia
19
Q

Paraquat

C/S

A

Toxic herbicide

  • GIT
  • Acute tubular necrosis
  • Pulomnary oedema and haemorrhage - lung accumulation
  • Usually fatal
20
Q

The ingredient that is toxic in slug pellets is …..

MOA

C/S

A

Metaldehyde - reduced GABA inhibition

  • Hyperaesthesia
  • Neurotox/hepatotox
  • Anxiety/restlessness
  • Salivation
  • Tremors
  • Tachycardia
  • Seizures
  • Death
21
Q

Why can paracetamol NOT be used in cats?

A

They are unable to glucoronidate paracetamol and so toxic intermediates of metabolism accumulate

22
Q

How does paracetamol cause toxicity?

C/S

A

Causes oxidative damage to RBCs and formation of methaemoglobin.

  • V+
  • Abdo pain
  • Tachycardia
  • MetHb mm - chocolate coloured
  • Depression
  • Hepatic failure
23
Q

Cimetidine

A

cytochrome P450 inhibitor - may reduce formation of toxic intermediates of paracetamol toxicosis

24
Q

N-acetyl cysteine

A

Acts as glutathione - aids glucoronidation

25
What clinical signs are associated with NSAID intoxication?
* GIT * mild epigastric pain * erosive gastritis, ulceration and haemorrhage * Decreased PLT function * Bone marrow supression * Seisures * Nephrotoxicity (after 3-5 days) - casts
26
What metabolites of elythlene glycol cause toxicosis? What effects do each have?
1. Glycolic acid - metabolic acidosis 2. Oxalic acid - +Ca2+ in blood vessels and renal tubules - obstruction/ epithelial damage, hypocalcaemia
27
Describe the three phases of Ethylene glycol intoxication.
1. Phase 1 - within 30m (lasts 2-12hrs) 1. Ataxia, \>HR/RR, PUPD, V+ 2. Phase 2 - 8-24hrs post ingestion 1. Metabolic acidosis, miosis, anorexic, v+, depression, coma, death 3. Phase 3 - 1-3days post ingestion 1. Oliguric, nephromegaly + pain, oral ulceration, v+, seizures
28
Describe the renal findings associated with ethylene glycol intoxication.
* Calcium oxalate crystaluria * Azotaemia * Hypocalcaemia * Hypophosphataemia * Metabolic acidosis
29
Why is decontamination of a cat which has ingested ethylene glycol not useful? Which specific therapy is used in these cases?
EG is rapidly absorbed from the GI tract and so it is usually too late. IV Ethanol
30
Which human drugs are associated with pet intoxication? Outline one clinical sign for each.
1. Marijuana - hypothermia, munchies, lethergy 2. Cocaine - restless, hyperactive, hyperthermia, muscle tremors 3. Amphetamines - stimulant - tachycardia, restless, seizures, death 4. Heroin - drowsy, ataxia, pulm oedema, resp arrest, emesis, delerium, seizures
31
Oxidative damage, heinz body formation and methaemaglobinaemia are associated with intoxication of which vegetables?
Onion Garlic Leek
32
Spoilage of foods is associated with which toxicosis? C/S
Mycotoxins * Muscle tremors * V&D * Lactic acidosis * Rhabdomyolysis * Hyperthermia +++
33
AKI (acute rubular necrosis) is associated with intoxication with which fruit?
Grapes/raisins
34
Methylxanthines
Caffine Thiobromine - chocolate, tea etc
35
What clinical signs are associated with methylxanthine intoxication?
1. GI upset 2. Cardiac - supraventricular arrhythmia 3. CNS - tremors/seizures
36
Profound hypoglycaemua due to excessive insulin release is associated with intoxication with which substance?
Xylitol
37
Name some breeds of dog which can be affected by avermectin toxicity. What anthelmintic should be used as an alternative in these breeds?
* Collies * OESD * Australian shepherd * Shetland sheepdog * GSD Selamectin
38
What clinical signs are associated with lead intoxication?
* Decreased Hb synthesis * GIT * CNS * Anaemia - regenerative * Basophilic stippling
39