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tox final Flashcards

1
Q

CO2 produced by

A

Incomplete oxidation of fossil fuels (gas, wood, coal)

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2
Q

CO2 forms ____ when bound to hemoglobin

A

Carboxy-hb

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3
Q

CO2 leads to what type of cyanosis

A

Cherry red cyanosis

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4
Q

CO2 primary target organs

A

Brain (Parkinson), Myocardium (MI/ angina)

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5
Q

Initial SS of CO2 poisoning

A

Headache, confusion

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6
Q

CO2 poisoning managed by

A

100% O2, Hyperbaric O2

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7
Q

Hb oxidizing agents

A

Nitrogen oxides- nitrates, nitrites, chlorates, meds

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8
Q

Heme Fe2 oxidized to

A

Heme Fe3 (methemoglobin)

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9
Q

Methemoglobin normally <5% due to

A

Methemoglobin reductase

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10
Q

Methemoglobin reductase deficiency

A

Methemoglobinemia (blue baby syndrome) FERTILIZER IN WELL WATER

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11
Q

Methemoglobin causes _____ cyanosis

A

Chocolate cyanosis

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12
Q

Strong inorganic acids cause

A

Precipitative necrosis at site of contact w/ Eschar

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13
Q

Strong acid burn management

A

Wash w/ cold running water 15 minutes

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14
Q

Strong inorganic bases cause

A

Dissolution necrosis at site of contact. No scar, progressive penetrative damage to underlying tissue possible

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15
Q

Salicylates

A

Acetylsalicylic acid (aspirin), sodium salicylate

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16
Q

Salicylate uses

A

Analgesic, antipyretic, anti-inflammatory, OSTEOARTHRITIS

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17
Q

Salicylate toxicity mechanisms

A

Acid base imbalance (stimulate medullary respiratory nuclei) ->

Hyperventilation/ respiratory acidosis –>

Oxidation uncoupled from phosphorylation ->

Heat released from ETC -> hyperthermia

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18
Q

Salicylate toxicity symptoms

A

Reye’s syndrome in children (when aspirin given for viral fever)

Tinnitus

Aggravate gouty arthritis

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19
Q

NSAIDs

A

Aspirin, ibuprofen, naproxen

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20
Q

Steroidal anti-inflammatory drugs all related to

A

Hydrocortisone- cortisol, prednisone, betamethasone, dexamethasone

21
Q

Steroids used

A

Advanced OA, asthma

22
Q

Steroid mechanism

A

Inhibit phospholipase A2, prevent arachidonic acid formation -> decreased prostaglandin

23
Q

Steroid toxicity

A

Hyperglycemia, Cushing’s (fat trunk, shoulders, face) (moon face, buffalo hump)

Protein catabolic effect - > muscle wasting, difficulty healing

Immunosuppression

Pituitary suppression (decreased ACTH)

24
Q

Narcotic analgesics

A

morphine, codeine, hydrocodone, oxycontin

25
Q

Narcotic analgesics suppress __ and ___

A

CNS (central reflexes depressed), Medulla (CV and respiratory collapse- CHEYNE STOKES RESPIRATORY PATTERN)

26
Q

Narcotic analgesics stimulate

A

vagus (sinus bradycardia and projectile vomiting)

EW nuclei- miosis/ pinpoint pupils

27
Q

Most important non-narcotic analgesic

A

Acetaminophen in tylenol

28
Q

Acetaminophen mechanism

A

Inhibits prostaglandin synthesis IN BRAIN ONLY. NOT ANTI-INFLAMMATORY

29
Q

Acute acetaminophen overdose effect

A

Centrilobular hepatic nedcrosis

30
Q

Chronic acetaminophen overdose effect

A

Kidney failure

31
Q

MAO inhibitor

A

Tranylcypromine

32
Q

MAO inhibitor usage

A

Anti-depressant

33
Q

Tranylcypromine mechanism

A

Increase activity at aminergic synapses (NE, serotonin)

34
Q

MAO inhibitor toxicity

A

Hypertensive crisis when combined with fermented food -> stroke

35
Q

Tricyclic antidepressant

A

imipramine

36
Q

Imipramine effect on ECG

A

Prolongs QT interval

37
Q

Imipramine mechanism

A

Anticholinergic (block muscarinic Ach muscle receptors, exocrine glands, SA node)

38
Q

Imipramine toxic effects

A

Flaccid intestinal stasis, pupil dilation, decreased sensation, dry mucous membranes

39
Q

SSRIs

A

Prozac, zoloft

40
Q

SSRI toxicity

A

Serotonin syndrome

41
Q

Antifreeze

A

Ethylene glycol

42
Q

Ethylene glycol mechanisms

A

CNS depression like ethyl alcohol

Forms oxalic acid in liver-> hypocalcemia -> decreased heart contraction and peristalsis

Calcium oxylate formation in ST

43
Q

Oxalic acid metabolized by ___ and ___

A

Alcohol dehydrogenase and aldehyde dehydrogenase

44
Q

Methyl alcohol AKAs

A

Methanol, Woos Spirit

45
Q

Methanol use

A

Solvent, de-icer

46
Q

Methanol toxicity mechanism

A

Forms formaldehyde, formate -> destroys retinal ganglion cells

47
Q

Methanol toxic effect

A

Blindness

48
Q

Methanol overdose treatment

A

Titrated doses of ethyl alcohol (preferred substrate for enzymes)

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