Toxi Flashcards
Learn all about toxicology
Avoid Quinidine , amiodsrone and flecainide In
Tricyclic AD poisoning
Ethanol acts on
Alcohol dehydrogenase
Ethylene alcohol poisoning
Haemodialysis……in refractory cases
pyrazinamide MOA
converted by pyrazinamidase into pyrazinoic acid, and then P ACID is converted to fatty acid synthase 1
ethambutol MOA
inhibits arabinosyl transferase
and polymerises arabinose to arabinan
isoniazid moa
inhibits mycolic acid synthesis and inhibits liver enzymes
rifampicin
inhibits bacterial DNA dependant RNA polymerase , prevents transscription of DNA into RNA
dialysis is ineffective for managing poisoning with which medications
tricyclic antidepressants
crack cocaine can cause
sympathomimetic and serotonergic effects
mechanism of death through nitric oxide
hypoxia
crack cocaine can cause
choreoathetoid movements
stimulants like MDMA, amphetamines and cocaine can cause
increased serotonin, dopamine and noradrenaline
causes a high feeling of euphoria.
mephedrone is another stimulant
also called as meow meow bath salts, M cat.
benzodiazepine antidote flumazenil
should not be administered to epileptic patients at high risk of seizures
benzo poisoning
GCS goes down, ventilation goes down, immediately deek anaesthetic support
heroin does not cause
haematological and neurological symptoms
spice can cause( is a synthetic cannabinoid)
ACPC BLIND NYS
agitation confusion psychosis coma
blindness and nystagmus
serious complication of nitric oxide toxicity
oxidization of ferrous ions inside haemoglobin molecules to ferric ions causing methmoglobinemia and therefore reduces oxygen carrying capacity of the blood.
nitric oxide can precipitate severe
severe B 12 def, causing subacute combined degeneration of the spinal cord
severe b12 def manifests with which neurological symptoms
ataxia, loss of DTRs, dorsal column signs, upper and lower motor signs, loss of proprioception and vibration, pos babinski, ………………….also called myelosis funicularis.
serotonin syndrome vs NMS ( similarities)
Serotonin syndrome is fast onset……NMS is slow
both have pyrexia rigidity (lead pipe rigidity in NMS), and sweating, patients are young, tachycardic and hypertensive,
S syndrome vs NMS
SS onset fast, NMS onset: slow
SS: reflexes brisk, NMS refexes are slow
Pupils in SS: are dilated, pupils in NMS: normal
drugs causing lung fibrosis
BBAN METH
bleomycin, busulphan, amiodarone, nitrofurantoin, methotrexate, sulfasalazine,
bromocriptine. cabergoline, and pergolide.
bromocriptone can excacerbate
Serotonin syndrome,
serotonin syndrome
causes
MESA
maois
ecstasy
SSRI’s
amphetamines
serotonin syndrome treatment
cyproheptadine
NMS treatment
dantrolene
organophosphate poisoning
small pupils or miosis. also muscle fasciculation.
buspirone , dextromethorphan, phenelzine, are all risk factors for
serotonin syndrome
procyclidine is used in the treatment of
acute dystonias and drug induced extrapyramidal symptoms
malignant hyperthermia caused by
anaesthetic agents
malignant hyperthermia knonw for
muscle rigidity and hyperpyrexia
defect see on chromosome 19
inherited in an autosomal dominant fashion
malignant hyperthermia is caused by
caused by excessive relsease of ca from the sarcoplasmic reticulum of skeletal muscle.
defect is on gene 19 that encodes the ryanodine receptor, which controls the ca release from the sarcoplasmic reticulum,
malignant hyperthermia vs serotonin syndrome
ck raised
diagnoed by contracture tests with halothane and caffeine
amiodarone induced thyrotoxicosis…….
type 1 seen in patients with underlying graves disease
type 2 seen in patients without underlying thyroid pathology
type 2 is the result of a toxic effect on thyroid follicular cells, that causes a destructive thyroiditis,
results in an excess relseaes of preformed t3 and t4 into the circulation,
patients eventually recover in type 2 after an intial thyrotoxic phase followed by hypotthyroid phase.
AIT
treatment for
type 1 : potassium perchlorate, or carbimazole , goitre is usually seen in
type 2: corticosteroids, goitre is usually absent,
