Toxicities Flashcards

Question

DES

Answer 1

Causes vaginal adenocarcinoma | Used in teens

Answer 2

Free radicals abstract H' from side chains forming a free radical in chain (L')-initiation L' reacts with neighboring lipids forming more L' Oxygen reacts forming (LOO') Propagation of lipid peroxidation Complex chain reactions occur resulting in destruction of lipid bilayer integrity E.g. CCL4->CCl3' , O2', OH' very reactive Also cause glutathione oxidation, protein oxidation and depletion of NADH

Answer 3

Forms reactive oxygen species

Answer 4

Superoxide dismutase: O2' to H2O2 plus Fe2+ and OH' forms H2O Glutathione peroxidase: H2O2 to H20 Glutathione reductase: replenishes glutathione peroxidase with H from NADPH Protein disulfide: replenishes glutathione disulfide If become compromised more sensitive to Vit E and C toxicity Selenium deficiency (Gs peroxidase requires Se) GSH depletion (malnutrition, fasting) Genetic abnormalities. (SOD deficiency)

Answer 5

Sources: silos-in incomplete reduction of NO3- Smogs Toxicity: bronchiolitis obliterans, silo fillers disease (100 ppm=dangerous 200=fatal) MOA: direct irritant (HNO3) Oxidant: lipid peroxidation

Answer 6

Illicit street drug Selective destruction of dopaminergic neurons Parkinson's like syndrome

Answer 7

Sedative Reduction in long bones of limbs-loss of fetal limb buds Between days 35-50 of pregnancy Teratogenic

Answer 8

Teratogenic | Synthetic retinoids

Answer 9

Teratogenic | GI, limb and kidney malformations

Answer 10

Inhalation Accumulates in: kidneys Converted to Hg++ in body 1-2 months for elimination Causes: corrosive bronchitis, interstitial pneumonitis, thyroid enlargement, hematologic changes, gingivitis, salivation, CNS:memory loss, excitability, depression, hallucination, tremor, decreased fine motor function (mad hatter) Treatment: hemodialysis or chelators: cysteine, penicillamine, British antilewisite, succimer (choice)

Answer 11

GI absorption Accumulates in kidneys Converted to Hg++ in body 1-2 months for elimination Corrosive in high doses: GI ulceration, bleeding necrosis, shock Renal failure necrosis of proximal tubules, glomerular injury, neuropathy Treatment: hemodialysis or chelators: cysteine, penicillamine, British antilewisite, succimer (choice

Answer 12

Aquatic microorganism a ingested by fish GI absorption Accumulates in brain Converted to Hg++ in brain 1-2 months for elimination Neurotoxicity-parsthesia, ataxia, neurasthenia, vision and hearing loss, spasticity, tremor, coma death Teratogenic: interferes with brain development, seizures Treatment: hemodialysis or chelators: cysteine, penicillamine, British antilewisite, succimer (choice

Answer 13

Sources: soil:leaded gasolines and paints, water: lead pipes, lead paint: children's toys, clothes and shoes from industrial workers, canned foods, ceramic glazers, moonshine whiskeys, traditional remedies and cosmetics Absorption: inhalation, most GI absorption Distributin: initially liver and kidney, 99% to blood, redistribution to bone, placental transfers Slow elimination: mostly by kidneys, hair and nails: chronic 1-2 months, 20-30 yrs from bone Diagnosis: blood lead levels indicate recent exposure 30-75 ug/dal mild signs, >70 clear signs, >100 Pb encephalopathy Children >10 risk for developmental abnormalities EDTA provocation test estimates body burden indicates need for chelation therapy Treatment: initially-supportive, prevent further exposures diazepam for seizures, maintain electrolyte balance, mannitol and dexmsthazone for cerebral edema Chelation therapy: CaNa2EDTA (Im or IV), dimercaprol (IM), D-penicillamine(oral), succimer (oral)

Answer 14

Metallic taste, nausea, abdominal pain, milky vomit, shock syndrome, parathesia, pain, muscle weakness, anemia, hemoglobinurea, oliguria kidney damage, death, placental transfers

Answer 15

CNS more in children, GI more in adults GI: lead colic anorexia, muscle discomfort, malaise, headache, constipation, metallic taste, severe abdominal pain Neuromuscular syndrome: lead palsy muscle weakness, fatigue CNS syndrome: lead encephalopathy ataxia, vertigo, headache insomnia, restlessness, irritability, excitement and confusion, projectile vomiting, visual disturbances, delirium, tonic convulsions, lethargy, coma Progressive mental retardation in children with BLL >60 Hematological: anemia, inhibition of synthesis of heme, d-ALA in plasma Renal:proteinuria, hematuria, urine casts, Hyperurecemia with gout Ashen face, retinal stippling, poor muscle tone and posture, gingival lead line, interference with vit d, hypertension, decreased sperm Count Death is rare

Answer 16

From tetra ethyl in gasoline Highly lipid soluble Readily absorbed from skin, lungs, GI tract and crosses BBB Mainly CNS signs

Answer 17

Sources: FeSO4 tablets Iron overload-idiopathic hemochromatosis excess dietary fe Frequent blood transfusions Effects: vomiting, GI ulceration, shock, metabolic acidosis, liver injury, coagulation effects, renal failure Mechanism: lipid peroxidation leading to organellar damage Antidote: deferoxamine chelator, ascorbate (increased fe excretion)

Answer 18

Incomplete combustion of organic fuels Competes with O2 for binding to heme 210x more affinity than O2 less than 1% in inspired air needed 20%COHb=headache 20-30=irritability, emotional, impaired judgment, defective memory, fatigue 30-40=weakness, vomiting, dizziness, dim vision, confusion, ataxia 40-50=loss of sphincter tone! severe ataxia collapse with exertion 50-60= coma, convulsion, tachycardia, weak pulse, reddish skin >60=death Diagnosis: cherry red blood Delayed neurological disorder: poor concentration, memory loss, cognitive impairment-1 month post exposure Treatment:O2 Sensitive populations: fetus and coronary artery disease

Answer 19

Cause type IV hypersensitivity Catechols found In poison ivy 3-n-pentadecandienyl Catechol most prominent 70% people exposed are sensitized to it

Answer 20

Type IV hypersensitivity | Due to chemical additives

Answer 21

Causes type I hypersensitivity Occupational exposure by inhalation in chemical factories resulting in asthmatic reactions Symptoms persist along time after cessation of exposure

Answer 22

Causes type I hypersensitivity | Attack of the killer bees

Answer 23

Cause anaphylactoid reactions Sprayed on restaurant salads, and wine Sensitive individuals deficient in sulfite oxidase which metabolizes organic sulfate Cause bronchospasm leading to asthma Enzyme deficiency and not an immune response

Answer 24

.7-8% of patients treated Anaphylaxis in.01% fatality rate 9% Forms immunogenic hapten carrier complexes by binding directly to macromolecules in plasma and on cell surfaces