toxicology 1 Flashcards
treatment of life threating complication
coma - ABCD - management- airway, breathing, circulation, Drugs (dextrose, thiamine, Naloxone, flumazenil)
hypothermia- rewarming
hypotension- slaine, isotonic crystalloid
hypertension- phentolamine, nitroprusside sodium, lorazepam
convulsions
hyperthermia
dantrolene
malignant hyperthermia
gastric lavage position
Trendelenburg, left lateral decubitus
oxalic acid
skin, gut mucosa damage
shock
electrolyte imbalance - hypocalcemia
tubular necrosis
fatal dose- 15-20g
fulminant- burning pain, sour/bitter taste, constriction of throat, coffee colored vomiting
acute- hypocalcemia symptoms, DILATED PUPIL, irritable nerves
delayed - nephritis
tx - ca lactate lavage, limewater, ca gluconate/ Cl, tx hypocalcemia, purgatives
pm- burns, mucosa corroded bleached, soft velvet red stomach, swollen kidneys
MLA- a, h, s, abortifacient
carbolic acid
pink, liquifies
fat soluble- attack nerve, respi paralysis, cvs centre
fatal - 1-2 g,3-4 hours
necrosis, gangrene, eschar,
burning tingling gut
phenolic breath
muscle spasm, convulsions
PUPILS CONTRACT, heqdache, tinnitus
carboluria- green urine (hydroquinone and pyrocatechol- oxidation)
pigmentation in cornea, cartilage (ochronosis)
CARBOL MARASMUS- anorexia, wt loss, increased saliva, headache, vertigo,dark urine, ochronosis
tx - lavage charcoal, paraffin, demulscent, saline diuresis
pm- corrosions, larynx, pulmonary edema
swollen brown silvery stomach mucosa, leathery stomach, hemorrhagic nephritis
mla- sometimes abortion
caustic alkali
ammonia, k oh,naoh, co3 of these
cell dehydration, liquifactive necrosis, saponification, edema
caustic taste, burning, alkaline strained painful vomiting,, mucus bloody feces, blistered skin/lips, gray slough soft swollen stomach mucosa, ESOPHAGEAL STRUCTURE
ammonical vapour
congestion, watery eyes, sneeze, cough, choking, suffocation
caustic alkali fatal doses
koh, naoh - 5g
Ammonia - 30gna, k carbonate - 15-30g
time- 24 hours
universal antidote
2 charcoal (adsorbs): 1 MgO (neutralise): 1 tannic acid (ppt)
pm findings in case of caustic poison
ammonical odour parchment like around mouth marks edema, slimy of tissues (esp squamous esophagus cells) alkali hematin - brown mucosa inflamed kidney
inorganic metallic irritant arsenic
oxides, cu arsenite, cu acetoarsenite, Na, K, trisulfide yellow opriment, red disulfide, arsine gas (garlic odour)
carcinogenic, uncouple oxidative phosphorylation (bind SH), increase fatty acid, decrease glucose
absorbed oral/parenteral - wide distribution HAIR, NAILS MUSCLES - stomach and urine excretion
200mg fatal 1-2 days (arsenophagist tolerate upto 300mg)
acute - n, v, pain, diarrhea
fulminant- >3mg shock, pv failure
narcotic- ms tenderness, delirium coma death
gas - hemolysis, liver, kidney failure, cns depression
lab d - urine 50 microg/l (methylarsonate/ dimethyl arsenic acid), setum 0.9, nails 100%, radioopaque shadow, ecg abnormal
tx - hemodynamic stabilisation, lavage warm water/milk, demulscent, peg,bal iv, succimer, purgatives, saline, hemodialysis
pm findings - dehydration, rigor mortis early, putrefaction late, arsenic in body, bloody vomitus, cyanosed skin, sunken eyeballs, mucousa upto esophagus inflammed, organs congested, edema, echymoses (lungs), petechiae heart, red velvet mucousa with arsenic in sticky mucus, congested rugae, pale violet hemorrhagic small intestine, cloudy swollen organs, nephritis, edema, encephalitis
arsenicosis
metallic taste, salivation, sweat, garlic odour
melanosis, leucomelanosis, RAIN DROP PIGMENTATION, (git : like acute), congested watery photophobic eyes, neuritis neuropathies (b12 given) painful swellings, cvs failure htn, red green urine, liver cirrhosis, bone marrow suppression, diabetes, pv insufficiency, dry gangrene, vaso spasm
tx - bal, symptomatic
pm - emaciation, pigmentation, alopecia, keratosis, gut mucosa- inflammed (atomach), thickened red (small intestine), tubular necrosis
imbibation of As
As
abortion, CATTLE poison
