Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

HDT 3.1 > Toxicology > Flashcards

Toxicology Flashcards

1
Q

what resources can be used for toxicology information?

A

TOXBASE and national poisons information services (NPIS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the types of poisoning?

A
  1. acute - rapid intake of poisoning agent
  2. chronic - mainly due to prolonged exposure
    e.g. industrial/ manufactoring/ occupational related
  3. accidental
    e.g. children accidentally ingesting
  4. intentional overdosing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is the main cause of overdosing?

A

paracetamol overdosing
ibuprofen overdosing
sertraline overdosing
even caffeine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are the clinical features of poisoned patients also known as?

A

toxidomes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are the clinical features of poisoned patients?

A
  1. opioid
  2. serotonergic
  3. anticholinergic
  4. cholinergic
  5. sympathomimetic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are the clinical features of opioid poisoning?

A

pinpoint pupils
reduced GCS (Glasgow coma scale)
reduced respiratory rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are the clinical features of serotonergic poisoning?

A

agitation
delirium
tremor
tachycardia
labile BP
sweating
hypertonia
brisk reflexes
clonus
fever
serotonin symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the clinical features of anticholinergic poisoning?

A

Dilated pupils
Warm, dry skin
Confusion, restlessness, hallucinations – Brisk reflexes, myoclonic jerks
Tachycardia
Urine retention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are the clinical features of cholinergic poisoning?

A

pin point pupils
Bradycardia
Sweating
Excessive secretions
-Hypersalivation
-Lacrimation
-Rhinorrhoea
-Bronchorrhoea
-Diarrhoea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are the clinical features of sympathomimetic poisoning?

A

Hypertension, tachycardia
dilated pupils
Sweating
Agitation, paranoia, psychosis
Hyperreflexia
Stereotypy
Hyperpyrexia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is Glasgow coma scale (GCS)?

A

consciousness scale
15 max score = conscious pt
3 = deep coma/brain dead

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what drug examples of serotonergic poisoning?

A

Ecstasy
antipressants
SSRI’s
e.g. sertraline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what drug examples of anticholinergic poisoning?

A

poisons berries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what drug examples of cholinergic poisoning?

A

organophosphates - industrial exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what drug examples of sympathomimetic poisoning?

A

amphetamines
ecstasy (impure)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how to assess poisoning clinically?

A

Routine blood tests
* ABG
–COHb
–MetHb
* Anion gap + osmolal gap
* Analytical toxicology
–Emergency measurement
* Salicylate, iron, theophylline, methanol, ethylene glycol,
lithium, phenytoin, carbamazepine

–Screening for overdose of…
* Paracetamol
* Drugs of abuse

17
Q

what causes an increased anion gap?

A

– Ketoacidosis
– Lactic acidosis
– Salicylate overdose
– Alcohols: ethanol, methanol, ethylene glycol
– Renal failure
– Rhabdomyolysis

18
Q

what is an anion gap

A
19
Q

what is an osmolal gap

A
20
Q

what is the general management for poisoning?

A

Supportive care of symptoms
Prevention of absorption
Enhancement of elimination
Specific antidotes - less common

20
Q

what causes an increased osmolal gap?

A

– Ethanol
– Methanol
– Ethylene glycol
– Acetone
– Isopropanol

21
Q

how to prevent absorption

A
  1. emetics - not recommended
  2. gastic lavage - rarely used
  3. activated charcoal to mop the drug up
  4. whole bowel irrigation if they carry body packers
22
Q

how to enhance elimination

A

Multiple dose activated charcoal x3/4 a day
– Carbamazepine, colchicine, quinine, theophylline, phenobarbital * Urine alkalinisation
– Aspirin
* Extracorporeal
– Haemofiltration
– Haemodialysis

23
Q

what antidotes must be given within an hour

A
24
Q

what are the type of mechanism for antidotes?

A
  1. form an inert complex with poison
  2. accelerate detoxification of poison
  3. reduce rate of conversion to a more toxic compound
  4. compete with toxic substances for essential receptor sites
  5. block essential receptor through which they exert their toxic effects to
  6. bypass the effect of the poison
25
Q

when is intralipids given?

A

reversal of local anaesthetics overdose during surgery

26
Q

how does intralipids reverse anaesthetic overdose?

A

acts as a lipid sink
drugs distribute to the lipid phase

27
Q

what is ethylene glycol?

A

antifreeze
metabolised in the liver by alcohol dehydrogenase = toxic metabolites formed
cause death to kidneys and liver due to metabolic acidosis and inhibition of OXPHOS and protein synthesis

28
Q

what is the treatment of ethylene glycol poisoning?

A
  • Ethanol
    –ADH has greater affinity for ethanol
    –Decreases formation of toxic metabolites
    – Serum concentration >100mg/dl should be achieved
  • Fomepizole (4-methylpyrazole)
    –Potent inhibitor of ADH
    –Easier to administer, predictable pharmacokinetics
    –Expensive and not readily available
  • Haemodialysis
    –Definitive treatment to remove parent compound and its metabolites
29
Q

why is ethanol toxic?

A

Causes retinal and optic nerve toxicity and blindness

30
Q

what drug can prevent ethanol/ADH causing retinal toxicity/blindness?

A

fomepizole

31
Q

what are sources of cyanide poisoning?

A

Cyanide in fire smoke
– Natural substances
* Wool
* Silk
* Cotton

– Synthetic
* Plastics
* Nylon
* Polyurethranefoam

32
Q

what are cyanide antidotes?

A

Oxygen
Methaemoglobin inducers (sodium nitrite)
Dicobalt edetate
Hydroxocobalamin (Cyanokit)

33
Q

what are sources of lead poisoning?

A

Occupational
* Inhalation of lead dust or fumes in lead-using industries (lead- acid battery manufacturing and recycling; mining, smelting and refining of lead and other ores)
* During demolition/renovation of old properties.

Non-occupational
* House renovation, lead paint, imported toys or cookware, pica, old lead pipes, contaminated traditional remedies or cosmetics.

34
Q

what are symptoms of lead poisoning?

A

abdominal pains, headache, raised BP,
lethargy, poor concentration, memory difficulties, constipation
(may be severe), anaemia.
* Peripheral neuropathy uncommon.
* Encephalopathy only occurs with very severe poisoning and is
more common in children than adults.
* Renal effects include reversible proximal tubular dysfunction
and, in more severe cases, irreversible interstitial fibrosis and progressive renal insufficiency.

35
Q

what are lead antidotes?

A

Oral DMSA (succimer)
IV sodium calcium edetate

HDT 3.1 (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions