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Mike and Nate's > Toxicology (1305) > Flashcards

Toxicology (1305) Flashcards

1
Q

What kind of neurotransmitters do cholinergic neurons use?

A

AcH

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2
Q

What kind of neurotransmitters do adrenergic neurons use?

A

Epinephrine/norepinephrine

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3
Q

Where do SYMPATHETIC NEURONS originate from?

A

Thoracic and lumbar regions of spinal cord

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4
Q

What are preganglionic (myelinated) fibers classified as? Cholinergic or Adrenergic?

A

Cholinergic fibers. Preganglionic fibers for BOTH PNS AND SNS is ALWAYS AcH

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5
Q

Are preganglionic nerves in the SNS short or long?

A

Short

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6
Q

Are postganglionic nerves in the SNS short or long?

A

Long

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7
Q

What are postganglionic (non-myelinated) fibers classified as? Cholinergic or Adrenergic?

A

Postganglionic fibers for PNS ALSO release AcH; therefore cholinergic

Postganglionic fibers for SNS release norepi; therefore adrenergic
* WITH THE EXCEPTION OF SWEAT GLANDS AND ADRENAL CORTEX - they don’t have a postganglionic fiber attached to the preganglionic fiber

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8
Q

What does the SNS do to our bodies/organs?

A
  • Dilation of pupils
  • Inhibition of salivation
  • Relaxation of airways
  • Acceleration of heartbeat
  • Inhibition of digestion
  • Stimulates glucose release from liver
  • Inhibition of gallblader/intestine activity
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9
Q

Where do PARASYMPATHETIC NEURONS originate from?

A

Cranial nerves 3, 7, 9, 10 and sacral region S2 and S4

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10
Q

Are preganglionic nerves in the PNS short or long?

A

Long

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11
Q

Are postganglionic nerves in the PNS short or long?

A

Short

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12
Q

What does the PNS do to our bodies/organs?

A
  • Constriction of pupils
  • Stimulation of salivation
  • Constriction of airways
  • Slowing of heartbeat
  • Stimulation of digestion
  • Stimulation of glucose uptake
  • Stimulation of gallblader/intestine activity
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13
Q

What kind of receptors are on POSTGANGLIONIC NERVES in BOTH SNS and PNS?

A

Nicotinic receptors (receptors in skeletal muscle are also nicotinic)

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14
Q

What are nicotinic receptors also known as?

A

Ionotropic receptors (meaning they work as an ion channel)

i.e: if AcH binds to a nicotinic receptors, it opens up which allows passage of ions such as Na - eventually leads to an action potential

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15
Q

What are adrenergic receptors?

A

Receptors on EFFECTOR ORGANS receiving signals from SYMPATHETIC NEURONS

i.e: this will cause DILATION in the eyes (remember that postganglionic nerves in the SNS are ADRENERGIC since they release epi/norepi)

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16
Q

What are muscarinic receptors?

A

Receptors on EFFECTOR ORGANS receiving signals from PARASYMPATHETIC NEURONS

i.e: this will cause CONSTRICTION in the eyes (remember that postganglionic nerves in the PNS are CHOLINERGIC since they release AcH)

17
Q

Importance of QT interval and QTc?

A

QT interval correlates with HR since it measures ventricular depolarization and complete repolarization.

IF assessing QT, use the QTc (which is the corrected QT interval)

18
Q

What do organophosphates do?

A

Inhibit acetylcholinesterase (enzymes that break down AcH) causing a MASSIVE cholinergic response (too much AcH in your receptors, over-stimulated)

Tl;dr if you don’t have Alzheimer’s you’re getting fucked

19
Q

S&S of someone with organophosphate poisoning? (SLUDGE-M)

A

Salivation
Lacrimation
Urination
Diaphoresis
GI Upset
Emesis

Miosis

20
Q

What are anticholinergics?

A

Drugs that inhibit AcH by blocking nicotinic and muscarinic receptors

21
Q

Examples of anticholinergics?

A

TCAs
Antihistamines (Benadryl)
Gravol
Atropine
Jimson Weed

22
Q

TCA’s have a large therapeutic window. T or F?

A

False. Super narrow (10-20mg/kg is overdosed already)

23
Q

Patho behind TCA overdose?

A

Causes loss of vascular tone via blockage of alpha AND muscarinic receptors. Results in:

Tachycardia
Red (flushed), hot, dry skin
Blockage of Na channels (huge for cardiac cycle)
Mydriasis (blindness)

24
Q

Why is the blockage of Na channels important when to comes to TCA overdose?

A

Slows down action potential within cardiac muscles, causing QT prolongation

25
Q

Patho behind sympathomimetics?

A

Releases norepi from presynaptic terminal OR inhibiting reuptake of norepi

26
Q

Examples of sympathomimetics and their functions?

A

Cocaine - blocks reuptake of norepi, serotonin, and dopamine causing euphoria. Chronic intake depletes dopamine causing depression

Methamphetamine - Similar to cocaine, but also releases catecholamines into synaptic space

27
Q

Sympathomimetic Patient vs Anticholinergic Patient?

A

Sympathomimetic patients will have diaphoresis AND bowel sounds; this is because muscarinic receptors are NOT blocked when it comes to sympathomimetics

28
Q

What is Serotonin?

A

Neurotransmitter in CNS responsible for mood/behaviour and sleep

29
Q

What is Serotonin Syndrome?

A

Occurs when excess serotonin is available for the body to use (ex: taking too much of antidepressants)

30
Q

S&S of Serotonin Syndrome?

A

Hyperactivity, hyperventilation, agitation, combative, arrhythmias

31
Q

What is Delirium Tremens?

A

Happens if alcohol withdrawal is left untreated. Patients present with hallucinations, tachycardia, confusion, hypertension, hyperthermia, and diaphoresis

32
Q

Mortality rate of DT due to cardiovascular collapse?

A

5-15%

33
Q

How do you treat benzodiazepine overdose?

A

Maintain ABC’s as much as you can; aggressive interventions are rarely needed.

*Competitive agonist called flumazenil but has a high risk of seizures so not widely used

34
Q

What happens in acetaminophen overdose?

A

-Occurs intentionally or unintentionally
- Toxicity occurs at 7g within a day; rapidly absorbed in <2 hours and as quickly as 30 minutes
- Asymptomatic in first 18-24 hours, followed by RUQ pain and hypotension, followed by liver failure, renal failure, metabolic acidosis by 3rd day, death normally occurs on 3rd or 4th day
- Rapid transport to hospital; not much you can do pre-hospital

*Antidote for acetaminophen OD is Acetylcysteine

35
Q

What do beta blockers do?

A

Block epinephrine’s effect on beta receptors (if selective to B1) which decreases rate and strength of contraction; decreases CO

36
Q

What do calcium channel blockers do?

A

Relaxes smooth muscle causing vasodilation of coronary arteries and sodium channels

37
Q

What happens if you overdose on beta blockers and calcium channel blockers?

A

Will cause profound hypotension, bradyarrhythmias + cardiac arrest.

Mike and Nate's (7 decks)

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