Toxicology

Question 1

Toxins that can cause hepatic failure.

Answer 1

Xylitol, amanita mushrooms, acetaminophen

Question 2

Toxin(s) that can cause Heinz-body anemia.

Answer 2

Onions, garlic, Tylenol

Question 3

In chocolate toxicity, what ingredients are the main concern and why?

Answer 3

Caffeine and theobromine. These are stimulants, which cause restlessness, agitation, tachycardia, diarrhea, and diuresis.

Question 4

What is the primary treatment for cardiac medication toxicosis?

Answer 4

Emesis (if warranted), activated charcoal, IVF therapy.

Question 5

What would be an alternative treatment for severe calcium channel blocker toxicosis?

Answer 5

Insulin therapy or lipids.

Question 6

Are SSRIs and SNRIs treated the same as far as decontamination?

Answer 6

Yes. They result in similar clinical signs so are treated the same.

Question 7

Name at least 4 clinical signs of serotonin syndrome related to SSRI and SNRI overdose?

Answer 7

Drooling, vomiting, abdominal pain, diarrhea, CNS stimulation, seizures, mydriasis, tremors.

Question 8

What are the primary treatments for SSRI and SNRI toxicosis?

Answer 8

Emesis (if warranted), sedation with acepromazine or chlorpromazine, BP and ECG monitoring, muscle relaxants, anticonvulsants, and serotonin antagonists.

Question 9

Name the primary serotonin antagonist used for SSRI and SNRI toxicosis.

Answer 9

Cyproheptadine

Question 10

Name common SSRIs and SNRIs.

Answer 10

Fluoxetine, Citalopram, paroxetine, sertraline, duloxetine, nefazodone, venafaxine.

Question 11

What is the mechanism of action of amphetamines?

Answer 11

They act as a sympathomimetic, meaning they stimulate the sympathetic system.

Question 12

Stimulation of the sympathetic system results in what clinical signs and symptoms?

Answer 12

Similar to those of SSRIs and SNRIs you see serotonin syndrome, vomiting, diarrhea, agitation, mydriasis, tremors, seizures, tachycardia, hypertension, panting.

Question 13

What is the primary treatment for amphetamine toxicosis?

Answer 13

Similar to SSRI and SNRI. Ace, chlorpromazine, muscle relaxants, anticonvulsants, etc.

Question 14

What is the mechanism of action of NSAIDS?

Answer 14

Competitive inhibition of prostaglandin synthesis by way of cyclooxygenase.

Question 15

What animals/breeds are more sensitive to NSAIDS?

Answer 15

Cats and German Shepherds.

Question 16

What are some clinical signs of NSAID toxicosis?

Answer 16

anorexia, vomiting, hematemesis, melena, lethargy, abdominal pain.

Question 17

Which organ is most affected by Tylenol toxicity and why?

Answer 17

The liver. Tylenol toxicosis results in oxidative injury to the liver secondary to the buildup of toxic metabolites.

Question 18

What is the difference between toxicosis and toxicity?

Answer 18

Toxicosis refers to the pathological condition caused by a toxin. Toxicity is the quality of being poisonous.

Question 19

What pathologies and clinical signs are more likely to occur in cats secondary to Tylenol toxicity?

Answer 19

Methemoglobinemia, swelling of the face or paws, respiratory distress, cyanosis, vomiting, and lethargy.

Question 20

What pathology and clinical signs are more likely to occur in dogs secondary to Tylenol toxicity?

Answer 20

Hepatic injury, hepatic encephalopathy, vomiting, melena, icterus, and dry eye.

Question 21

What is the primary treatment for Tylenol toxicosis?

Answer 21

Emesis, activated charcoal, anti-nausea/anti-emetics, antioxidant administration, liver protectants.

Question 22

What is the antidote to the toxic metabolite NAPQI and its purpose?

Answer 22

N-acetylcysteine. It’s acts as a glutathione substrate and limits the formation of NAPQI by conjugating it with glutathione.

Question 23

Define the acronym NAPQI.

Answer 23

N-acetyl-para-benzoquinone imine.

Question 24

Why are cats more susceptible to Tylenol toxicosis at lower doses than dogs?

Answer 24

They have altered glucuronidation pathway, which results in a decreased ability to metabolize Tylenol.

Question 25

What specific type of anemia can Tylenol toxicity cause?

Answer 25

Heinz body anemia

Question 26

What other toxin aside from Tylenol are cats more susceptible to due to their liver metabolism?

Answer 26

Pyrethrin