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SS - Exam 1 > Toxicology 2 > Flashcards

Toxicology 2 Flashcards

1
Q

Bacterial neurotoxins

A

Tetanus (C. Tetani)
Botulism (C. Botulinum)

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2
Q

Mechanism of botulism

A

Toxin decreases acetylcholine release
Causes muscle paralysis & weakness
Differentials include other agents causing muscle weakness
Difficult to confirm diagnosis

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3
Q

Mechanism of tetanus

A

Decreases GABA causing muscle stiffness
Differential is strychnine
Treat with GABA agonist, time
Prevent with tetanus toxoid

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4
Q

Toxic mushrooms

A

Misc. GI
Hydrazines
Isoxazoles
Muscadine
Psilocybin
Amatoxins

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5
Q

Hydrazines

A

Decreased GABA lead to CNS stimulation, not a common problem.

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6
Q

Isoxazoles

A

Ibotenic acid & muscimol in Amanita muscaria causes CNS effect that mimic tremorgans. Almost as common as GI mushroom problems

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7
Q

Muscarine

A

Stimulate muscarinic parasymapthomimetic receptors; does not inhibit AChE

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8
Q

Psilocybe

A

Cause hallucinations & possible seizures but no coma; relatively rare toxicosis

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9
Q

Source of amintoxins

A

Death angel - 95% of mushroom fatalities
Grow under oak, birch, pine trees “fishy odor”

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10
Q

Toxicity of amatoxins

A

Cyclopeptide toxins - amatoxins
Rapidly absorbed, bioavailability greater in dogs
1-2 mushrooms will kill a dog
Enterohepatic recirculating - mostly excreted in urine
Not destroyed by heat, freezing or stomach acidity

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11
Q

Mechanism of action of amatoxins

A

Inhibits protein synthesis - cell death, especially hepatocytes

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12
Q

Clinical signs of amatoxins

A

GI signs delayed 6-24 hours, appear
Anorexia, vomiting, diarrhea, colic
Hepatic signs around 36-48 hours
Renal failure - multi-organ failure

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13
Q

Diagnosis and treatment of amatoxins

A

Liver lesions: massive hepatic & acute renal necrosis
Amatoxin detection in urine, serum, liver, kidney or GIT
- seen in urine & serum before clinical signs appear

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14
Q

GI signs for mushroom toxicosis

A

Chlorophyllum molybdities
- lawns & grow fairy rings, large caps

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15
Q

Clinical signs for gi mushrooms

A

Similar to gastroenteritis
Vomiting, diarrhea, abdominal pain
Good prognosis

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16
Q

Chlorophyllum molybdites

A

Produce fairy rings
Green spores mature specimens, late summer, early fall
Most common cause of mushroom poisoning in NA

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17
Q

Source of toxin for hydrazines

A

Gyomitra sp (false morel)
Under conifers & aspen in spring
Due to gyomitrin

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18
Q

Mechanism of hydrazines

A

Direct GI irritant
Gyomitrin hydrolized in GI tract - monomethylhydrazine (MMH) - decreased active form of Vit b6 - decreased GABA synesthesia and increased glutamic acid = increased CNS activity /seizures
Can cause oxidative damage to RBC, liver & kidney

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19
Q

Clinical signs of hydrazines

A

GI, CNS, hematopoietic, hepatic, renal
<3 onset, 1-2 days
Vomiting, depression/lethargy
Clonic-tonic seizures, coma
Methemoglobinemia, icterus

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20
Q

Diagnosing and treating hydrazines

A

ID of mushroom, increased AST/ALT, methemoglobin, hemolysis
Diazepam
Pyridozine (Vit B6)

21
Q

Source of toxin for isoxazoles

A

Amanita muscaria
Large & colorful
Coniferous & deciduous forests - oak, pine, hemlock

22
Q

Toxicity of isoxazoles

A

Thermostable toxin - not destroyed by boiling or drying
Ibotenic acid, muscazone, muscarine, muscimol
Ibotenic acid is present at highest levels
Passed in urin highest levels in cap

23
Q

Mechanism of action for isoxazoles

A

Ibotenic acid mimincs glutamate (excitatory neurotransmitter)
Muscimol as potent GABA agonist - CNS depressant at high doses, glutamate & GABA easily exchanged

24
Q

Clinical signs for isoxazoles

A

Onset <3 hrs, course of 1-2 days
Salivation, vomiting, diarrhea, depression/lethargy, disorientation, vestibular signs, respiratory depression, somnolence, miosis, abnormal behavior, bradycardia, muscle tremors, seizures, coma

25
Diagnosing / treating isoxazoles
History of consumption, delirium, coma Decontamination - act quickly due to short latent period Emesis, GI lavage, activated charcoal Symptomatic for seizure control, respiratory support
26
muscarine
Inocybe pudica Clitocybe dealbata
27
Clinical signs for muscarine
SLUDDE Salivation, lacrimation, urination, defecation, dyspnea, Emesis + Bradycardia, miosis, abdominal pain
28
Diagnosis and treatment for muscarine
Muscarine detection in urine, response to atropine Decontamination, activated charcoal, atropine dose of 0.04mg/kg Prognosis is rarely fatal
29
Source of toxin for muscarine
Inocybe lacera & I. Pudica - fishy order Clitocybe dealbata & c. Truncicola- found in forests, lawns
30
Toxicity of muscarine
Muscarine (0.1-0.3%) Rabidly absorbed, doesnt cross BBB
31
Mechanism of action for muscarine
Acetylcholine agonist - competes at parasympathetic muscarinic receptors SLUDDE signs and decreased HR Not inactivated by acetylcholinesterase No nicotinic or CNS effects
32
Source of psilocybin
Magic mushrooms, hallucinogenic mushrooms, straw mush Commonly found in fields/cow pastures esp in north east
33
Toxicity of psilocybin
Primarily toxin psilocybin metabolized via esterases to psilocin Primarily dog & cat Toxic dose for dogs
34
Mechanism of action of psilocybin
Psilocin of similar in structure to serotonin Lysergic acid diethylamine (LSD like properties)
35
Clinical signs for psilocybin
Onset <1 hr, 12-24 hours Ataxia, vocalization, anxiety, abnormal behavior, vomiting, nystagmus, mydriasis, muscle tremors, hyperthermia, tachycardia, seizures
36
diagnosis and treatment for psilocybin
History of consumption w accompanying signs Analysis of urine, serum, GI contents Symptomatic, diazepam, short acting & resolve
37
Blue green algae
Hepatotoxins Neurotoxins
38
Cyanobacteria
Bioaccumulation Death caused by microcystins (liver) & anatoxins
39
Microcystin
Cyclic heptapeptide, crosses BBB Causes cytoskeletal disorganization No treatment, mortality rates are high, prognosis is poor
40
Clinical signs of mycrocystin
Acute hepatotoxicosis, vomiting, diarrhea, weak, shocky, death Nodularin - onset within 5 hrs Acutely lethargic, vomiting, diarrhea, inappetance, liver & kidney failure
41
Diagnosing microcystins
History Microcystin - increased ALT, AST, ALP; hyperbilirubinemia; hypoglycemia; abnormal coagulation & hyperammonemia Nodularin: BUN, creatinine, phosphorus
42
Anatoxins
Anatoxin A - potent nicotinic, cholinergic agonist leads to respiratory paralysis & death. Contributes to dopamine & noradrenaline release Homoanatoxin -A - potent nicotinic, cholinergic agonist Acetylcholinesterase inhibitor, does not cross BBB, opens L-type Ca2+ channels, release of acetylcholine in PNS
43
Neurotoxin in tick saliva
Decreases release of acetylcholine Differentials include botulism
44
Latrodectus spiders
Black widow spiders - every state from Alaska Both male/female bite, only female has long fangs
45
Toxicity of latrodectus spiders
Bite causes Ca2+ to release neurotransmitters (esp ACh) from synaptic vesicles Painful & can cause muscle spasms, LD50 - 0.43-1.39mg/kg Toxicity highest in autumn & lowest in spring
46
Venomous snakes in US
Elapids - coral snakes Pit vipers & crotalids - rattle, copperheads, water moccasins
47
Pit vipers
Aggressive, venom primarily proteolytic and anticoagulant
48
Clinical signs for pit vipers
FAST onset Bruising/swelling Hypotension, tachycardia, nausea, shock, anticoagulation no cold & no tourniquet Immobilize extremities

SS - Exam 1 (33 decks)

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