Toxicology

Question 1

What does paracetemol do to hepatocytes?

Answer 1

depletes antioxidant stores in hepatocytes

Question 2

paracetmol poisoninig blood signs/

Answer 2

elevated liver enxymes;

AST, ALT, Bilirubin.

elevated prothrombin (impaired liver synthesis of liver clotting factors)

Impaired kidney functions (elevated urea and creatinine)

Metabolic acidosis due to liver failure.

Question 3

When to measure paracetemol levels?

Answer 3

After 4 hours, or it is not a true representative of the levels.

Question 4

What is need to acquiretly know how much N-acetylcysteine to give?

Answer 4

The time they took the dose.

Question 5

Lethal quantity of paracetemol?

Answer 5

>12g

Question 6

Patients at high risk of paracetmol overdose?

Answer 6

On hepatic enzyme-inducing drugs (eg phenytoin, rifampicin, carbamazepine)

Alcoholics

Malnutrition (including anorexia nervosa)

patients ith AIDS

Question 7

Salicyclic overdose causes?

Answer 7

acid-base balance disorder

Question 8

Acid base disorders cause?

Answer 8

The respiratory centre in the brain to be stimulate causing patients to hyperventilate and “blow off” carbon dioxide.

Question 9

TCA complications?

Answer 9

Cardiac toxicity

Seizures

Do and ECG.

QRS broadens, tall T wave in aVR lead.

Question 10

Drugs with low therapeutic ratio?

Answer 10

Digoxin

Theophylline

Lithium

Phenytoin

Antibiotics eg. gentamicin, vancomycin, tobramycin.

Question 11

Typical components of urine drugs screen?

Answer 11

Amphetamines, barbituates, benzos, methaone, cannabinoids, cocaine metabolites, LSD, opiates.