Toxicology 3 (Aromatic Hydrocarbons, Methanol, Acid And Base Intoxication)

Question 1

Phenols are acid or bases? Routes of intoxication? Effects at that those entry points and systemic effects?

Answer 1

Phenols are acids that enter transdermally or orally.
Topically
-local anesthetic effect with serious necrosis without pain leading to absorption and systemic effects
Orally
-Necrosis on the mucosa
Systemic effect (mainly on the CNS)
-stimulation and depression
-seizures
-coma
-respiratory inhibition (to the point of stopping)

Question 2

Phenols elimination and therapy

Answer 2

Elimination is vis lung and kidney (no metabolism) which can lead to toxic nephritis
Therapy is gastric lovage and purgation with cooking oil (to reduce the absorption)
*Alcohol promotes the absorption!!!!

Question 3

Nitrobenzol (C6H5NO2) absorption

Answer 3

Nitrobenzol is absorbed acutely and chronically
Acute
-through intestinal wall, skin, and lung
Chronic
-through lung

Question 4

Nitrobenzol symptoms (acute and chronic)

Answer 4

Acute
-Irritation of mucosa (vomiting, spasm)
-depression of CNS (dizziness, excitement, seizures, coma, respiratory stop)
Chronic
-anemia, hemolytic icterus, CNS disturbance

Question 5

Nitrobenzol therapy

Answer 5

Reduction of methaemoglobinemia

Milk, oil (alcohol enhances the absorption!!!)

Question 6

Aniline (C6H5NH2) i.e. pesticides absorption and symptoms

Answer 6

Absorption same as nitrobenzol
Symptoms (acute and chronic)
Acute
-Same as nitrobenzol (except first euphoria and not dysphoria)
Chronic
-Hypochomic anemia (prehabs cyanosis)
-CNS disturbances
-General cachexia
-Urinary bladder papilloma or cancer??? (Provoked by Benzedrine, naphtylamine, aminophenydile)

Question 7

Dinitrophenol (DNP) and Dinitroortocresol (DNOC) are found in?

Answer 7

Dinitrophenol (DNP) is in pesticide and in the chemical industry
Dinitroortocresol (DNOC) in herbicides

Question 8

Dinitrophenol (DNP) and Dinitroortocresol (DNOC) routes of poisoning

Answer 8

Inhalation
Absorption through the skin
Absorption from the gut

Question 9

Dinitrophenol (DNP) and Dinitroortocresol (DNOC) MOA

Answer 9

Discoupling of oxidation and phosphorylation leads to no formation of phosphates of high energy. This causes increased oxidation (no inhibition of respiration). Leading to increased basal metabolic rate. Increased energy converts to heat.

Question 10

Dinitrophenol (DNP) and Dinitroortocresol (DNOC) symptoms and therapy

Answer 10

Dinitrophenol (DNP) and Dinitroortocresol (DNOC)
Symptoms
Acute
-hyperprexia, dehydration, blood pressure drop, heart rate increased, dyspnea, cyanosis, anoxia, and lung edema
Chronic
-Loss of weight, fever
-Impairment of kidney, liver, heart, bone, marrow function
-hemolytic anemic

Treatment (acute)
-cold bath for hyperprexia, O2 inhalation for dyspnea and cyanosis, 0.9% NaCl infusion

Question 11

Methanol forms what

Answer 11

Methanol is converted by alcohol dehydrogenase to formaldehyde. Formaldehyde is converted by aldehyde dehydrogenase to Formic acid

Question 12

Methanol symptoms and therapy

Answer 12

Asymptomatic latency period
-If ingested with ethanol, symptoms of ethanol intoxication
Symptoms 8-30 hours later
-metabolic acidosis leading to respiratory failure
-abdominal pain (pancreatic damage)
-blindness- destructive inflammation leading to atrophy

Therapy

• Ethanol (10g/hr)
• fomepizole
• hemodialysis

Question 13

Acid Intoxication depends on what and the routes of intoxication

Answer 13

Acid intoxication depends first on all on the H+ concentration
Routes of intoxication
-Oral, through the skin, eye, inhalation

Question 14

Acid intoxication symptoms

Answer 14

Coagulation necrosis on the skin, on the mucosa
Spasm of glottis, glottis edema
Coagulation is the esophagus and stomach leading to severe pain and shock
Reoccurring emesis leading to aspiration and thus glottis spasm
Perforation in the stomach causes shock and peritonitis
Symptoms of acidosis
-collapse, coma, respiratory disturbances
Kidney damage leading to anuria
Formation of scabs cause secondary bleeding and later stenosis in the esophagus

Question 15

Therapy of acid intoxication

Answer 15

No induction of emesis (no gastric lavage!!!)
Dilution of acid in the stomach (milk, egg, no neutralization!!!)
Oral local anesthetic
Morphine, atropine, glucocorticoids
Drop infusion of 5% NaHCO3 or Na lactate (don’t give orally)
Antimicrobial therapy

Question 16

Oxalic acid- K, Na oxalate absorbed and causes? Therapy?

Answer 16

Oxalic acid binds Ca2+ in the blood causing tetany and cardiac depression
Calcium oxalate is excreted through the kidney leading to poor hydrophility causing precipitation and finally oliguria and anuria

Therapy

• CaCl2, p.o.
• CaCl2, Ca gluconate i.v.
• Forced dieresis with excessive fluid infusion

Question 17

Base intoxication symptoms and therapy

Answer 17

As with acids but colliquational necrosis
Alkalosis leads to reduction of Ca2+ and tetany

Therapy
The same as with acids, except alkalization
Administration of Ca2+