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Pharmacology > Toxicology > Flashcards

Toxicology Flashcards

1
Q

Aspirin MOA

A

uncoupling of oxidative phosphorylation –” icnreased Co2

icnreased heat production

ketone bodies

increased pyruvate and lactate

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2
Q

symptoms of aspirin

A

n/v, fever, tachypnea

fluid loss and dehydration
tinnitus
mixed resp alklaosis and increased anion gap metabolic acidosis

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3
Q

death from aspirin = ?

A

respiratory failure due to central respiratory paralysis

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4
Q

tx of aspirin

A

IV sodium bicarbonate = acidosis and at severe - hemodialysis

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5
Q

acetaminophen death?

A

fulminant liver failure – hepatic encephalopathy and death

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6
Q

tx of acetaminophen?

A

NAC and liver transplant with fulminant hepatic failure

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7
Q

list the amphetamines and other stimulants

end in E

A 
methamphetaminE
methylenedioxymethamphetaminE
cocainE
pseudoephedrinE
ephedrinE
phenylpropanolaminE
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8
Q

sxs of amphetamines and stimulants at usual doses

A

euphora
wakefulness
sense of power
sense of well being

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9
Q

sx of amphetamines and stimulants at higher doses

A

agitation

acute psychosis

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10
Q

o/d of amphetamines and stimulants = ?

A

tachyarrhtymias

seizures and muscular hyperactivity – hyperthermia and rhabdomyolsis

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11
Q

~~~pupils dilated with warm and sweaty skin

A

amphetamines and stimulants

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12
Q

treatment of amphetamines and other stimulants

A

symptomatic only. no specific antidote

  • ammonium chloride* acidification of urine
  • phentolamine or nitroprusside - HT
  • propanolol or esmolol - tachyarrhthymias
  • benzos - seizures
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13
Q

List drugs that have anticholinergic effects

A

anticholinergics
antihistamines
antidepressnats TCAs
antipsychotics

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14
Q

a/se of antihistamines

A

anticholinergic – seizures

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15
Q

a/se of TCAs

A

anticholinergic – CV toxicity

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16
Q

typical presentation of anticholinergic

A

red as a beet - skin flushed
hot as a hare - hyperthermia
dry as a bone - no sweating and dry mucous membranes
blind as a bat – blured vision, cyclopledia, pupillary dilation
mad as a hatter - condusion delirium, tachycardia

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17
Q

treatment of anticholinergics

A

pysostigmine

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18
Q

treatment of TCA overdose

A

so not give physostigmine bc will aggravate cardiotoxicity

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19
Q

most toxic beta blocker

A

propranolol bc at high doses it blocks Na channels

lipophilis and enters the CNS causing seizures and coma

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20
Q

sx of beta blocker

A

bradycardia
hypotension

seizures and cardiac conduction block bc lipophilic and blocks Na channels

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21
Q

tx of bb blocker

A

IV glucagon – increases cAMP

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22
Q

CCB overdose

A

Ca IV
glucagon
epinephrine
to icnreased BP at refractory hyptension

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23
Q

symptoms of TCA

A

antag at muscarnic - mad, hot, blind, dry
alpha blockers - vasodilation
quinidine like depressnat at heart - block na channels - slow conduction and depress contractility

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24
Q

treat TCA overdose

A

NE for hypotehsnion and sodium bicarbonate

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25
Q

MAOi symptoms

A

severe hypertension reactions when with tyramine foods or drugs like phenylpropnaolamine or ephedrine

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26
Q

treat MAOi

A

phentolamine or labetolol

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27
Q

what is serotonin syndrome

A

MAOI with a serotenergic agent –> overstimulation with 5HT1a and 5HT2 receptors

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28
Q

sxs of serotonin syndrome

A

hyperthermia
muscle rigidity
myoclonus
hyperreflexia

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29
Q

treatment of serotonin syndrome

A

cyproheptadine 5HT2 antag

benzos - rigidity, serizures, agitation

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30
Q

Neuroleptic malignant syndrome caused by

A

antipsychotics

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31
Q

sx of neuroleptic malignant syndrome

A 
muscle ridigity
hyperthermia
metabolic acidosis
confusion
FEVER
F: fever
E: encephalopathy
V: vitals unstable
E: elevated enzymes
R: rigidity of muscles
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32
Q

tx of neuroleptic malignant syndrome

A

bromocriptine and dantroline

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33
Q

O/d sxs of opioids

A

letaryg
small pupils
bp and pulse decrease

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34
Q

higher dose o/d opioids

A

coma
respiratory depression
apnea

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35
Q

treatment of opioids

A

maintain vitals
naloxone
nalmefene

36
Q

what is the most common side effect of sulfonylureas and meglitinides?

A

hypoglycemia

37
Q

how to treat sulfonylureans and meflinitides

A

glucose bolus
IV octretoide - antagonizes insulin release

OR

diazoxide - antagonize insulin release

38
Q

CO + Hb

A

carboxyhemoglobin

LEFT SHIFT

39
Q

sx of Co poisoning

A

headache and tightness in temporal region

death - respiratory paralysis

40
Q

tx of CO

A

100& O2 hyperbaric

41
Q

Ethanol sxs

A

disinhibition, lethary, ataxia, impaired judgement, stupor, coma, death

42
Q

ethanol signs

A

hypoglycemia
hypothermia
increased anion gap metabolic acidosis

43
Q

tx ethanol

A

prevent aspiration
thiamine
IV dextrose
correct electrolytes

44
Q

Methanol is found where?

A

paint solvent
photocopying fluid
windshield washing fluid

45
Q

what is methanol metabolized to?

A

formaldehyde

46
Q

consequences of methanol

A

acidosis
retinal damange
blindness
death - sudden cessation of respiration

47
Q

tx of methanol

A

ethanol @ oh dehydrogenase
fomepizole - inhibits alcohol dehydrogenase
bicard
hemodialysis

48
Q

Ethylene glycol source

A

antifreeze

49
Q

ethylene is metabolized to?

A

aldehydes adn oxalate

50
Q

consequences of ethylene

A

severe acidosis

renal dmage

51
Q

treatment of ethylene

A

ethanol

fomepizole

52
Q

a high osmolar gap suggests poisoning with?

A

methanol

ethylene glycol

53
Q

toxicity from cholinesterase inhibitors found @ whom?

A

suicidal
work exposure
terrorist attack

54
Q

sxs of muscarinic overactivation like organophosphates

A 
DUMBELS:
D - diarrhoea
U - urination
M - miosis
B - brady cardia an dbronchoconstriction
E - emesis
L - lacrimation
S - salivation and sweating
55
Q

signs of nicotinic overactivation @ organophosphates

A

hypertension, tachy or brady

muscle twicth and fasiculations

most common cause of death is resp paralysis

56
Q

treatment of organophosphates

A

atropine and pralidoxime

57
Q

treatment of carbamate insecticides

A

atropine only bc short lived and spontaneously reversible no pralidoxime

58
Q

sources of cyanide

A

plastic, jewelry, wool, silk, cassave and apricot seed

59
Q

cause of death @ cyanide

A

respiratory arrest

60
Q

MOA cyanide

A

high affinity for Fe3+ – binds heme of cytochrome a, a3 = O2 cant act as final acceptor in the ETC – CYTOTOXIC HYPOXIA - lactic acidosis

61
Q

treatment of cyanide

A

provide a large pool of ferric iron to compete for cyanide

62
Q

compnent of cyanide antidote kit

A

amyl nitrite pearls
sodium nitrite
sodium thiosulfate

63
Q

how do the components of the cyanide antidote kit work?

A

nitrites oxidze Hb to methemoglobin (prilocaine) –> forms cyanmethemoglbin and cytochrome oxidase is restored

64
Q

how does thiosulfate help cyanide antidote style?

A

thiosulfate donates sulger that then makes cyanmethemoglobin thiocyante and methemoglobin by rhodanese –> pee out thicyanate

65
Q

what does methylene blue do?

A

restores methemoglobin to ferrous form

66
Q

how does hydroxocobalamin help wtih cyanide poisoning?

A

reacts with cyanide to yield cyanocobalamin (precursor of B12)

better because no metemoglobin

67
Q

source of lead

A

ammunition
lead miners
battery manufacturers
lead containing pain

68
Q

sx of acute lead poisoning

A

abdominal colic and CNS changtes

69
Q

sx of acute lead poisoning

A

plumbism
peripheral neuropathy - tremor, anaemia, anorexia, weight loss gi symptoms
normocytic/microcytic and hypochromic anaemai

delta ALA dehydratase and ferrochetlase
a

70
Q

treat lead poisoning

A

diazepam - seizures
mannitol and dexamethasone - cerebral oedema

chelation - EDTA , dimercaprol siccimer

71
Q

What are you treating? diazepam, manntiol, dexamethasoen, EDTA, dimercaprol, succimer

A

lead poisoning

72
Q

arsenic

A

contaminated wine or moonshine and water of fodo contamination - shell fish and other seafood

73
Q

i say diarhhoea ricewater stools and sweet garlicky breath

A

acute inorganic arsenic poisoning

74
Q

sx or arsine gas

A

massive hemolysis

75
Q

sxs of chronic organic arsenic poisonings

A

skin changes
cancer
RAINDROP

76
Q

MOA arsenic

A

trivalent react wtih SH
uncouple oxidative phosphoylation
hemolysis by depleting glutathione in the rbc

77
Q

tx of arsenic

A

unithiol

dimercaprol

78
Q

MOA mercury

A

SH groups

79
Q

source of mercury

A

battery
thermometer
barometer
fish

80
Q

symptoms of mercuric chloride

A

corrosive - hemorrhagic gastroenteritis

81
Q

symptoms of chronic meurcry poisoning

A

classic triad

1) tremor
2) neuropsychiatric disturbances
3) gingivostomatis

82
Q

mercury poisoning in children

A

acrodynia

painful erythemia
mil

83
Q

treatment of mercury

A

unithiol and succimer

DO NOT USE DIMERCAPROL

84
Q

iron symptoms

A 
vomiting
gi bleeding
lethardy
GRAY CYANOSIS
gi necrosis
85
Q

treatment of iron

A

deferoxamine

Pharmacology (70 decks)

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