Toxicology 4 (Aldehydes, Polyvalent Alcohols, Carbon Monoxide)

Question 1

What are the name of the aldehydes

Answer 1

Formaldehyde
Acetylaldehyde
Methaldehyde

Question 2

Formaldehyde (HCHO) symptoms and therapy

Answer 2

Symptoms
Protein precipitation (necrotic effect)
Symptoms similar to acid poisoning

Therapy
Gastric lavage
100 mL 2% ammonium carbonate and 20 grams carbamide leading to the formation of hexamethylene tetramine (less toxic)
Alkalization
Hemodialysis

Question 3

Acetylaldehyde (CH3CHO) symptoms

Answer 3

Local irritating effect

Central narcotic effect

Question 4

Methaldehyde (CH3CHO)4

Lethal dose for adults and children

Answer 4

Lethal dose
4 grams for adults
0.1-0.5 gram for children

Question 5

Symptoms of methaldehyde

Answer 5

GI reaction
-Local irritation
-hemorrhagic gastritis
Central effects
-increased muscle irritability
-muscle rigidity
-decreased blood pressure
-epileptiform convulsion
-stop of respiration

Therapy
-symptomatic

Question 6

Polyvalent alcohols are found in?

Answer 6

Polyvalent alcohols are used as solvents, lubricants, anti-freeze substance
They dissolve both hydro- and lipophylic substances

Question 7

Polyvalent alcohols are what substances and what do they cause

Answer 7

Diethylenglycol and ethylenglycol is transformed by alcohol dehydrogenase to glycol aldehyde to oxolic acid leading to tubular necrosis and anuria

Question 8

Other symptoms of polyvalent alcohols

Answer 8

Transient excitation than depression (at the beginning)
Changes of water and osmotic balance, metabolic acidosis (strong water suction effect)
Hepatic failure
In the case of inhalation irritation of the alveoli

Question 9

Polyvalent alcohols (Divalent glycols) therapy

Answer 9

No specific antidote
Early ethanol or fomepizole infusion to inhibit alcohol dehydrogenase
Gastric lavage with K permanganate
First (save the kidney) so have a glucose infusion (not amino acids)

Question 10

Trivalent glycol (glycerin) therapy

Answer 10

Not toxic

Question 11

Carbon monoxide intoxication pharmacodynamics and pharmacokinetics

Answer 11

It’s affinity to hemoglobin is about 200 times that of O2
It’s binding to hemoglobin is reversible

Pharmacokinetics is a half-life of about 4-5 hours

Question 12

Signs and symptoms of carbon monoxide poisoning (concentration correlation)
0-10%
10-20%
20-30%
30-40%

Answer 12

0-10%
No symptoms
10-20%
Tightness across forehead; possibly slight headache; dilation of cutaneous blood vessels
20-30%
Headache; throbbing in temples
30-40%
Severe headache; weakness; dizziness; nausea

Question 13

Signs and symptoms of carbon monoxide poisoning (concentration correlation)
40-50%
50-60%
60-70%
70-80%

Answer 13

40-50%
Same as previous item with greater possibility of collapse or syncope; increased respiration and pulse
50-60%
Syncope: increased respiration and pulse; coma with intermittent convulsions; Cheyene-Stokes respiration
60-70%
Coma with intermittent convulsions; depressed cardiac function and respiration; possible death
70-80%
Weak pulse and slowed respiration; respiratory failure and death

Question 14

Therapy of carbon monoxide

Answer 14

Restoration of Hb-O2, from CO-Hb when inhaling atmospheric air, pure oxygen or carbogen