Toxicology Flashcards

1
Q

What is toxicology?

A

Subtopic that covers their

  • detection
  • effects
  • properties
  • regulation
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2
Q

What does it mean that poisoning is situational, and quantitative in nature?

A

Any substance can be harmless or toxic depending on when given, and the dose

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3
Q

What are the two factors that determines if a drug is poisonous?

A

Dose

Duration of exposure

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4
Q

What are the two reasons to study toxicology?

A

Protect humans from toxicants

Improve toxicants (abx, pesticides)

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5
Q

What are the common poisons in children less than 5 yo?

A

Plants
Cosmetics
Salicylates
Acetaminophen

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6
Q

What are the common poisons in adults?

A
Barbs
CO
Salicylates
Narcs
Insecticides
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7
Q

What is the LD 50?

A

Dose at which 50% of the animals tested die

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8
Q

Legally, a poison is defined at what LD 50?

A

Less than 50 mg/kg

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9
Q

What is the Therapeutic index? A larger number indicates what?

A

LD50 / ED50

Larger = safer

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10
Q

What is the average lethal dose calculated from?

A

Estimated from accidental deaths in humans

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11
Q

What is the primary determinant of toxicity?

A

Dose

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12
Q

What are the three rapid measures that need to be considered with an overdose/poisoning?

A

Airway
Breathing
Circulation

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13
Q

After ABCs are accounted for, what is the next step in an overdose?

A

Reduce/remove the drug

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14
Q

What is the drug used for acute overdose?

A

Naloxone

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15
Q

What are the two things to consider with an unconscious patient?

A

Glucose/insulin

Naloxone

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16
Q

What is the major issue with trying to identify a poison?

A

Time

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17
Q

What are toxidromes?

A

Comparison of drug or chemical responses of the patient with known toxicology standards

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18
Q

What are the two major urine tests?

A

EMIT
ELISA
TLC

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19
Q

What are the two emesis inducers that can be used?

A

Apomorphine

Syrup of Ipecac

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20
Q

What are the two major contraindications for emesis inducers?

A

Petroleum hydrocarbon solvents d/t chemical pneumonitis

Caustic acid or alkali agent (rupture)

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21
Q

What is gastric lavage?

A

NG tube passed and suction applied

22
Q

When is activated charcoal indicated?

A

Caustic agents and petroleum

23
Q

What is the MOA of activated charcoal?

A

Very large surface area, allows for binding or organic toxicants which prevents absorption

Induces emesis

24
Q

How soon should charcoal be administered following ingestion of the poison?

A

30 minutes

25
Q

Why should charcoal not be given with other drugs used to treat poisoning?

A

Will reduce their effectiveness

26
Q

What is the MOA of pralidoxime (2-PAM)?

A

nucleotide reagent that covalently binds to organophosphates and permits rapid excretion

27
Q

What are pralidoxime usually administered with? Why?

A

Atropine to block muscarinic effects of parasympathetic nervous system

28
Q

What is the MOA of cyanide? What systems are primarily affected?

A

Binds to and deactivates cytochrome C oxidase.

CNS and cardiac tissue are particularly affected

29
Q

What is the LD50 for cyanide? How long does this take to cause death?

A

2 mg /kg

1-15 minutes

30
Q

What is the antidote for Cyanide poisoning? MOA?

A

Amyl nitrate and NaSO4 with O2

Combines with CN to form nontoxic cyanmethemoglobin

31
Q

What is the MOA of botulinum?

A

Prevents ACh release from nerve terminals

32
Q

What is the antidote to botulinum toxin?

A

Ab towards botulinum

33
Q

What is the cause of death with botulinum poisoning?

A

respiratory arrest

34
Q

What are the chelators that can be used in heavy metal poisoning?

A

EDTA
DMSA
Deferoxamine

35
Q

What are the heavy metals that can be chelated?

A
Hg
Pb
As
Fe
Ag
36
Q

What is DMSA, succimer usually used for?

A

Ar, Hg or Pb poisoning

37
Q

What is the dosage for DMSA (succimer) for kids greater than 12 yo? Less than 12?

A

10 mg/kg PO for 5 days

Same + q12 hours for 14 days after

38
Q

What is the morphology of C. botulinum?

A

Gram positive drumsticks

39
Q

What is the dose of trivalent antitoxin?

A

10 ml vial per pt

40
Q

What is used for CN poisoning? MOA?

A

sodium nitrite

Oxidize a portion of the Hb Fe from the ferrous state to the farric state, converting the Hb into methemoglobi

41
Q

What is the use and MOA of sodium thiosulfate?

A

Reacts with Cyanmethhemoglobin

42
Q

What is the antidote for alcohol (isopropyl or ethylene glycol) poisoning?

A

EtOH + dialysis

43
Q

Methanol is converted into what via what enzyme?

A

Formaldehyde

Alcohol dehydrogenase

44
Q

What is the MOA of fomepizole?

A

Blocks alcohol dehydrogenase

45
Q

What are the major toxic effects of methanol/ethylene glycol

A

Renal failure

Blindness

46
Q

CO has a (__)x greater affinity for Hb than O2.

A

210

47
Q

What is the treatment for CO poisoning?

A

Artificial respiration with pure O2. Maybe hyperbaric O2.

48
Q

What is the telltale sign of CO poisoning?

A

HA, lethargy, cherry red skin

49
Q

What is the normal percent of carboxyHb?

A

2.5% of all Hb for nonsmokers

7-10% of smokers

50
Q

What is the treatment for Warfarin Overdose?

A

Vitamin K, prothrombin complex or fresh frozen plasma