Toxicology 5 (cyanide, Mushroom Poisoning, Botulism, Specific Antidotes)

Question 1

Cyanide mechanism of action

Answer 1

Binds to the trivalent irons of cytochrome oxidase-> inhibition of cellular respiration-> lactic acidosis and cytotoxic hypoxia

Question 2

Cyanide symptoms

Answer 2

Increased respiration (stimulations of the chemoreceptive cells)
Hyperpnoe
Hypoxia
Convulsion

Question 3

Therapy of Cyanide

Answer 3

Formation of methemoglobin (amyl-nitrite, Na-nitrite iv. 10 ml 3x)
Thiosulfate iv. 50 ml 25% -> formation of thiocyanate (SCN-) -> excretion in the urine

CO2 EDTA

O2 potentiates the effect of the a.m. compound

Question 4

Mushroom poisoning contain what and how fast does it take effect

Answer 4

Alkaloids and has rapid onset

Question 5

Types of mushroom poisoning

Answer 5

Inocybe
Amanita muscaria
Amanita pantheriana
Amanita phalloides

Question 6

Inocybe type mushroom poisoning contains? Symptoms? Therapy?

Answer 6

Contains muscadine
Symptoms including parasympathomimetic effects
Therapy is atropine 1-2 mg in every 30 minutes

Question 7

Amanita muscaria and pantheriana onset? Contains? Symptoms? Therapy?

Answer 7

Amanita muscaria and pantheriana rapid onset
Contains muscadine and isoxazole derivatives of anticholinergic activity
Symptoms include restlessness, hallucination, ataxia, delirium
Therapy include symptomatic (NO atropine)

Question 8

Amanita muscaria and pantheriana poison chemicals

Answer 8

Ibotenicacid and muscimol

Question 9

Mushroom containing toxic polypeptides
Amanita phalloides, virosa, and verna
Onset? Contains? MOA?

Answer 9

Delayed onset
Contains amatoxins
-amanitin alpha (cyclic octapeptide)
-phalloidine (cyclic heptapeptide)
MOA
Inhibition of the DNA depending RNA polymerase

Question 10

Mushrooms contain toxic polypeptides are?

Answer 10

Amanita phalloides
A. virosa
A. Verna

Question 11

Symptoms of mushrooms containing toxic polypeptides

Answer 11

Emesis, diarrhea, shock
-fluid loss
-inhibition of vasomotor center
-cardiac effect
Damage of intestinal mucosa, liver, kidney
Hepatotoxicity- icterus, atrophia hepatic flava (HIGH LETHALITY BECAUSE OF HEPATOTOXICITY)
Toxic nephrosis

Question 12

Therapy of mushrooms contain toxic polypeptides

Answer 12

Supportive- protection of liver and kidney
Hemoperfusion
Glucocorticoid

Question 13

Botulotoxine is from which bacteria and lethal dose

Answer 13

Clostridium botulinum (anaerobe)
Lethal dose 0.001-0.002 mg/kg

Question 14

Botulotoxine MOA and latency time

Answer 14

Inhibition of the release of acetylcholine

Long latency time (12-36 hours)

Question 15

Botulotoxine symptoms

Answer 15

First diarrhea, then paralytic ileus
Ptosis, dilation of pupils
Salivation, then stop of secretion
Aglobulism, aphasia (clear consciousness) -> aspiration -> pneumonia
Bladder atony
Paralysis of skeletal muscle (respiratory stop!)

Question 16

Therapy for botulism

Answer 16

Antitoxin (A,B, E)
Purging with castrol oil and neostigmine
Transfusion

Question 17

Infant botulism between?

How does it occurs

Answer 17

Between 3 weeks to 6 months of age

It develops by ingesting the spores themselves, which can germinate in the intestines and produce toxin

Question 18

Infant botulism Symptoms

Answer 18

Constipation, poor feeding, decreased activity, weak cry, generalized muscle weakness, decreased reflexes, dilated pupils that do not react quickly to light, and finally paralysis, which may include the eye muscles

Question 19

How long does infant botulism symptoms last

Answer 19

2-6 weeks and the infant has a complete recovery

Question 20

Heavy metals poisons antidotes

Answer 20

Chelating agents
Dimercaprol (BAL)
Ca-EDTA
Penicillamine
N-acetyl-penicillamine
Dithiocarb

Question 21

Iron poisoning antidote

Answer 21

Deferoxamine

Question 22

Cholinesterase blocker toxicity antidote

Answer 22

Atropine
Enzyme reactivators
Toxogonin
PAM

Question 23

Cyanide antidote

Answer 23

Oxidants producing met-hemoglobin

Co-EDTA

Question 24

Methemoglobin producer antidote

Answer 24

Methylene blue, thionin

Question 25

Snake venom antidote

Answer 25

Specific antiserum

Question 26

Methanol and ethylene glycol antidote

Answer 26

Ethanol

Question 27

Coumarin toxicity antidote

Answer 27

Vitamin K

Question 28

Opiates toxicity antidote

Answer 28

Naloxone

Question 29

Paracetamol toxicity antidote

Answer 29

Acetylcysteine

Question 30

Cardiac glycoside toxicity antidote

Answer 30

Digoxin antibodies

Question 31

CO antidote

Answer 31

O2

Question 32

Benzodiazepines toxicity antidote

Answer 32

Flumazenil