Toxicology Flashcards
Cadmium
Targets kidneys, lungs, CV
Chelation
Methanol
Metabolism = Formeldehyde
Metabolic Acidosis
Neurotoxicity - Retina/Optic Nerve (BLIND)
Pancreatitis
TX: Lavage w/ bicarbonate, Ethanol, Fomepizole
Hemodialysis if blood levels exceed 50 mg/dL
Symp: Intoxication (30 min), Metabolic Acidosis (12-24 hr), OLIGURIC Renal failure (72 hr)
Metabolism = Oxalate
TX: Lavage w/ bicarbonate, Ethanol, Fomepizole
Ethylene Glycol
MOA: Binds sulfhydryl groups
Fatal = 120 mg
Arsenic
Chlordane, DDT, Lindane
Insecticides - Chlorinated Hydrocarbons
MOA: Ion channels Na+ and Ca2+
Symp: CNS stimulation –> Tremors and then Convulsions
Sulfur Oxide
MOA: Forms sulfurous acid on contact with mucous membranes –> Thickens mucus
Symptoms: Bronchospasms, Asphyxiation
TX: Remove source
MOA: Potent oxidizer
Symptoms: Irritation, inflammation
TX: Remove source
Ozone
Nitrogen Oxide
Brownish irritant gas (combustion)
Symptoms: Pulmonary edema
TX: Remove/manage
Brownish irritant gas (combustion)
Symptoms: Pulmonary edema
TX: Remove/manage
Nitrogen Oxide
Ethanol
Metabolism: Alcohol Dehydrogenase –> Acetaldehyde
Symp: CNS depression, gastritis, pancreatitis, feminization of males, inhibits ADH/oxytocin secretion
TX: Supportive, Hemodialysis effective but invasive, Disulfiram (alcoholics)
Carbamates
Insecticides - Carbaryl, Baygon
Reversible AChE inhibitors
TX: Decontaminate, support. Atropine
*pralidoxamine = contraindicated
Mercury
Elemental = vapor, lungs Organic = skin Inorganic = GI
Symp: “Mad Hatter”
MOA: Covalent bonds with sulfhydryl groups
TX: Dimercaprol (IM), D-Penicillamine, Succimer
Iron
Symp: Corrosive to GI Tract
- Watery diarrhea with strips of mucosa
- Quiescent period (6-12 hrs)
- Acidosis, pulmonary edema, cyanosis
- Hepatic necrosis
TX: Milk + Vomit, Lavage, DEFEROXAMINE
Symp: CNS depression, gastritis, pancreatitis, feminization of males, inhibits ADH/oxytocin secretion
TX: Supportive, Hemodialysis effective but invasive, Disulfiram (alcoholics)
Ethanol
Propylene Glycol (PEG)
Food additive (daily intake 34 mg/kg) Tasteless metabolized to lactic acid
Pyrethrins
Insecticides - Fatal oral dose = 50 g
MOA: Targets Na+ ion channels
Symp: Contact dermatitis, asthma, CNS excitation
MOA: Blocks synthesis of aromatic hydrocarbons
Glyphosphate
Aromatic Hydrocarbons
Benzene, Toluene
MOA: CNS depression
Acute = euphoria, locomotive problems, coma/death Chronic = Aplastic anemia, pancytopenia, increased risk of leukemia
*Toluene - no myelotoxicity
Metabolism = Formeldehyde
Metabolic Acidosis
Neurotoxicity - Retina/Optic Nerve (BLIND)
Pancreatitis
TX: Lavage w/ bicarbonate, Ethanol, Fomepizole
Hemodialysis if blood levels exceed 50 mg/dL
Methanol
Amyl Sodium Nitrate - Methemoglobin
Add thiosulfate
Hydroxycobalamin
Cyanide Treatment