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Toxicology Flashcards

1
Q

Cadmium

A

Targets kidneys, lungs, CV

Chelation

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2
Q

Methanol

A

Metabolism = Formeldehyde
Metabolic Acidosis
Neurotoxicity - Retina/Optic Nerve (BLIND)
Pancreatitis

TX: Lavage w/ bicarbonate, Ethanol, Fomepizole

Hemodialysis if blood levels exceed 50 mg/dL

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3
Q

Symp: Intoxication (30 min), Metabolic Acidosis (12-24 hr), OLIGURIC Renal failure (72 hr)

Metabolism = Oxalate

TX: Lavage w/ bicarbonate, Ethanol, Fomepizole

A

Ethylene Glycol

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4
Q

MOA: Binds sulfhydryl groups

Fatal = 120 mg

A

Arsenic

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5
Q

Chlordane, DDT, Lindane

A

Insecticides - Chlorinated Hydrocarbons
MOA: Ion channels Na+ and Ca2+

Symp: CNS stimulation –> Tremors and then Convulsions

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6
Q

Sulfur Oxide

A

MOA: Forms sulfurous acid on contact with mucous membranes –> Thickens mucus

Symptoms: Bronchospasms, Asphyxiation

TX: Remove source

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7
Q

MOA: Potent oxidizer

Symptoms: Irritation, inflammation

TX: Remove source

A

Ozone

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8
Q

Nitrogen Oxide

A

Brownish irritant gas (combustion)

Symptoms: Pulmonary edema

TX: Remove/manage

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9
Q

Brownish irritant gas (combustion)

Symptoms: Pulmonary edema

TX: Remove/manage

A

Nitrogen Oxide

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10
Q

Ethanol

A

Metabolism: Alcohol Dehydrogenase –> Acetaldehyde

Symp: CNS depression, gastritis, pancreatitis, feminization of males, inhibits ADH/oxytocin secretion

TX: Supportive, Hemodialysis effective but invasive, Disulfiram (alcoholics)

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11
Q

Carbamates

A

Insecticides - Carbaryl, Baygon

Reversible AChE inhibitors

TX: Decontaminate, support. Atropine
*pralidoxamine = contraindicated

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12
Q

Mercury

A 
Elemental = vapor, lungs
Organic = skin
Inorganic = GI

Symp: “Mad Hatter”

MOA: Covalent bonds with sulfhydryl groups

TX: Dimercaprol (IM), D-Penicillamine, Succimer

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13
Q

Iron

A

Symp: Corrosive to GI Tract

  1. Watery diarrhea with strips of mucosa
  2. Quiescent period (6-12 hrs)
  3. Acidosis, pulmonary edema, cyanosis
  4. Hepatic necrosis

TX: Milk + Vomit, Lavage, DEFEROXAMINE

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14
Q

Symp: CNS depression, gastritis, pancreatitis, feminization of males, inhibits ADH/oxytocin secretion

TX: Supportive, Hemodialysis effective but invasive, Disulfiram (alcoholics)

A

Ethanol

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15
Q

Propylene Glycol (PEG)

A 
Food additive (daily intake 34 mg/kg)
Tasteless metabolized to lactic acid
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16
Q

Pyrethrins

A

Insecticides - Fatal oral dose = 50 g

MOA: Targets Na+ ion channels

Symp: Contact dermatitis, asthma, CNS excitation

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17
Q

MOA: Blocks synthesis of aromatic hydrocarbons

A

Glyphosphate

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18
Q

Aromatic Hydrocarbons

A

Benzene, Toluene

MOA: CNS depression

Acute = euphoria, locomotive problems, coma/death
Chronic = Aplastic anemia, pancytopenia, increased risk of leukemia

*Toluene - no myelotoxicity

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19
Q

Metabolism = Formeldehyde
Metabolic Acidosis
Neurotoxicity - Retina/Optic Nerve (BLIND)
Pancreatitis

TX: Lavage w/ bicarbonate, Ethanol, Fomepizole

Hemodialysis if blood levels exceed 50 mg/dL

A

Methanol

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20
Q

Amyl Sodium Nitrate - Methemoglobin
Add thiosulfate
Hydroxycobalamin

A

Cyanide Treatment

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21
Q

Lead Treatment

A

IV EDTA (!!!) - chelates but MUST be given IV because oral will enhance absorption
Succimer - oral chelating agent
Dimercaprol (IM) - in severe poisoning

22
Q

MOA: High affinity for Hgb

Symp: Headaches, nausea, malaise, arrythmias, dyspnea, myonecrosis, renal failure

TX: 100% O2. Decreasing half life under hyperbaric conditions

A

Carbon Monoxide

23
Q

MOA: CNS depression

Acute = euphoria, locomotive problems, coma/death
Chronic = Aplastic anemia, pancytopenia, increased risk of leukemia
A

Aromatic Hydrocarbons
Benzene, Toluene

*Toluene - no myelotoxicity

24
Q

Ethylene Glycol

A

Symp: Intoxication (30 min), Metabolic Acidosis (12-24 hr), OLIGURIC Renal failure (72 hr)

Metabolism = Oxalate

TX: Lavage w/ bicarbonate, Ethanol, Fomepizole

25
Q

Lines on bones/gums

26
Q

Nickel

A

Contact dermatitis, carcinogen

Chelation

27
Q

Insecticides - Reversible AChE inhibitors

TX: Decontaminate, support. Atropine
*pralidoxamine = contraindicated

A

Carbamates

Carbaryl, Baygon

28
Q

Carbon Tetrachloride, Chloroform

A

Symp: CNS depression, Liver/Cardiotoxicity

TX: Manage based on organ system involved

29
Q

Symp: “Mad Hatter”

MOA: Covalent bonds with sulfhydryl groups

TX: Dimercaprol (IM), D-Penicillamine, Succimer

30
Q

Chromium

A

Nephrotoxic, carcinogen

31
Q

Lead

A

Paint, gasoline
MOA: Binds to RBCs and is distributed systemically. Binds sulfhydryl groups of proteins
Interferes with Ca2+, Zn2+, iron

Lead line on bones/gums, encephalopathy, anemia

TX: IV EDTA (!!!) - chelates but MUST be given IV because oral will enhance absorption
Succimer - oral chelating agent
Dimercaprol (IM) - in severe poisoning

32
Q

Arsenic

A

MOA: Binds sulfhydryl groups

Fatal = 120 mg

33
Q

Agent Orange

A

Chloropenoxy Compounds

Toxicity may be due to dioxin contaminant (TCDD)

Symp: Severe dermatitis, Neurological problems

34
Q

Paraquat

A

High mortality from accidental poisoning

GI symp: Vomiting, burning, renal/hepatic failure
Delayed pulm: Massive Fibroblast proliferation

TX: Lavage, hemodialysis
Steroids and Cyclophosphamide

35
Q

Cyanide

A

MOA: Blocks Complex IV of electron transport chain

Venous blood bright red

TX: Amyl Sodium Nitrate - Methemoglobin
Add thiosulfate
Hydroxycobalamin - form cyanocobalamin

36
Q

Symp: Severe dermatitis, Neurological problems

A

Agent Orange

Chloropenoxy Compounds

37
Q 
Food additive (daily intake 34 mg/kg)
Tasteless metabolized to lactic acid
A

Propylene Glycol (PEG)

38
Q

Symp: Corrosive to GI Tract

  1. Watery diarrhea with strips of mucosa
  2. Quiescent period (6-12 hrs)
  3. Acidosis, pulmonary edema, cyanosis
  4. Hepatic necrosis

TX: Milk + Vomit, Lavage, DEFEROXAMINE

39
Q

Halogenated Aliphatic Hydrocarbons

A

Carbon Tetrachloride, Chloroform

Symp: CNS depression, Liver/Cardiotoxicity

TX: Manage based on organ system involved

40
Q

Carbon Tetrachloride, Chloroform

Symp: CNS depression, Liver/Cardiotoxicity

TX: Manage based on organ system involved

A

Halogenated Aliphatic Hydrocarbons

41
Q

High mortality from accidental poisoning

GI symp: Vomiting, burning, renal/hepatic failure
Delayed pulm: Massive Fibroblast proliferation

TX: Lavage, hemodialysis
Steroids and Cyclophosphamide

42
Q

Organophosphates

A

Parathion, Malathion, Echiothiophate, TPP, Dichlorvos

MOA: Irreversible AChE inhibitor
Symptoms: SLUDGEM

TX: Atropine - treat muscarinic symptoms
Pralidoxamine - AChE reactivator, must be give w/in 24 hrs

43
Q

Carbon Monoxide

A

MOA: High affinity for Hgb

Symp: Headaches, nausea, malaise, arrythmias, dyspnea, myonecrosis, renal failure

TX: 100% O2. Decreasing half life under hyperbaric conditions

44
Q

Glyphosphate

A

Roundup

MOA: Blocks synthesis of aromatic hydrocarbons

45
Q

Symptoms: SLUDGEM

TX: Atropine - treat muscarinic symptoms
Pralidoxamine - AChE reactivator, must be give w/in 24 hrs

A

Organophosphates

Parathion, Malathion, Echiothiophate, TPP, Dichlorvos

46
Q

Ozone

A

MOA: Potent oxidizer

Symptoms: Irritation, inflammation

TX: Remove source

47
Q

Particulate Matter

A

Silicosis, Asbestosis
MOA: Inflammation and scarring of lungs

Symptoms: Delayed mesothelioma, dyspnea, tachypnea, Bronchial cancer

48
Q

MOA: Forms sulfurous acid on contact with mucous membranes –> Thickens mucus

Symptoms: Bronchospasms, Asphyxiation

TX: Remove source

A

Sulfur Oxide

49
Q

Cyanide Treatment

A

Amyl Sodium Nitrate - Methemoglobin
Add thiosulfate
Hydroxycobalamin

50
Q

Silicosis, Asbestosis
MOA: Inflammation and scarring of lungs

Symptoms: Delayed mesothelioma, dyspnea, tachypnea, Bronchial cancer

A

Particulate Matter

51
Q

MOA: Targets Na+ ion channels

Symp: Contact dermatitis, asthma, CNS excitation

A

Pyrethrins

Insecticide

Pharmacology (19 decks)

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