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Pharmacology > Toxicology > Flashcards

Toxicology Flashcards

1
Q

Who is the father of the science of toxicology❓

A

Paracelsus

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2
Q

Define:

  1. Toxicity
  2. Acute toxicity
  3. Chronic toxicity
  4. LD50
  5. ED50
  6. Therapeutic index
A

Toxicity: intrinsic tendency to produce an adverse effect

Acute toxicity: toxic effect of an agent observed with 24hrs of a single exposure

Chronic toxicity: toxic effects of an agent observed after long term exposure

LD50: dose that will kill 50% of the population

ED50: dose that will produce a desirable effect in 50% of the population

Therapeutic index: used in determining the safety of drugs.
LD50/ED50

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3
Q

What are the processes of risk management❓

A

Hazard identification

Dose-response assessment

Exposure assessment

Risk characterization

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4
Q
  1. What is a chelate❓
  2. How is it formed❓
  3. Are chelating agents specific in their affinity for metals❓
  4. What do they do❓
A
  • A chelate is a chemical compound in which one atom is enclosed within a larger cluster of atoms that surround it like an envelope
  • Chelating agent+metal ion
  • Chelating agents are non-specific in their affinity for metals
  • ⬆️excretion of metals, used in metal overdose/toxicity
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5
Q

List some examples of chelating agents and their uses

A

Dithiocarbamate:
Nickel
Arsenic
Mercury poisonings

Penicillamine:
Cooper poisoning

Dimercaprol:
Arsenic
Mercury poisoning

Desferoxamine:
Iron poisoning

EDTA:
Lead poisoning

British antilewisite BAL

Diethylene triamine penta acetic acid

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6
Q

What are the toxic effects of arsenic❓

Which chelating agent can be used❓

Chelation doesn’t reverse damage from delayed effects of acute arsenic poisoning
True or false❓

A

1.
Neurotoxicity

Liver toxicity (ascites/cirrhosis)

Teratogenicity (congenital abnormalities)

Hypersensitivity rxn

2. 
BAL
D-penicillamine 
Dithiocarbamate 
Dimercaprol
  1. True
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7
Q

What are the toxic effects of mercury❓

Which chelating agent can be used❓

A 
1.
CNS effects:
Ataxia 
Loss of hearing and vision 
Tremor 
⬆️excitability

Respiratory effect:
Bronchitis
Pneumonitis

2.
BAL
D-penicillamine

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8
Q

What are the toxic effects of lead❓

Which chelating agent can be used❓

A

1.
Neurotoxicity
Nephrotoxicity
Haematological effects

  1. EDTA
    BAL
    D-penicillamine
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9
Q

What are the toxic effects of cadmium❓

Which chelating agent can be used❓

A
  1. GIT effects:
    Nausea/vomiting

Respiratory effect:
Chronic pulmonary dx

Renal tubular dx

Carcinogenicity

2.
DMSA

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10
Q

Beryllium toxicity has effects mainly in the lungs

True or false

A

True

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11
Q

Chromium toxicity has effects mainly on the renal tubules

True or false

A

True

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12
Q

What are the toxic effects of cyanide❓

Which chelating agent can be used❓

A 
1.
GI effects/Salivation 
Anxiety/Confusion 
Paralysis 
Cardiac arrhythmias 
Respiratory failure 
Coma
  1. D-pencillamine
    BAL
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13
Q

What are the properties of an ideal chelator❓

A 
Water soluble 
Resistant to biochemical transformation 
Able to reach site of toxicity 
Form non-toxic compounds 
Have ⬇️affinity for essential metals
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14
Q

How would you evaluate for specific diagnosis of a poison❓

A

History: Food/Chemical consumed

Physical examination: BP/Pulse/Temp

Lab tests: liver/kidney/electrolytes/ECG/X-ray findings

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15
Q

What are the specific Rx methods of poisonings❓

A

•Prevent future absorption of poisons:
Emesis
Gastric lavage
Chemical adsorption

Antidotes

•Enhance elimination of poisons:
Purgation
Dialysis

Alkalinization/Acidification of urine

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16
Q

What drugs can one use to induce emesis❓

A

•Ipecac syrup:
(irritant effect on enteric tract and chemoreceptor trigger zone CYZ)

15ml for children
30ml for adults

•Apomorphine:
SC administration

6mg/kg for adults
0.06mg/kg for children

17
Q

Stimulation of CYZ as a method to induce emesis is not used in which type of pts❓

Why❓

A

Respiratory
CNS depressed pts

It is a respiratory depressant

18
Q

How is a gastric lavage done❓

A

Insertion of tube into the stomach

Washing with water/normal saline to remove unabsorbed poison

Used in life threatening situations

Oral/nasogastric

19
Q

How does one induce chemical adsorption in poisoned pts❓

A

10:1 ration of charcoal to drug

50mg/10 tablespoonful glass of water

Oral/gastric tube

20
Q

Chemical adsorption techniques shouldn’t be used concurrently with emetic agents and antidotes

True or false

A

True

21
Q

What are some examples of purgatives❓

A

Sorbitol
Sodium sulfate
Magnesium sulfate

Use osmotic cathartic

22
Q

An acidic drug should be alkalinized in the urine with❓

A

Sodium carbonate

23
Q

An basic drug should be acidified in the urine with❓

A

Ammonium chloride

Ascorbic acid

24
Q

What is the antidote for formaldehyde toxicity❓

What product is formed❓

A

Ammonia

Hexamethylene tetramine

25
Q

What is the antidote for mercury toxicity❓

What product is formed❓

A

Sodium formaldehyde sulfoxylate

Less soluble metallic mercury

26
Q

What is the antidote for ferrous ion paracetamol toxicity❓

What product is formed❓

A

Sodium bicarbonate acetylcysteine

Ferrous carbonate

27
Q

What harmful substances may chlorinated hydrocarbon insecticides contain❓

What do they cause❓

What are the side effects❓

A 
1. 
DDT (dichloro-diphenyltrichloroethane)
Cyclodienes 
Toxaphenes 
Lindane 
Aldrin

2.
Interfere with active transport of Na+ and K+

  1. CNS: convulsion/vertigo/tremor/muscle paralysis
    Liver: hypertrophy/neoplasm
28
Q

What harmful substances may organophosphate insecticides (Anti ACh agents) contain❓

What do they cause❓

What are the side effects❓

A 
1. 
Parathion 
Malathion 
Dimethoate 
Dichlorvos 
Trichlorfon

2.
Excess ACh-paralysis

29
Q

What harmful substances may botanical (natural) insecticides contain❓

What are the side effects❓

A
  1. Pyrethrum
    Rotenone
    Nicotine
  2. Depolarization of membranes of NMJs of parasympathetic ganglia
30
Q

What harmful substances may rodenticides contain❓

What are the side effects❓

A

Warfarin-anticoagulant

Red squill- CNS paralysis

Indocid- hemorrhage

Pharmacology (10 decks)

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