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I hate DRUGS!! > TOXICOLOGY > Flashcards

TOXICOLOGY Flashcards

1
Q

The light brownish color of smog often apparent in a major metropolitan area on a hot summer

A

Nitrogen Oxide

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2
Q

Antidote to Carbon monoxide poisoning

A

Oxygen

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3
Q

Treatment for parathion exposure

A

Atropine and pralidoxime

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4
Q

A compound that is toxic to bone marrow cells in the early stages of development and that may also be leukemogenic

A

Benzene

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5
Q

A compound or group of compounds that damages the skin and whose use in manufacturing has largely been eliminated because of extensive persistence in the environment and bioaccumualtion

A

Polychlorinated biphenyls (PCBs)

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6
Q

Signs and symptoms of paraquat ingestion

A

GI irritation with heamtemesis and bloody stools

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7
Q

Chemical warfare agent that causes dyspnea, abdominal cramps, and diarrhea. They also had copious nasal and tracheobronchial secretions

A

Organophosphates

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8
Q

Asthma is often exacerbated in patients wxposed to this reducing agent. When concentrations in the air are as low as 1-2 ppm

A

Sulfur dioxide

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9
Q

Acute exposure to this alipathic hydrocarbon solvent causes CNS depression; chronic exposure has led to impairment of memory and peripheral neuropathy

A

Tetrachloroethylene

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10
Q

This compound is apotential environmental environmental hazard that is formed as a contaminating byproduct in the manufacture of herbicides

A

Dioxin

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11
Q

A small child is brought to a hospital department suffering drom severe GI distress and abdominal colic. If this patient has severe acute lead poisoning with signs and symptoms of encephalopathy. treatment should be instituted immediately with

A

EDTA

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12
Q

A young woman empliyed as a dental laboratory technician complains of conjunctivitis, skin irritation and hair loss. On examination she has perforation of the nasal septum and a “milk and roses” complexion. These signs and symptoms are most likely due to

A

Chronic inorganic arsenic poisoning

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13
Q

A patient complains of chronic headache, fatigue, loss of appetite and constipation. He has slight weakness of the extensor muscles in the upper limbs. Based on the laboratory data. The most reasonable Diagnosis is

  • HgB <13
  • Urine coproporphyrin >80mcg/100 mg
    • Urinary aminolevulinic acid >2 mg/100 mg
A

Inorganic lead

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14
Q

A young engineer involved in the smelting process of cobalt and gold presented with severe GI discomfort, rice water stools, and sweet garlicky breath. Acute arsenic poisoning was diagnosed. What drug should be included in the management?

A

Dimercaptol

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15
Q

A 24 year old man was employed in the supply department of a company that manufactures semiconductors. After an accident at the plant, he presented with nausea and vomiting, headache, hypotension, and shivering. Laboratory showed hemoglibinuria and a plasma free hemoglobin level >1.4 g/dL This young man was probably exposed to

A

Arsine

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16
Q

A 2 year old boy ingested an unknown table. His symptoms included marked GI distress, vomiting,(with hematemesis) and epigastric pain. MEtabolic acidosis and leukocytosus were also present. This patient probably ingested

A

Iron

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17
Q

This toxic compound can be produced in seawater by the action of bacteria and algae, It also synthesized chemically for commercial use as a fungicide.

A

Methylmercury

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18
Q

This agent is used in the treatment of wilson’s disease and has been reported to cause SLE and hemolytic anemia

A

Penicillamine

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19
Q

High doses of this agent can cause histamine release and extreme vasodilation

A

Deferoxamine

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20
Q

Gingivitas, discolored gums, and loose teeth are common symptoms of chronic exposure to this agent

A

Inorganic mercury

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21
Q

EDTA

A

Chelator of many divalent and trivalent metals

USed in lead poisoning. Posioning by zince, manganese and certain heavy radionucleide

Parenteral

Administered as calcium disodium salt to avoid calcium depletion. Nephrotoxicity, ECG changes

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22
Q

Deferoxamine

A

Chelates excess iron

Used in acute iron poisoning. Inherited or acquired henochromatosis

Preferred rout of administraion: IM or SQ
Rapid IV adminsitration may cause hypotension. neutoroxicity and icnreased susceptibility to certain infections have occured with long term use

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23
Q

Oral iron chelator for treatment of hemochromatosis

A

Defasirox

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24
Q

Dimercaprol

A

Bidentate chelator forms 2 bonds with metal ions

Arsenic and inorganic mercury poisoning. COmbined with EDTA for lead poisoning.

Parenteral

Transient hypertension, tachycardia, headache, nausea, vomiting, paresthesias, fever, thrpmbocytopenia, and increased prothrombin time with long term use

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25
Q

Water soluble cogener of demercaprol used for oral treatment of lead poisoning

A

Succimer

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26
Q

Water soluble cogener of dimercaprol used IV for initial treatment of severe mercury or arsenic poisoning and used orally for lead poisoning

A

Unithiol

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27
Q

Penicillamine

A

Bidentate Chelator

Copper poisoning and Wilson’s disease

Oral

Nephrotoxicity, pancytopenia, autoimmune dysfunction, including SLE and hemolytic anemia

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28
Q

A 2 year olf girl presented with lethargy, increased respiratory rate and an elvated temperature that appeared to result from drug poisoning. Laboratory testing revealed the following serum concentrations: glucose 36 mg/DL; Na: 148 K 5 Cl 111 HCO3 12, BUN 21, osmolality 300

Anion gap? Osmolal Gap? what is the drug?

A

+30

-5

Aspirin

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29
Q

an 18 month old boy presented in semiconcsious state with profound hypotension and bradycardia after ingesting a number of his grandmother’s metoprolol tablets. In this case, the most appropriate antidote is

A

Glucagon

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30
Q

______ can be used in metormin overdose with lactic acidosis

A

Hemodialysis

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31
Q

A 24 year old female was rushed to the ER after she was found in herroom hypotensive with seizure. In the ER, the ECG confirmed Ventricular arrhythmias. An overdose of what drug is most likley?

A

Amitriptyline (TCA)

32
Q

A patient is brought to the ER having an overdose (unknown quantitiy) of a sustained release of theophylline by oral administration 2h previously. He has marked GI distress with vomiting, is agitated and exhibits hyperreflexia and hypotension.

  • Measure: 80 mg/L
  • Vd 35L
  • T1/2

Amount of ingested? what can be used to reduce tachycardia

A

2.8

Esmolol

33
Q

A contraindication to the use of gastric lavage for the removal of drugs from stomach of a victim of poisoning

A

Ingestion of corrosive

34
Q

Can cause hypertension and tachycardia

A

Amphetamines, cocaine, antimuscarinic drugs

35
Q

Hypotension with bradycardia

A

CCB and sedative hypnotics

36
Q

Hypotension with tachycardia

A

TCA, phenothiazines, theophylline

37
Q

Hyperthermia

A

antimuscarinic, salycylates or sympathomimetics

38
Q

Hypothermia

A

ethanol and CNS depressants

39
Q

Increased RR

A

carbon monoxide, salicylates

40
Q

[Toxic syndrome]

Delirium, hallucinations, seizures, coma, tachycardia, hypertension, hypethermia, mydriasis, decreased bowel sounds, urinary retention

A

Antimuscarinic

  • Control hyperthemia
  • physostigmine may be helpful, but not for TCA overdose
41
Q

[Toxic syndrome]

Anxiety, agitation,s eizures, coma, bradycardia or tachycardia, pinpoint pupils, salivation, sweating, hyperactive bowel, muscle fasciculations, then paralysis

A

Cholimomimetic drugs (Carbamate or organophosphate cholinesterase inhibitots)

  • Support resipiration
  • Treat with atropine and pralidoxime
  • Decontaminate
42
Q

[Toxic syndrome]

Lethargy, sedation, coma, bradycardia, hypotension, hypoventilation, pinpoint pupils, cool skin, decreased bowel sounds, flaccid muscles

A

Opiods (heroin, morphine, methadone)

  • Provide airway and respiratory support
  • Give naloxone as required
43
Q

[Toxic syndrome]

Confusion, lethargy, coma, seizures, hyperventilation, hyperthermia, dehydration, hypokalemia, anion gap, metabolic acidosis

A

Salicylates

  • Correct acidois and fluid and electrolytes imbalance
  • alkaline diuresis or hemodialysis to aid elimination
44
Q

[Toxic syndrome]

Disinhibition initially, later lethargy, stupor, coma, nystagmus is common, decreased muscle tone, hypothermia, small pupils, hypotension, and decreased bowel sounds in severe overdose

A

Sedative hypnotics (barbiturates, BZ, ethanol)

  • Provide airway and respiratory support
  • Avoid fluid overload
  • Consider flumazenil for benzodiazepine overdose
45
Q

[Toxic syndrome]

Agitation, anxietym seizures,. Hypertension, tachycardia, arrhythmias, mydriasis, certical and horizontal nystagmus with PCP. SKin warm and sweaty, hypethermia, icnreased muscle tone, possible rhabdomyolysis

A

Stimulants (amphetamines, cocaine, PCP, bath salts)

  • Control seizures with BZ (lorazepam), hypertension and hyperthermia
46
Q

[Toxic syndrome]

Mild: shivering, hyperreflexia, and diarrhea. Sevre: muscle rigidity, fever seizures, and cardiovascular instability

A

SSRIs

  • Stop offending drug, supportive management, and antidote with cyproheptadine
47
Q

[Toxic syndrome]

Antimuscarinic effects. The 3Cs of coma, convulsion and cardiac toxicity (widened QRS, arrhythmias, hypotension)

A

TCA

  • Control seizures.
  • Correctr acidosis and cardiotoxicity with ventilation, sodium bicarbonate, and norepinephrine (for hypotension). COntrol hyperthermia
48
Q

Mild anorexia, nausea, vomiting, delayed jaundice, and renal failure

A

Acetaminophen

49
Q

Dysphagia, dysarthria, ptsosi, ophthalmoplegia, muscle weakness; incubation period 12-36h

A

Botulism

50
Q

Coma, metabolic acidosis, retinal hemorrhages

A

Carbon monoxide

51
Q

Bitter almond odor, seizures, coma, abnormal ECG

A

Cyanide

52
Q

Renal failure, crystals in urine, icnreased anion and osmolar gap, initial CNS excitationl eye exam normal

A

Ethylene glycol

53
Q

Bloody diarrhea, coma, radioopaque material in gut, high leukocyte count, hyperglycemia

A

Iron

54
Q

Abdominal pain, hypertension, seizures, muscle weakness, metallic taste, anorexia, encephalopathy, delayed motor neuropathy, changes in renal and reproductive function

A

Lead

55
Q

Hallucinations, dilated pupils, hypertension

A

LSD

56
Q

Acute renal failure, tremor, salivation, gingivitis, colitis, erethism (fits of cryingm irrational behavior), nephrotic syndrome

A

Mercury

57
Q

Rapid respiration, visual symptoms, osmolar gap, severe metabolic acidosis

A

Methanol

58
Q

Severe nausea and vomiting 8h after ingestion; delayed hepatic and renal failure

A

Amanita phalloides

59
Q

Coma wirh eyes open, horizontal and vertical nystagmus

A

PCP

60
Q

[Antidote]

acetaminophen

A

Acetylcysteine

Best given within 8-10 h of overdose

61
Q

[Antidote]

cholinesterase inhibitors, rapid onset mushroom poisoning with muscarinic effects

A

Atropine

62
Q

[Antidote]

Membrane depressant cardiotoxic drugs

A

Bicarbonate, sodium

63
Q

[Antidote]

fluoride, CCB

A

Calcium

64
Q

[Antidote]

iron salts

A

Deferoxamine

65
Q

[Antidote]

digoxin and related cardiac glycosides

A

Digoxin antibodies

66
Q

[Antidote]

caffeine, theophylline, sympathomimetics

A

Esmolol

67
Q

[Antidote]

Benzodiazepies, zolpidem

A

flumazenil

(can cause seizures)

68
Q

[Antidote]

methanol, ethylene glycol

A

Fomepizole

69
Q

[Antidote]

Beta-blcokers

A

Glucagon

70
Q

[Antidote]

hypoglycemics

A

glucose

71
Q

[Antidote]

cyanide

A

Hydroxycobalamin

72
Q

[Antidote]

opiod analgesics

A

Naloxone

73
Q

[Antidote]

Carbon monoxide

A

Oxygen

74
Q

[Antidote]

muscarinic receptor blcokers when effect needed in CNS

A

Physostigmine

(not for TCA)

75
Q

[Antidote]

Organophosphate cholinesterase inhibitors

A

Pralidoxime

(most effective if used within 24 hours of exposure)

I hate DRUGS!! (26 decks)

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