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Toxicology I Flashcards

1
Q

What are most poisons produced by?

A

medication

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2
Q

What type of medications produce the greets number of poisons?

A

OTC analgesics

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3
Q

What do street drugs rank on the poisons list?

A

10th

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4
Q

What are the most common non-medication toxicities from?

A

household cleaning products

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5
Q

Are people actually worried more about lower risks than higher ones?

A

yes

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6
Q

What are the 2 main goals of toxicology?

A
  1. protection of humans and the environment

2. development of better selective toxicants.

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7
Q

What was paracelsus major statement in terms of toxicology?

A

All substances are poison, there is none which is not a poison. The right dose differentiates a poison from a remedy.
[1. tried to experiment with toxins
2. tried to distinguish dose ranges
3. requested that active ingredients be extracted to have better and stronger effect]

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8
Q

Is poison a quantatative or qualitative concept?

A

Quant.

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9
Q

What is the most lethal toxin?

A

Botulinus Toxin

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10
Q

What is the most lethal manmade toxin?

A

TCDD dioxin

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11
Q

How many children die each year of unintentional poisoning? leading cause of death?

A

More than 45,000 (5-17 age) 5th leading cause of injury death

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12
Q

How man unintentional poisoning deaths in the US. in 2014

A

36,280

11.6 per 100,000

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13
Q

T-F–trends of deaths by poison has been falling? motor vehicle accidents?

A

False

True

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14
Q

When does rates of poisoning deaths jump up according to age?

A

late teens, 20

drops off at 60

highest at 50

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15
Q

Poisoning in young children <5 is most likely caused by what? 2nd cause? 3rd?

A

Parents medications (over half)
Cosmetics
Cleaning supplies

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16
Q

How many of adolescent poisonings are intentional, either as a suicide or substance abuse?

A

Over half

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17
Q

In adults what poisons far outnumber street drugs?

A

prescriptions

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18
Q

What is the percentage of unintentional poisoning in hospitals by drugs?

A

79%

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19
Q

What is risk in terms of toxicology?

A

The probability or likelihood of adverse effects occurring

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20
Q

Is smoke plum or alcohol exposure voluntary? under own control? known risks? common risks? immediate adverse effects? consequences reversible?

A
  1. alcohol
  2. alcohol
  3. Alcohol
  4. Alcohol
  5. Alcohol but both can be or not be
  6. Alcohol, but both can be or not be.
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21
Q

IS poisoning a growing problem?

A

Yes

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22
Q

What is the 3 step approach to risk prevention?

A
  1. Hazrd Identification and analysis
  2. Risk Assessment
  3. Risk Management
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23
Q

T-F- inhalation exposure is easy to avoid?

A

False

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24
Q

4 key air pollutants?

A

CO, SOx, NOx, Ozone

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25
Q

Air pollution is a risk factor for what 2 things?

A

cardiac death and pulmonary conditions

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26
Q

How many US people live in areas with pollutant concentrations deemed unsafe?

A

1/3

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27
Q

What two air pollutants are asphyxiants?

A

CO

cyanide

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28
Q

What air pollutants are irritants?

A

SO2
NO2
SMOG-OZONE, aldehydes, particles, hydrocarbons

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29
Q

What are the 6 criteria pollutants?

A 
CO
SO2
NO2
OZone
PM
Lead
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30
Q

Where does SOx come from?

A

fossil fuel power plants»>industry

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31
Q

Where does NOx come from?

A

Fossil fuel power plants>vehicles

32
Q

Where does CO come from?

A

vehicle»fires, smoking

33
Q

Where does PM come from?

A

Fires, fossil power plants, industry

34
Q

Order the air pollutants that cause more severe Acute respiratory health effects

A

SOx > PM >NOx > CO

35
Q

Is CO irritanting?

A

No- there is really no way of knowing

36
Q

What is CO a result of ?

A

incomplete combustion with too little oxygen

37
Q

What is the most abundant pollutant in the lower atmosphere

A

Carbon Monoxide

38
Q

Death rates of CO are higher in what populations?

A

Men, blacks, 15-24, and elderly

39
Q

What states is CO poisoning higher in?

A

N. and Midwest

40
Q

T-F– most CO deaths in garages occur even with doors or windows open?

41
Q

Is CO hemoglobin reversible?

A

Yes, but affinity is 220 times greater

42
Q

If you add .1% if CO in the air, what would be the carboxylhemoglobin percentage?

43
Q

Obviously in CO poisoning hypoxia is a problem, but what occurs when there is altered dissociation characteristics of oxyhemoglobin?

A

decreased oxygen release in tissues= cellular asphyxia

44
Q

Where are the 1st effects of CO?

A

brain and heart where the demand is high

45
Q

What binds CO more avidly than hemoglobin A? Why?

A

Fetal hemoglobin, maternal shift of O2 to the left

46
Q

What are the main symptoms of mild and medium CO exposure?

A

Headaches that get worse and then unconsciousness etc.

47
Q

Why do we get severe headache in CO poisoning?

A

edema and up intracranial pressure

48
Q

We know we get heart damage with CO, but do we get congestion and hemorrhages elsewhere?

A

Yes, in all organs

49
Q

T-F–CO poisoning is marked by delayed neuropsych impairment?

50
Q

review the pathology of acute CO poisoning

A 
severe headache
heart damage
congestion and hemorrhaging all over
delayed neuropsych impairment
ischemic anoxia
delayed encephalopathy due to autoimmune
51
Q

What are the symptoms of chronic exposure of CO?

A

headache- everyone in family

[may be misdiagnosed as influenza, other tips, morning headache in multiple members of family.

52
Q

What are the CO effects on ST changes?

A

earlier and longer lasting ST changes

53
Q

With CO is there a lower threshold for arrhythmias?

54
Q

Can pulseox detect HbCO?

A

Not really

55
Q

What lab diagnosis do we usually do for CO? 2

A

Expired CO

Carboxyhemoglobin- co-oximeter/blood sampling. be aware of time of exposure and measurement

56
Q

What is Tx for CO?

A

fresh air, O2 100%, hyperbaric, correct hypotension and acidosis

57
Q

Do many victims of CO have subtle memory problems after recovery?

A

yes about 1/3

11% have long term neurpsych problems

58
Q

Is tobacco smoke a major cause of CO poisoning?

59
Q

What is a major problem of sulfur dioxide with moisture?

A

conversion to acids–> acid rain, pH change of soil, metal leaching

60
Q

IS SO2 water soluble? what does this mean

A

Yes–>damage in upper airways

heavy breathing may lead to damage in lower airways

61
Q

Air SO2 levels are in strong association with what?

A

Asthma episodes

62
Q

At 3ppm of SO2, what happens

A

You can smell it!

50-100 max tolerable dose for 30-60 min

63
Q

What are the 6 acute affects of SO2?

A

irritation, cough, burning, lacrimation, difficulty, swallowing

64
Q

What are the long-term effects of SO2?

A

Aggravation of chronic cardiopulmonary disease

children- reduced lung function and up respiratory infections

65
Q

What is the pathophysiology of SO2? leads to what?

A

sulfur dioxide+moisture–> sulfurous acid (irritation, inhibition of mucociliary transport, vagal stim, constriction)

66
Q

What is a major treatment of SO2?

A

Removal from source (no jogging on bad days)

support airway and breathing

decontaminate

67
Q

What color is NO2?

A

brownish and highly reactive

68
Q

What is NO2 a major source of?

A

OZONE

NO2+ O2 + light–> NO + O3

O3+NO+dark–>O2+NO2

69
Q

Is NO2 water soluble? what does this mean?

A

Not really, penetrates deep into the lung

70
Q

What is a very potent respiratory tract toxin? features?

A

NOx

brinchitis, pneumonia, hemorrhagic pulmonary edema, alvolar damage

71
Q

What is the pathophys of NOx?

A

lipid peroxidation, decreased ciliary movement, bronchoconstriction, enzyme inhibition

72
Q

What color is ozone?

A

bluish, slightly pungent odor

73
Q

Is ozone soluble? What does this mean?

A

penetrate deep into the lung

74
Q

What is the pathophys problem of O3?

A

forms hydroxy radical–> per oxidation of lipids and oxidation of thiols, amines, proteins

75
Q

In the stratosphere, ozone problems due to decrease halogenated hydrocarbons leads to what?

A

UV exposure, skin cancer

76
Q

In the troposphere problems due to increase cars on the ozone lead to what?

A

Acute high dose= pulmonary edema and hemorrhage
Acute low= asthma, irritation
Chronic= bronchitis, emphysema, fibrosis

4 Pharm Self (17 decks)

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