toxicology lecture 1 Flashcards
what is ocular decontamination, how do you flush it out
local irritation or permanent corneal damage - requires immediate treatment, flush medial to lateral
what is dermal deconamination
irritation, dermatitis
what can happen when GI decontamination locally
ingested toxins, gastric irritation -> induce vomiting
what can happen when GI decontamination centrally
chemoreceptor trigger zone (CRTZ) ->induce vomiting - the drug binds onto receptors and sends the message to the vomiting centre and then vomits
what 3 factors should be considered for GI Decontamination
- time of ingestion
- agents ingested
- clinical status of patients
how much time do you have to get out some ingested toxins
1-2 hour window, 17-62% if emesis is done within an hour
what are some contraindications for GI decontamination
- unconscious/depressed
- CNS stimulant
- respiratory distress
- strong acid/alkalis
- gasoline/ petroleum distillates
what are 4 ways of induction for emesis
3% hydrogen peroxide, apomorphine, xylazine, syrup of ipecac
3 things to know about 3% hydrogen peroxide induction
- can do an emesis at home - can travel to hospital if less than 1 hour
- higher than 3% HP may cause severe vomiting, mucosal irritation
- 1tbsp/20lbs or 1 ml /kg
5 things to know about apomorphine induction
- stimulates the dopamine receptors in the CRTZ
- rapid onset = first choice
- IV/SQ? tablet and conjunctival disc
- side effects include - protracted vomting, CNS depression/stimulation
* **5. does not work on cats
2 things to know about Xylazine induction
- side effects outweigh the benefits
2. don’t use on cardiac patients
2 things to know about syrup of ipecac induction
- gastric irritant and CRTZ stimulant
2. side effects include prolonged vomiting, cardiotoxic at high dose, hemorrhagic diarrhea, skeletal muscle weakness
what is gastric lavage
- used when you can’t use vomiting
- administration and evacuation of liquid through an orogastric tube
- effective within the first 1-2 hours post ingestion
- narrow margin of safety -> lethal dose LD50 = obstruction
what does activated charcoal do in GI decontamination
-binds and traps the toxin in the GI tract and exits via feces
-does not get absorbed in the GI tract
Sorbitol/ Cathartic
can you give food with activated charcoal
you can, a small amount only because the activated charcoal may bind to the food and won’t work on the animal
why would you add Carthartic (Sorbitol) with an activated charcoal?
- to accelerate the expulsion from the GI tract
- makes gastrointestinal distress when combined
which substances are not absorbed with activated charcoal
- ethanol
- fertilizer
- petroleum distillates
- heavy metal (mercury)
when should you not use an activated charcoal with a patient
vomiting, hydrocarbon, seizure, compromised airway, caustic substance
what is toxicology
the study of poison
what are the 5 most common poisons
- ethylene glycol toxicity
- rodenticide toxicity
- organophosphate toxicity
- acetaminophen toxicit
- phyrethrin toxicity
what do you monitory for ethylene glycol toxicity
fluid therapy, urine output, body weight, blood work
what is the lethal dose for ethylene glycol toxicity
- 4 ml/kg for dogs
0. 9 ml/kg for cats
what are initial clinical signs for ethylene glycol toxicity
- dose dependant
- caused by unmetabolized EG
- ~30 min after ingestion
- CNS depression, vomiting, lethargy, seizure, ataxia, PU/PD
what should you be careful about for initial clinical signs for ethylene glycol toxicity
they may disappeared, 12 hours post ingestion but they might not actually be recovered
