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toxicology lecture 1 Flashcards

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1
Q

what is ocular decontamination, how do you flush it out

A

local irritation or permanent corneal damage - requires immediate treatment, flush medial to lateral

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2
Q

what is dermal deconamination

A

irritation, dermatitis

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3
Q

what can happen when GI decontamination locally

A

ingested toxins, gastric irritation -> induce vomiting

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4
Q

what can happen when GI decontamination centrally

A

chemoreceptor trigger zone (CRTZ) ->induce vomiting - the drug binds onto receptors and sends the message to the vomiting centre and then vomits

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5
Q

what 3 factors should be considered for GI Decontamination

A
  • time of ingestion
  • agents ingested
  • clinical status of patients
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6
Q

how much time do you have to get out some ingested toxins

A

1-2 hour window, 17-62% if emesis is done within an hour

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7
Q

what are some contraindications for GI decontamination

A
  1. unconscious/depressed
  2. CNS stimulant
  3. respiratory distress
  4. strong acid/alkalis
  5. gasoline/ petroleum distillates
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8
Q

what are 4 ways of induction for emesis

A

3% hydrogen peroxide, apomorphine, xylazine, syrup of ipecac

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9
Q

3 things to know about 3% hydrogen peroxide induction

A
  • 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
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10
Q

5 things to know about apomorphine induction

A
  1. stimulates the dopamine receptors in the CRTZ
  2. rapid onset = first choice
  3. IV/SQ? tablet and conjunctival disc
  4. side effects include - protracted vomting, CNS depression/stimulation
    * **5. does not work on cats
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11
Q

2 things to know about Xylazine induction

A
  1. side effects outweigh the benefits

2. don’t use on cardiac patients

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12
Q

2 things to know about syrup of ipecac induction

A
  1. gastric irritant and CRTZ stimulant

2. side effects include prolonged vomiting, cardiotoxic at high dose, hemorrhagic diarrhea, skeletal muscle weakness

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13
Q

what is gastric lavage

A
  1. used when you can’t use vomiting
  2. administration and evacuation of liquid through an orogastric tube
  3. effective within the first 1-2 hours post ingestion
  4. narrow margin of safety -> lethal dose LD50 = obstruction
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14
Q

what does activated charcoal do in GI decontamination

A

-binds and traps the toxin in the GI tract and exits via feces
-does not get absorbed in the GI tract
Sorbitol/ Cathartic

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15
Q

can you give food with activated charcoal

A

you can, a small amount only because the activated charcoal may bind to the food and won’t work on the animal

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16
Q

why would you add Carthartic (Sorbitol) with an activated charcoal?

A
  • to accelerate the expulsion from the GI tract

- makes gastrointestinal distress when combined

17
Q

which substances are not absorbed with activated charcoal

A
  1. ethanol
  2. fertilizer
  3. petroleum distillates
  4. heavy metal (mercury)
18
Q

when should you not use an activated charcoal with a patient

A

vomiting, hydrocarbon, seizure, compromised airway, caustic substance

19
Q

what is toxicology

A

the study of poison

20
Q

what are the 5 most common poisons

A
  1. ethylene glycol toxicity
  2. rodenticide toxicity
  3. organophosphate toxicity
  4. acetaminophen toxicit
  5. phyrethrin toxicity
21
Q

what do you monitory for ethylene glycol toxicity

A

fluid therapy, urine output, body weight, blood work

22
Q

what is the lethal dose for ethylene glycol toxicity

A
  1. 4 ml/kg for dogs

0. 9 ml/kg for cats

23
Q

what are initial clinical signs for ethylene glycol toxicity

A
  • dose dependant
  • caused by unmetabolized EG
  • ~30 min after ingestion
  • CNS depression, vomiting, lethargy, seizure, ataxia, PU/PD
24
Q

what should you be careful about for initial clinical signs for ethylene glycol toxicity

A

they may disappeared, 12 hours post ingestion but they might not actually be recovered

25
Q

what are the clinical signs for ethylene glycol toxicity

A
  • acute renal failure (dogs - 24 to 72 hrs post/ cats - 12 to 24 post)
  • anuria (kidneys completely shut down) 72 to 96 hours post
  • depression, anorexia, vomiting, seizures, azotemia, uremia, ptyalism, oral ulcers, hyperglycemia
26
Q

what may you find in the lab for testing ethylene glycol toxicity

A
  • metabolic acidosis
  • calcium oxalate crystals both monohydrate/ dihydrate crystals
  • hypocalcemia
27
Q

what testing can you do for ethylene glycol toxicity

A

EG test kit
lab test
wood’s lamp

28
Q

what treatment can be done for ethylene glycol toxicity

A

ADH inhibition - only effective when give soon enough (6 to 8 hours post exposure)

29
Q

2 things about ethanol

A
  • has a higher affinity for ADH than EG

- side effects include CNS depression, acidosis, makes hyperosmolality worse, hypoglycemia

30
Q

3 things about 4 methylphyrazole (4-mp)

A
  • strong, competitive inhibitor of ADH
  • strong affinity than ethanol
  • less intensive monitoring and more predictable
31
Q

what should you know about hemodialysis in regards to toxicity

A

remove both EG and its metabolic

32
Q

what should be monitored for ethylene glycol toxicity

A
  • fluid therapy
  • urine output
  • body weight
  • blood work (blood glucose, electrolytes, and kidney values)
33
Q

what is the prognosis of ethylene glycol toxicity

A

acute renal failure -> anuria, death……

34
Q

what is the dosage reference for dogs for ethanol

A
  • 20% Eth. 5.5ml/kg q4hr x 5 tx, then q6 x htx

- 30% Eth. 1.3ml/kg slow IV bolus, 0.42 ml.kg/hr for 48 hours

35
Q

what is the dosage reference for cats for ethanol

A

20% Eth., 5ml/kg, q6hr x 5tx, then q8hr x 4tx

36
Q

what is the dosage reference for dogs for 4-MP

A

20mg/kg IV bolus
15mg/kg at 2 hr and 24 hr
6mg/kg at 36hr

nursing vet tech (13 decks)

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