Term
| What metal has no known necessary physiological role in the body, can be ingested or inhaled, and binds to hemoglobin? |
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Definition
| Lead (may be asymptomatic but there is no level of lead that is acceptable) |
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Term
true or false:
2 compounds having the same LD50 will have the same dose response curve |
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Definition
False
2 compounds can have same LD, doesn’t mean that they will have the same dose response curve |
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Term
True or false:
The lethal dose affecting the population is true for all individuals |
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Definition
False
For individuals, LD may be different, but if you look at population you will get even distribution. You should consider that when talking about toxic effects, there is a lot of interpatient variability |
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Term
| What is the equation for therapeutic index? |
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Definition
| lethal dose 50 / effective dose 50 |
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Term
| What is the shape of the dose-response for essential minerals and vitamins? |
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Definition
U-shaped (too much or too little vitamins and minerals is bade for you)
need to consider if a drug is a linear or U-shaped dose response |
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Term
| What is one of the major causes of liver toxicities in the US? |
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Definition
| acetaminophen, Tylenol (therapeutic index is not that big; fairly toxic) |
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Term
| Toxicity is (disproportional or proportional) to exposure? |
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Definition
Toxicity proportional to exposure:
local vs systemic
Immediate vs delayed
Reversible vs irreversible |
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Term
| *What is most frequently affect in systemic toxicity? |
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Definition
|
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Term
| Most poisons are (unintentional or intentional)? |
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Definition
unintentional (85%)
environmental exposures, occupational exposures, therapeutic drug errors, misuse of a substance, bites and stings, food poisoning
-Therapeutic errors – 10.5% of total exposures |
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Term
Where do exposures usually occur?
Is it mostly (acute or chronic) exposures? |
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Definition
90% occur at home
91% acute |
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|
Term
What age do most human exposures occur in?
More in boys or girls?
How do most exposures occur? |
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Definition
53% of human exposures involve children under the age of 6
Evenly divided by gender
Nearly 80% occur by ingestions |
|
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Term
Of the following poisons that are associated with the largest number of human fatalities, which ones usually occur together?
Cocaine
Opiods (Morphine, Heroin, Codeine)
Benzodiazepines [diazepam, Xanax (alprazolam)]
Acetaminophen
Cardiovascular drugs [Beta blockers (propranolol), Calcium Channel Blockers]
Alcohol
Antidepressants (Zoloft, Celexa, Prozac, Lexapro) |
|
Definition
| alcohol and antidepressants |
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Term
| What is the treatment approach for acute poisoning? |
|
Definition
ABCDE
Airway
Breathing
Circulation
Disability (CNS dysfunction)
Exposure |
|
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Term
| How do you decrease absorption of the poison? |
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Definition
Enhance elimination by
induce vomiting with ipecac syrup
Gastric lavage (stomach pumping)
Activated charcoal, oral suspension, large surface area for adsorption of organic compounds
Cathartic (laxative) agents
hemodialysis
antidote(s) |
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Term
| What is the leading cause of death due to poison in the US? |
|
Definition
Carbon monoxide poisoning (unintended-CO is odorless, colorless)
hospitals generally do not measure blood CO level |
|
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Term
| How does carbon monoxide poison people cellularly? |
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Definition
| Carbon monoxide has a higher affinity for hemoglobin than oxygen and forms carboxyhemoglobin --> oxygen depletion |
|
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Term
| How does carbon monoxide affect people's organs? |
|
Definition
With moderate CO exposure, breathing remains normal
Gradual hypoxia causes vasodilation which increases cardiac output
Fainting occurs more often than difficulty breathing
(takes very little CO to cause symptoms) |
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Term
| What is a clue in diagnosing someone with carbon monoxide poisoning? |
|
Definition
| cherry-red color of Hb(CO), pink skin |
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Term
A patient has bright red venous blood: increased saturation of Hb with O2; O2 not utilized in tissues, less unloading of O2 from Hb, oil of bitter almonds odor; difficulty breathing, irregular heartbeat, uncontrolled movement, convulsions, coma
What poisoning would you suspect? |
|
Definition
|
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Term
| How would you treat cyanide poisoning? |
|
Definition
Administer antidote(s) - Sodium nitrite and sodium thiosulfate to compete with cytochrome oxidase for cyanide and eliminated, then gastric lavage if ingested
(death in seconds to minutes due to respiratory arrest) |
|
|
Term
| **Methanol is converted to _________ by alcohol dehydrogenase which causes? |
|
Definition
formic acid'
blindness, metabolic acidosis, coma, death |
|
|
Term
| *Overdose of acetaminophen causes ______ by being modified by _______ |
|
Definition
|
|
Term
| *How would you treat an overdose of acetaminophen? |
|
Definition
| increase production of glutathione |
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|
Term
| Where is arsenic metabolized and eliminated? |
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Definition
| Toxicity proportional to accumulation in the body: metabolized in the liver and eliminated mostly in urine |
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Term
| Where are arsenic levels a major concern? |
|
Definition
|
|
Term
| If a patient has abrupt onset of gastroenteritis (pain, nausea, vomiting, diarrhea); hypotension and metabolic acidosis, Muscle weakness & aching; edema; renal & liver damage; “pins & needles” with stocking-glove distribution, and small "corns" on their palms, what type of poisoning do you suspect this person to have? |
|
Definition
|
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Term
| *How do you treat arsenic poisoning? |
|
Definition
| chelation therapy with succimer |
|
|
Term
| *How do you treat lead poisoning? |
|
Definition
succimer (same to treat arsenic)
Thiol group will chelate heavy metals |
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|
Term
| How would you diagnose someone for lead poisoning? |
|
Definition
| blood levels of lead (and also affects CNS-clumsiness, falling, etc.) |
|
|
Term
| Why is succimer effect in treating metal poisoning? |
|
Definition
Does not release metal in urine
Does not increase excretion of essential metals,
e.g., Zn, Cu, Fe
Does not enter cells |
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