Term
| What are the most common toxicities in vet med? |
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Definition
-Human meds: OTC, anti-depressants, ADHD
-Insecticides: cats
-Rodenticides
-People food: xylitol, grapes, raisins, onions, garlic
-Vet meds
-chocolate
-household toxins
-plants
-herbicides
-outdoor toxins |
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Term
| What is your first thought in a toxicity case? |
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Definition
| -ABC's: Airway, Breathing, Circulation |
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Term
| What are the 4 decontaminaiton goals? |
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Definition
-eliminate toxin
-limit absorption
-promote excretion
-prevent reabsorption |
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Term
| What is the first step with ocular decontamination? Follow up treatment? |
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Definition
-flush eye(s) with water or saline for min of 20-30 mins from inner corner out
-then treat with lubricant ointments and examine cornea for damage |
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Term
| HOw do we approac a topical deconatamination? |
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Definition
-gloves + E-collar
-wash with Dawn and rinse well with warm water
-towel dry!!! |
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Term
| How do we approach oral dilution decontamination? WHat agents can we use to soothe the stomach? |
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Definition
-dilution with milk or water in combo with demulcents in cases of corrosive ingestion
-demulcents to coat stomach: Kaopectate and Mylanta |
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Term
| What are the 5 major methods of gastric decontamination? |
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Definition
-emesis
-activated charcoal admin
-cathartics/enema
-gastric lavage
-whole bowel irrigation (WBI) but not often not recommended due to side effects |
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Term
| Describe the time constraints of emetic GID. |
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Definition
| -anything after 4 hrs past ingestion is probably useless |
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Term
| IN addition to time constraints, what other concerns do we have with emetic GID? |
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Definition
-productive emesis requires food presence in stomach
-only removes 40-60% of stomach contents |
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Term
| When is emesis contraindicated? |
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Definition
-corrosive materials, caustic materials, petroleum distillates, volatile materials
-in patients with: dec mentation, dec consciousness, alck of gag reflex, having or likely to have seizures, IF THE PATIENT HAS ALREADY VOMITED |
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Term
| What are some centrally acting emetics? Locally acting? |
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Definition
-Apomorphine, Syrup of Ipecac, XYlazine
-ydrogen peroxide, syrup of Ipecac |
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Term
| Can we repeat doses of Syrup of Ipecac? |
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Definition
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Term
| What is the emetic of choice in dogs? Possible side effects? Reversal agent? |
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Definition
-Apomorphine
-CNS/resp depression, ataxia, excitement, protracted vomiting (more common with IV dose)
-reversible with Naloxone |
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Term
| What is the emetic of choice in cats? Possible side effects? Reversal agent? |
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Definition
-Xylazine
-Bradycardia, hypotension, reduced resp rate, and CNS depression
-Yohimbine |
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Term
| How does activated charcoal work? What is it used for? |
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Definition
-absorbs and holds chemicals to its surface, facilitates excretion without further absorption
-used for organic poisons, chemicals or bacterial toxins or if enterohepatic recirculation of is a concern |
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Term
| In which general cases would activated charcoal be beneficial greater than 2 hours post-ingestion? |
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Definition
-dec gastric motility is present
-large volume of toxin
-toxins that undergo entero-hepatic recirculation
-delayed release capsules |
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Term
| What are the contraindications of activated charcoal? |
|
Definition
-abnormal mentation
-hydrocarbon ingestion
-GI tract perforation |
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Term
| What are a few examples of administration techniques for activated charcoal? |
|
Definition
-voluntary consumption
-syringe feeding
-nasogastric tube
-orogastric tube |
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Term
| What agents do we use for enema GID? |
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Definition
-saline cathartic
-sorbitol
-colonic lavage |
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Term
| What are the indications for gastric lavage? |
|
Definition
-intoxication where the amount of toxin ingested is potentially harmful
-ingested within one hour of performing GL
-emesis cannot be achieved due to altered mentation or neuro signs |
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Term
| What are the contraindications/risks of gastric lavage? |
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Definition
-ingestion of small amount of toxin or previous emesis (exception = snail bait)
-ingestion of caustic or volatile substances
-risks: general anesthesia, aspiration, GI tract trauma |
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Term
| How are absorbed toxins generally excreted? What other routes are possible? |
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Definition
-usually excreted by the kidneys
-but also bile/feces, lungs, body secretions |
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Term
| HOw can we manipulate urinary excretion of absorbed toxins? |
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Definition
| -diuretics and drugs that alter urinary pH |
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Term
| What are the two huge requirements of diuretic administration? |
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Definition
| -maintenance of adequate renal function and hydration |
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Term
| What are the most commonly used diuretics? |
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Definition
|
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Term
| What do we use as a urinary acidifier? |
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Definition
| -Ammonium chloride, Ethylenediamine dihydrochoride, physiologic saline |
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Term
| What do we use as a urinary alkalinizer? |
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Definition
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Term
| Describe the supportive care for a toxicity case? |
|
Definition
-control body temp
-maintain resp and CV function
-control acid base imbalances
-control CNS disorders
-alleviate pain |
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