Term
| Name some compounds that either are acidic or have acicidc metaboits |
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Definition
| salicyate, ethyene gycl, metaldehyde or methanol |
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Term
| Name some toxic compounds that may require the patient to have respiratory support |
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Definition
| barbiturates, anticoagulat rodenticides, methemogobin-inducting intoxicants (ie. acetaminophen in cats) |
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Term
| How would you treat toxin-induced acidosis in a patient? |
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Definition
IV infusion w/ NaHCO3 slowly over 1-3 hrs
NOTE: Rapid IV infusion can lead to paradoxical CNS acidosis |
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Term
| What are some causes of metaboic alkalosis (tho rare) in patients? |
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Definition
| excess vomiting, D3 poisoning or hypercalcemia, citrated whole blood |
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Term
| How would you treat metabolic alkalosis? |
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Definition
| infusion with 0.9% normal saline |
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Term
| How would you treat bradycardia?
A-V block?
Atrial standstill? - what is this caused by?
VPCs? |
|
Definition
| Glyco, Atropine
Atropine, Dopamine
Atrial standstill is often caused by hyperkalemia; Normal saline or NaHCO3 to correct hyperkalemia may eliminate this
Dog: Lidocaine or phenytoin; Cats Propanolol
NOTE: Lidocaine can cause methemoglobinemia, CNS toxicity, and cardiotoxicity in cats & Phenytoin causes prolonged sedation, ataxia, and anorexia in cats |
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Term
| Atrial standstill (hyperkalemia) can be caused by which toxicants? |
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Definition
| K+-sparing diuretics, Lithium, NSAIDs, digitalis glycosides, amphetamine-related intoxicants |
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Term
| Generalized seizures are typically cause by which toxins? |
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Definition
| clorinated HCs, strychnine, metaldehyde, OPPs/carbamates, amphetamine, tremorgenic mycotoxins, lysergic dethyl amide (LSD) |
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Term
| Generalized seizures are typically cause by which toxins? |
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Definition
| clorinated HCs, strychnine, metaldehyde, OPPs/carbamates, amphetamine, tremorgenic mycotoxins, lysergic dethyl amide (LSD) |
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Term
| How would you treat generalized seizures caused by toxicants? |
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Definition
| Diazepam (first choice), Phenobarb, Pentobarb
NOTE: Phenothiazine tranquilizers should be AVOIDED as they can cause profound CNS depression or seizures |
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Term
| Which toxicants can cause excessive CNS depression? |
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Definition
|
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Term
| How would you treat excessive CNS depression due to intoxication? |
|
Definition
Naloxone +/- Doxopram
NOTE: These two are rapidly metabolized so use increased dosages & increased frequency of dosings |
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Term
| In re-evaulating an intoxicated patient after stabilization, which samples/tests should be performed for toxicologic analysis? |
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Definition
| CBC/Chem, U/A vomitus is helpful too |
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Term
| In preventing further absorption of a toxicant, emesis should be induced if? |
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Definition
| the patient has not yet vomited, the compound is not causeic (pH <4, >8) or a light fraction HC, the animal is alert and unlikely to seizure, and if, preferrably, presented within 1-2 hrs of ingestion |
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Term
| Which compounds can be used to induce emesis? which is the first choice for its respective species? |
|
Definition
| Dogs: Apomorphine (first choice), syrup of ipecac, 3% H2O2
NOTE: AVOID apomorphine in CATS Xylazine is first choice for cats, syrup of ipecac, & H2O2 also
NOTE: Syrup of ipecac should be removed via stomach lavage if no vomiting occurs within 15-20 minutes as it is cardiotoxic NOTE: Xylazine causes respiratory depression and bradycardia (Yohimbine reversal) |
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Term
| After emesis has been successful, what is therapy is recommended? |
|
Definition
| Activated charcoal + osmotic cathartic
NOTE: Activated charcoal alone may cause constipation so an osmotic cathartic is highly recommended
SuperChar-Vet contains sorbital (omsmotic cathartic) Can use a saline catharic: Na Sulfate or Mg Sulfate M Another option (v. cathartics) would be a gastric lavage especially for comatose patients or those prone to seizures, where emesis is unsucessful, or in cases when the ingested toxicant is known to delay gastric emptying (ie. TCA antidepressants) |
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Term
| Which toxins are known to cause Malignant Hyperthermia? |
|
Definition
| Hops & those that cause uncoupling of oxidative phosphorylation (pentachlorophenol, dinitrophenol) |
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Term
| What would you use to treat toxicant-induced cerebral edema? |
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Definition
|
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Term
| What would you used to treat intoxicant-induced mucosal ulceration/protect the GIT? |
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Definition
| Sucralfate, Misoprostol, Cimetidine, Rinatidine |
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Term
| What is used to enhance excretion of toxic compounds that undergo extensive enterohepatic recirculation? |
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Definition
| Ion exchange resins (Cholestyramine) |
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Term
| Name 3 intoxicants which are known to undergo extensive enterohepatic reciculation? |
|
Definition
| warfarin, digitalis glycosides, thyroid preparations |
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|
Term
| What are some examples of weakly acidic intoxicants in which ion trapping would be beneficial? (ie. trapped in alkaline urine) |
|
Definition
| salycilates, ethylene glycol, barbiturates |
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Term
| What are some examples of weakly basic intoxicants in which ion trapping would be beneficial? (ie. trapped in acidic urine)? |
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Definition
|
|
Term
| How would you achieve urine alkalinization? acidification? |
|
Definition
| NaHCO3 via IV fluids (ie. normal saline) ammonium chloride NOTE: acidification of urine is contraindicated if hemolysis or myoglobinuria are present as this may potentiate hemoglonbin-induced nephrotoxicity Hemodialysis can also be performed |
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|
Term
| When is hemodialysis beneficial? |
|
Definition
| beneficial v. low molecular weight, water-soluble compounds with low protein binding. This may also be beneficial in patients with renal failure or with a potentially lethal exposure dosage of intoxicant.
salicylate, baribturates, ethylene glycol, lithium, and theophylline toxicosis |
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|
Term
| What is the antitdote v. acetaminophen toxicity? |
|
Definition
| N-acetylcysteine, Methylene blue |
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|
Term
| What is the antitdote v. anticoagulant rodenticide toxicity? |
|
Definition
|
|
Term
| What is the antitdote v. arsenic toxicity? |
|
Definition
|
|
Term
| What is the antitdote v. cholecalciferol toxicity? |
|
Definition
| Pamidronate disodium, Salmon calcitriol |
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|
Term
| What is the antitdote v. copper toxicity? |
|
Definition
| D-penicillamine, Trientine (Cuprid) |
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|
Term
| What is the antitdote v. ethylene glycol toxicity? |
|
Definition
|
|
Term
| What is the antitdote v. lead toxicity? |
|
Definition
| Calcium disodium, EDTA, Succimer |
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|
Term
| What is the antitdote v. OPP/carbamate toxicity? |
|
Definition
| atropine, 2-PAM (pralidoxime chloride) |
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|
Term
| What is the antitdote v. iron salts toxicity? |
|
Definition
| Deferoxamine mesylate (Desferol) |
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|
Term
| Which toxicants cause NPN toxicosis and Hepatic encephalopathy? |
|
Definition
|
|
Term
| Which toxicants cause urinary casts? |
|
Definition
| Aminoglycosides, arsenic, cadmium, mercury, *Oak MAC-Oak + AGs |
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|
Term
| Which toxicants are known to cause methemoglobin? |
|
Definition
| Red maple, copper, nitrates, acetaminophen, *chlorate herbicides |
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|
Term
| Which toxicants are known to cause iron toxicosis? |
|
Definition
|
|
Term
| Which toxicants are known to cause iron toxicosis? |
|
Definition
|
|
Term
| Which toxicants are known to cause hypoprotenemia? |
|
Definition
|
|
Term
| Which toxicants are known to cause hypocalcemia? |
|
Definition
| antifreeze, *oxalate plant poisoning |
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|
Term
| Which toxicants are known to cause hyperalcemia? |
|
Definition
| Vitamine D3, *day-blooming Jessamine |
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|
Term
| Which toxicants are known to cause hyperkalemia? |
|
Definition
| Digitalis glycosides, *Oleander, NSAIDS |
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|
Term
| Which toxicants are known to cause hyperosmolarity? |
|
Definition
| Antifreeze, Aspirin, Ethanol, Propylene glycol |
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|
Term
| Which toxicants are known to cause hemolysis? |
|
Definition
| Garlic, ionion, red maple, copper,, zinc, phenothiazine anthelmintics |
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|
Term
| Which toxicants are known to cause crystalluria? |
|
Definition
| antifreeze; *oxalate plants |
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|
Term
| Which toxicants are known to cause coagulopathy (PT, PTT) |
|
Definition
| *moldy sweet clover, antigoaculant rodenticides, prolonged toxic liver disease |
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|
Term
| Which toxicants are known to cause GGT increase? |
|
Definition
| aflatoxin, fumosins, pyrrolizidine alkaloides, glucocoricoids (GCCs)
AFP |
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|
Term
| Which toxicants are known to cause CK increase? |
|
Definition
| ionophores (monensin, lasalocid, *White snake root, *Cassia spp. |
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|
Term
| Which toxicants are known to cause cholinesterterase? |
|
Definition
| OPPs, *Blue-green algae, *Solanum plants |
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|
Term
| Which toxicants are known to affect bile acids? |
|
Definition
|
|
Term
| Which toxicants are known to cause carboxyhemoglobin? |
|
Definition
|
|
Term
| Which toxicants are known to cause basophilic stippling? |
|
Definition
| lead (inconsistent in equines) |
|
|
Term
| Which toxicants are known to cause azotemia? |
|
Definition
| antifreeze, oak, *oxalate plants, arsenic, cadmium, mecury |
|
|
Term
| Which toxicants are known to cause AST< ALT, LDH increase |
|
Definition
| PHENYLBUTAZONE, cloramphenicol, gasoline, petroleum solvents, **trichotecene mycotoxins |
|
|
Term
| Which toxicants are known to cause AST, ALT, LDH increase? |
|
Definition
| aflatoxin, fumosins, pyrrolizidine alkaloids, *Cocklebur, *lantana, *moldy alfalfa hay, *blue-green algae, amantia mushrooms :AFP + CLAMB |
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|
Term
| What are warfarin, diphacinone, chlorophacinone? |
|
Definition
|
|
Term
| What are Brodifacoum, Bromadiolone, Diphenthialone? |
|
Definition
| Second generation rodenticides Formulated at 0.005% |
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|
Term
| Which toxicant causes acute effects including tremors and rigidity? |
|
Definition
|
|
Term
| Which toxicant causes vomiting, running, and seizures? |
|
Definition
|
|
Term
| Which toxicant causes delayed signs with tremors and ataxia? |
|
Definition
|
|
Term
| Which toxicant causes SLUDD and tremors? |
|
Definition
|
|
Term
| Which toxicant causes acute and continuous tremors? |
|
Definition
|
|
Term
| Which toxicant causes increased HR, tremors and hyperesthesia? |
|
Definition
|
|
Term
| Which toxicant causes diarrhea, tremors, and increased temperatures? |
|
Definition
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|
Term
| Which toxicant causes peracute symptoms with salivation and diarrhea? |
|
Definition
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