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Tox
Tox
66
Veterinary Medicine
Graduate
01/29/2012

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Cards

Term
Name some compounds that either are acidic or have acicidc metaboits
Definition
salicyate, ethyene gycl, metaldehyde or methanol
Term
Name some toxic compounds that may require the patient to have respiratory support
Definition
barbiturates, anticoagulat rodenticides, methemogobin-inducting intoxicants (ie. acetaminophen in cats)
Term
How would you treat toxin-induced acidosis in a patient?
Definition
IV infusion w/ NaHCO3 slowly over 1-3 hrs
NOTE: Rapid IV infusion can lead to paradoxical CNS acidosis
Term
What are some causes of metaboic alkalosis (tho rare) in patients?
Definition
excess vomiting, D3 poisoning or hypercalcemia, citrated whole blood
Term
How would you treat metabolic alkalosis?
Definition
infusion with 0.9% normal saline
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

Term
Atrial standstill (hyperkalemia) can be caused by which toxicants?
Definition
K+-sparing diuretics, Lithium, NSAIDs, digitalis glycosides, amphetamine-related intoxicants
Term
Generalized seizures are typically cause by which toxins?
Definition
clorinated HCs, strychnine, metaldehyde, OPPs/carbamates, amphetamine, tremorgenic mycotoxins, lysergic dethyl amide (LSD)
Term
Generalized seizures are typically cause by which toxins?
Definition
clorinated HCs, strychnine, metaldehyde, OPPs/carbamates, amphetamine, tremorgenic mycotoxins, lysergic dethyl amide (LSD)
Term
How would you treat generalized seizures caused by toxicants?
Definition
Diazepam (first choice), Phenobarb, Pentobarb

NOTE: Phenothiazine tranquilizers should be AVOIDED as they can cause profound CNS depression or seizures

Term
Which toxicants can cause excessive CNS depression?
Definition
Barbiturates & Opiates
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
Term
In re-evaulating an intoxicated patient after stabilization, which samples/tests should be performed for toxicologic analysis?
Definition
CBC/Chem, U/A

vomitus is helpful too

Term
In preventing further absorption of a toxicant, emesis should be induced if?
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
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)

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)

Term
Which toxins are known to cause Malignant Hyperthermia?
Definition
Hops & those that cause uncoupling of oxidative phosphorylation (pentachlorophenol, dinitrophenol)
Term
What would you use to treat toxicant-induced cerebral edema?
Definition
Mannitol
Term
What would you used to treat intoxicant-induced mucosal ulceration/protect the GIT?
Definition
Sucralfate, Misoprostol, Cimetidine, Rinatidine
Term
What is used to enhance excretion of toxic compounds that undergo extensive enterohepatic recirculation?
Definition
Ion exchange resins (Cholestyramine)
Term
Name 3 intoxicants which are known to undergo extensive enterohepatic reciculation?
Definition
warfarin, digitalis glycosides, thyroid preparations
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
Term
What are some examples of weakly basic intoxicants in which ion trapping would be beneficial? (ie. trapped in acidic urine)?
Definition
amphetamines
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

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

Term
What is the antitdote v. acetaminophen toxicity?
Definition
N-acetylcysteine, Methylene blue
Term
What is the antitdote v. anticoagulant rodenticide toxicity?
Definition
K1
Term
What is the antitdote v. arsenic toxicity?
Definition
Dimercaprol (BAL)
Term
What is the antitdote v. cholecalciferol toxicity?
Definition
Pamidronate disodium, Salmon calcitriol
Term
What is the antitdote v. copper toxicity?
Definition
D-penicillamine, Trientine (Cuprid)
Term
What is the antitdote v. ethylene glycol toxicity?
Definition
4-methyl pyrazol
Term
What is the antitdote v. lead toxicity?
Definition
Calcium disodium, EDTA, Succimer
Term
What is the antitdote v. OPP/carbamate toxicity?
Definition
atropine, 2-PAM (pralidoxime chloride)
Term
What is the antitdote v. iron salts toxicity?
Definition
Deferoxamine mesylate (Desferol)
Term
Which toxicants cause NPN toxicosis and Hepatic encephalopathy?
Definition
ammonia (serum)
Term
Which toxicants cause urinary casts?
Definition
Aminoglycosides, arsenic, cadmium, mercury, *Oak

MAC-Oak + AGs

Term
Which toxicants are known to cause methemoglobin?
Definition
Red maple, copper, nitrates, acetaminophen, *chlorate herbicides
Term
Which toxicants are known to cause iron toxicosis?
Definition
iron (serum) & TIBC
Term
Which toxicants are known to cause iron toxicosis?
Definition
iron (serum) & TIBC
Term
Which toxicants are known to cause hypoprotenemia?
Definition
aflatoxin
Term
Which toxicants are known to cause hypocalcemia?
Definition
antifreeze, *oxalate plant poisoning
Term
Which toxicants are known to cause hyperalcemia?
Definition
Vitamine D3, *day-blooming Jessamine
Term
Which toxicants are known to cause hyperkalemia?
Definition
Digitalis glycosides, *Oleander, NSAIDS
Term
Which toxicants are known to cause hyperosmolarity?
Definition
Antifreeze, Aspirin, Ethanol, Propylene glycol
Term
Which toxicants are known to cause hemolysis?
Definition
Garlic, ionion, red maple, copper,, zinc, phenothiazine anthelmintics
Term
Which toxicants are known to cause crystalluria?
Definition
antifreeze; *oxalate plants
Term
Which toxicants are known to cause coagulopathy (PT, PTT)
Definition
*moldy sweet clover, antigoaculant rodenticides, prolonged toxic liver disease
Term
Which toxicants are known to cause GGT increase?
Definition
aflatoxin, fumosins, pyrrolizidine alkaloides, glucocoricoids (GCCs)

AFP

Term
Which toxicants are known to cause CK increase?
Definition
ionophores (monensin, lasalocid, *White snake root, *Cassia spp.
Term
Which toxicants are known to cause cholinesterterase?
Definition
OPPs, *Blue-green algae, *Solanum plants
Term
Which toxicants are known to affect bile acids?
Definition
aflatoxin
Term
Which toxicants are known to cause carboxyhemoglobin?
Definition
CO (buildings, trailers)
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

Term
What are warfarin, diphacinone, chlorophacinone?
Definition

Forumulated at 0.005%

Term
What are Brodifacoum, Bromadiolone, Diphenthialone?
Definition
Second generation rodenticides

Formulated at 0.005%

Term
Which toxicant causes acute effects including tremors and rigidity?
Definition
strychnine
Term
Which toxicant causes vomiting, running, and seizures?
Definition
Zinc phosphide
Term
Which toxicant causes delayed signs with tremors and ataxia?
Definition
Bromethalin
Term
Which toxicant causes SLUDD and tremors?
Definition
OPP/Carbamates
Term
Which toxicant causes acute and continuous tremors?
Definition
pyrethrins
Term
Which toxicant causes increased HR, tremors and hyperesthesia?
Definition
A-aminopyridine
Term
Which toxicant causes diarrhea, tremors, and increased temperatures?
Definition
Penitrem A
Term
Which toxicant causes peracute symptoms with salivation and diarrhea?
Definition
Blue-green algae
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