Term
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Definition
1.biotransformation to toxic metabolite, NAPQI--immediate binds PRO=necrosis, & have low glutathione
2. malnutrition/ETOH, CYP-inducers/ETOH, OD; 4 phases - most die in phase 3; see high PLASMA APAP early, high LFTs late
3. N-acetylcysteine, Liver Transplant (Kings College Criteria) |
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Term
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Definition
1. uncouples oxidative phos after switch to Zero Order = incr metabolism = heat aka hyperthermia! also pylorospasm
2. mixed metabolic acidosis/resp alk, Renal Failure;
ACUTE: Acid/Base, Neuro, Pulmonary edema, FEVER, TINNITUS
CHRONIC: fever+altered mental+pulm edema
3. Serum/Urine Alkalinize with Sodium-Bicarb, Dialysis |
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Term
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Definition
1.metabolite alcohol ketoacidosis; incr NADH:NAD+ = make b-hydroxybutyrate ketones, inseatd of preferred acetoacetate
2. Chronic use + malnourished + dehydrated; CNS depression, tachycardia, low bicarb, belly pain
3. fluids, glucose, feed; benzos for alc addiction |
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Term
| Methanol (Windshield washer) |
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Definition
1.acidosis with OCULAR damage & CNS damage; metabolized to formaldehyde slowly, then to formic acidy quickly = ETC inhibited
2.elevated osmol gap, anion gap acidosis, visual problems, CNS strokes; NO KETOSIS
3. compete with ETOH or 4-methylpyrazole & dialysis |
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Term
| Ethylene Glycol (antifreeze) |
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Definition
1. Profound Acidosis (tons of acidic metabolites) with Renal failure; oxalic acid metabolite directly nephrotoxic--Ca Oxalate cystals precipitate
2. alterned mental + big anion gap, acidosis, real failure, crystals; NO KETOSIS
3. compete with ETOH or 4-methylpyrazole & dialysis |
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Term
| Isopropyl Alcohol (rubbing alc) |
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Definition
1. a "stinky" Ketosis with acidosis; GI irritant, metabolized directly to acetoacetate
2. profund ketosis with NO ACIDOSIS
3.support, rarely dialysis |
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Term
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Definition
1.inhibit CYPs--shut down oxid. phosph. = HYPOthermia, incr lactate; binds Hb
2. Fire/Furnace; incr venous PaO2, refractory shock, lactic acidosis
3. hyperbaric O2, supplemental O2 |
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Term
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Definition
1.inhibit CYPs--shut down oxid. phosph. = HYPOthermia, incr lactate2.
2.fruit pits/nitroprusside; incr venous PaO2, refractory shock, lactic acidosis
3. amyl- or Na-nitrate + sodium thiosulfate; or hydroxocobalamin |
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Term
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Definition
1.inhibit CYPs--shut down oxid. phosph. = HYPOthermia, incr lactate
2. Manure/Sewage; incr venous PaO2, refractory shock, lactic acidosis
3. amyl- or Na-nitrate and O2 |
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Term
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Definition
1. block phase 0, fast Na-ch = prolong phase 0 with widened QRS--begins to look like VTach but not HR change since I(f) not affected usually
2. wider QRS = more toxic; hypotension, decr CO, bradycardia pre-death bc now hitting I(f)
TCAs, Class I anti-arryth, local anesth, chloroquine, antihistamines, b-Blockers
3. Sodium Bicarbonate, more Na to channels and fix acidosis |
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Term
| Potassium Efflux Blockers |
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Definition
1. Prolonged QT via delayed Phase 3 repolarize (TORSADES!); Class I Antiarryth, antipsychotics, antibiotic, antihistamines, Antidepressants, methadone
2. Risks with hypokalemia hypomagnesemia, and bradycardia
3. fix K+ levels + give Mg; beta1-agonist or pacemaker if needed |
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Term
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Definition
1. block L-Type: phase 0 and 4 of pacemakers, phase 2 of myocytes, and vascular smooth muscle cells
2.Verapamil, diltiazem, amolodipine, felodipine; = bradycardia+hypoTN+ HYPERGLYCEMIA (islet L-type block)
3. Give Ca++, insulin, pressors for BP |
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Term
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Definition
1. decr phase 4 of pacemakers; Propranolol-also blocks Na-ch = WORST toxicity; labetalol-also blocks a1-Rs on periph vessels
2. Sever hypoTN-labetolol; Hypoglycemia, esp in kids
3. out-compete with beta agonist, atropine, glucagon-mimics beta agonists w/o need for receptor binding |
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Term
| Na/K ATPases (oleander, digoxin) |
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Definition
1.block Na/K-->Na/Ca = incr INTRAcell Ca and Na and incr myocardial contraction; incr vagal PSNS tone=decr HR
2. high levels cause PVCs-->arrythmia; Color vision changes, HypoTN, bradycardia/depressed contract early on; Get serum K(predictive) and digoxin levels!
3. digoxin-specific polyclonal antibody fragments (Fab) aka Digibind; atropine, lidocaine |
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Term
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Definition
1.Heme synthase enzymes affected; microcytic anemia--basophilic stippling, cerebral edema; chronically: Gout, Renal tox, HTN
2. Lead lines, zinc protoporphyrin incr, incr blood lead levels
3. Chelate with DMSA, BAL, or Edetate and remove exposure |
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Term
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Definition
1.Acute - resp failure, Chronic - acrocynia, erethism (personality)
2.Inhalation of Hg Vapors
3. DMSA Chelation |
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Term
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Definition
1.HG interacts with sulfhydryl groups
2. GI bleed, diarrhea, renal failure - not Neurologic
3. DMSA Chelation |
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Term
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Definition
1. methylmercury crosses the BBB - NEUROtoxic: numbness, visual field defects, ataxia, tremor, progressive cog decline--resp failure; Minamata disease to neonates
2.eating infected seafood, vaccinations
3.DMSA Chelation |
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Term
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Definition
1. Inorganic (water) and Gaseous forms = bad! Inorganic = blocks pyruvate DG of ETC; Gas = hemolysis
2. GI, Cardiac problems-->peripheral nerve damage;
Chronic = hyperkeratosis, hyperpigmentation on palms/soles; Mees' Lines... can cause CANCER!
3. DMSA or BAL chelation |
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Term
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Definition
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Term
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Definition
Allopecia
Tx - Prussian Blue |
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Term
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Definition
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Term
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Definition
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Term
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Definition
Dementia
Tx - deferoxamine |
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Term
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Definition
| Dermal discoloration (aka Argyria) |
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Term
Methamphetamine, Ephedra, Cocaine
"Stimulants" |
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Definition
1. Crack Dance-Chorea, Formication, Fatal Hyperthermia, Dental Decay
2.fight/flight; incr BP, HTN, Hyperglycemia
3. Benzos, Haloperidol |
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Term
Benzos (alprazolam, diazepam, lorazepam)
GABA-A "Sedatives" |
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Definition
1. Depressed CNS - unresponsive/coma; hypothermic
2.
3. supportive, or flumazenil(dangerous) |
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Term
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Definition
1. Depressed CNS - unresponsive/coma; hypothermic
2.
3. supportive |
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Term
| Opiates: Morphine, Codeine |
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Definition
1.mu receptors: pinpoint pupils, GI dysmotility, resp depression
2.
3. Naloxone; mixed-pentazocine, partial ag-buprenorphine |
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Term
| Opioids: heroin, dilaudid, hydrocodone, diphenylpropylamine, phenylpiperidine |
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Definition
1.mu receptors: pinpoint pupils, GI dysmotility, resp depression
2.
3. Naloxone; methadone for heroin addiction |
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Term
| Inhaled Hydrocarbons - toluene/turpentine |
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Definition
1. kills neurons; sudden death with halogenated ones via cardiac sensitization; renal tubular acidosi; metHb with nitrite; B12 deficiency syndrom in nitrous oxide
2. pass out with sudden startle
3. nothing specific; counseling! |
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Term
Hallucinogens - Serotonergic Agonists
tryptamines, ergolines(LSD), phenethylamine(MDMA Ecstasy), Mescaline |
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Definition
1.Club drug - Serotonin Agonist
2. "hearing colors" "smelling lights", mydriasis
3. sympathomimetic type tx; atypical antipsychotics |
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Term
| Hallucinogens - NMDA receptor Antagonists: PCP, Ketamine, dextromethorphan |
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Definition
| 1.NMDA-r antagonist 2. dissociative anesthesia; myoclonus, NYSTAGMUS, act psychotic, DROOLING, Super-human strength... chronically - mental illness 3. benzos, NE-RI's, D-RI's, Nic-agonist, Muscar-agonist... incr catechols |
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Term
Hallucinogens - Cannabinoids
marijuana, Spice/K2 |
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Definition
1.Hunger hallucinogen, tachycardic; seizures/syncope
2.
3. same as for adrenergic toxicity |
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