Toxicology 2 Flashcards

Terms Definitions
Methanol
HA
BLIINDNESS
Methanol
Fomepizole
EtOH
Identify.
Pigweed
carbamate ex
sevin
Anticoagulants
Seizures (rare)
Hemorrhage
Coagulopathy
Paralysis (rare)
Delayed onset
heparin
protamine sulfate
TCA
(amitryptiline)
Anticholinergic
QT, PR, QRS prolongation, tachy
Extrapyramidals
RIGIDITY, ophthalmoplegia
TCA
(amitryptiline)
Charcoal
HCO3 (arrhythmia stabilization)
Guarana
Decrease Adenosine
Decrease PDE
Increase Ca++
Increase NE
Potential teratogenicity
Vomiting, hyperactivity, tachycardia
Decontamination
Control seizures - don't use Diazepam if Ma Huang present
lead
succimer, EDTA, dimercaprol
Name the plant.
Rhododendron
heavy metal treatment
chelation therapy
Methemoglobin
Methelyne BLUE

Alternative
Vitamin C
Paintballs
Polyethylene glycol
Colorful poop
No Activated Charcoal
Emesis
Monitor acidosis
zearlenone spp affected
cattle, swine
AKA for anti-psychotic drugs
Neuroleptics
zhu sha
contains mercury sulfide
duration of opiates?
1-3 days
source: cleaning materials, solvents, paints, varnishes, sterno fuel, fomaldehyde solutions, antifreeze, gasohol, moonshine, windshield washer fluid, duplicating fluids
Methanol
Anticholinergics
(ipraTROPIUM, atropine)
Dry mouth
Urinary retention
QRS widening
Anticholinergics
(ipraTROPIUM, atropine)
Physostigmine (cholinesterase inhibitor)
Amphetamines (basic)
NH4 CL (acidify urine)
TRUE/FALSE: Most toxicoses associated with household fertilizers are non-lethal and involve dogs more than cats.
TRUE!
Muscarinic Mushrooms
Ach effects
SLUDDE
Rabbits are resistant
Give Atropine
What is covalent binding?
-electophilic metabolites
Name a blood thinner
-warfarin (Coumadin)
Shi gao contains what mineral?
Clacium
avicide, rapid, rapid, rapid, blocks K+ channels, increased release of ACh, tremors, seizures, cardiac arrhythmias, death, seizure control, AC/SC, propranolol
4-aminopyridine
glucose use
treat hypoglycemia (acute ethanol intox)
TLV?
Threshold limit value -
Concentration below which there is no expected untoward effect over a period of 8 hrs.day, 5 days/wk
Hemolytic anemia is an autoimmune diease (t/f)
true
Mercury
(elemental in instruments. Salts used as amalgum,
battaries, Fish, fireworks
electroplating
Acute vapor inhalation: C/P dyspnea, pneumonitis

Acute: Inorgani salt ingestion- Hemmorhagic gastroenteritis acute Tubular Necrosis Shock
Mercury
(elemental in instruments. Salts used as amalgum,
battaries, Fish, fireworks
electroplating
Dimercaperol
or Succimer
Dioxin-TCDD
byproduct of industrial processes of germicide and herbicides, also found in AGENT ORANGE(fucked up vietnam with this fucker)

almost 100% mortality

A/E: CHLORACNE! LIVER DAMAGE, RISK OF GI AND LYMPHATIC CANCER, CV RISK
Problem with warfarin
some rodents are resistant
MOA of bromethalin
Uncoupling of oxidative phosphorylation, resulting in loss of ATP
In pts with organophosphate poisoning, large doses of this drug are frequently needed to dry tracheobronchial secretions. What is this drug?
atropine
organophosphorus carbamate insecticides mech of action
acetylcholinesterase inhibitor --> increased acetylcholine
Which drug can occasionally interfere with the normal heartbeat, causing irregular heartbeats or skipped beats?
Digitalis
Ren shen
contraindicated in hypertension, and can lower blood sugar so use with caution in diabetics. Not recommended in large does during pregnancy or breast feeding. May reduce the anticoagulative effect of warfarin.
meprobamate fits into which toxidrome?
opiate, sedative-hypnotic
antipsychotic meds fits into which toxidrome?
anticholinergic
Synergist.
Why have the makers of Kelthane recently reformulated this common miticide?
apomorphine disadvantages
respiratory depressant, so can be supplemented with naloxone to block the emetic and respiratory effects after emesis
Symptoms: drowsiness, tremor & rigidity, orthostatic hypotension, and hypothermia (poikliothermia),
Toxicon: Phenothiazines

Treatment: gastric lavage, Activated charcoal
T cells are processed through the ______
thymus
WHo is the father of toxicology?
Bonaventura Orfila
What is the RFW, or biological effectivenesss factor, of alpha radiation
20
What is the Wr for beta radiation
1.0
What is the chemical name for Lindane?
hexachlorocyclohexane
Water Deprivation/Sodium Ion Toxicosis
Sodium ion toxicosis
Excess sodium
Water depreivation
Crosses into CSF
Cerebral edema
Neurologic signs
Eosinophilic perivascular cuffing (swine)
NO Activated charcoal
Control seizures
Rehydrate slowly
If you see hypoglycemia and CNS depression, what toxic agent can you assume is the culprit?
Rotenone
Pine oils and phenols are particularly bad for ____ because they are deficient in glucuronide conjufation.
cats
What is neoplasia?
-the process of neoplastic growth
What cell types have high susceptibility? time frame?
-neurons
-3-5 min
What are the effects of antihistamine OD?
seizures
Which is more safe? Barbiturates or benzodiazepines?
Benzodiazepines
Da huang
contra indicated in pregnancy and intestinal obstruction, IBDS, and appendicitis and abdominal pain of unknown origin.
which types of antidotes are most dangerous?
cholinergics
Removal and adsorption; supportive care; hemodialysis
Name 2 toxic hydrocarbons.
CO treatment
remove victim from exposure, admin O2, no pharmacologic trtmnts
base tissue contact
saponify fats and cause liquefactive necrosis (deeper and more severe than acid burn)
Which of the following ingestions is associated with GI hemorrhage
a. lithium
b. iron
c. phosphorus
d. arsenic
b. iron
Toxicon: Phenytoin MOA
Mechanism of Action: sodium channel blocker, decreases neuronal excitability.
Name the three types of immune responses
*Immunosuppresion
*Hypersensitivity and alergy
*Autoimmunity
Q. In which household products are PCBs found in?
Coolants, lubricants
How many kiloton-yield was there in Hiroshima?
16 Kiloton
Physiostigmine salicylate antidote
AC (atropine)
don't use with TCA overdose bc of arrhythmias
What clinical signs are apparent from a chronic OC exposure?
Endocrine disruption
Reproductive/dermal effects
Anorexia
Adrenal involution
Hepatomegaly
OC's in blood and fat
What are the cardiac c/s of petroleum distillate toxicity?
arrhythmias
Pindone and chlorophacinone are what generation?
First generation anticoagulant
acute iron intoxication stages...
1. GI upset/disturbance
2. shock, metabolic acidosis
3. hepatic failure
4. bowel obstruction from GI scarring
What is hyperplasia?
1.Increase in cell number, resulting in an increase in
the size of the organ, both physiologic and pathologic.
2.Generally involving dividing cells and often occurring
with hypertrophy.
3.Reversible
What is ED50 (LD50)?
-defining characteristic in measuring death
Chlorinated hydrocarbon pesticides (organochlorines) mech of action
diffuse nervous stimulation. Biologic magnification (increase effect as you move up food chain) with environmental contamination
What is methanol metabolized to?
formalehyde and formic acid
Mu is what kind of receptor?
an endorphin receptor
Sheng ma
Can cause an increases risk of spontaneous abortion
false positives for opiates?
poppy seeds, morphine, codeine, fluroquinolones
Exposure Assessment
The procedure that \". . . identifies populations exposed to the toxicant, describes theircomposition and size, and examines the roots, magnitudes, frequencies, and durations of such exposures.\"
whole bowel irrigation definition
large vol of physiologcial like solutions orally or through a nasogastric tube to quickly cause diarrhea
What treatment options are available to control the seizure in a seizuring patient?
1. Benzodiazepines (Diazepam=valium) (may not be strong enough
2. Barbituates (phenobarbital, pentobarbital
3. Skeletal muscle relaxants (Methocarbamol=Robaxin-V)
4. Short acting hypnotics (Propofol) - not labeled for use in seizures, but a good option when other therapies not effective
5. Inhalation anesthetics (Isoflurane)
Also, ascess airway and cardiac function, maintain hydration to keep kidney well-perfused, monitor and correct acid/base disturbances, monitory and correct hyperthermia (wet down, use fan), avoid stimulation
Toxicon: Oxalate plant poisoning MOA
Mechanism of Action: Nonsoluble calcium oxalate crystals are found in plant stems, roots, and leaves. These needlelike crystals produce pain and edema when they contact lips, tongue, oral mucosa, conjunctiva, or skin. Edema primarily is due to direct trauma from the needlelike crystals and, to a lesser extent, by other plant toxins (eg, bradykinins, enzymes).
This is what causes each organ to respond to a toxicant in a different way
Cellular specialization
Q. Organochlorines do what in the body?
bioaccumalate, and biomagnify.
Which organization conducted the studies in 1950 of the atomic bomb survivors?
Atomic Bomb Casualty Commission (ABCC)
What is the LD50 of Soap?
7 - 20 g/kg
Give 2 examples of toxins/toxicants that cause acute toxicity
cyanide and carbon monoxide
When should mannitol NOT be given?
anuric, cardiac decompensation, pulmonary congestion/edema, dehydrated, or intracranial hemorrhage patients
Antidote to amitraz?
Alpha 2 antagonists such as yohimbine or antisedan
Ruminant urine is ____ (ph range), while canine urine is ___ (ph range).
ruminant- alkaline

canine- acid
What is selenium toxicity?
-cofactor for enzymes such as glutathione peroxidase
-excess produces CNS toxicity
What does decreased ATP during ischemia lead to?
decreased sodium pump
-increased glycolosys
-other effects such as detachment of ribosomes (leads to decreased protein synthesis and then lipid deposition)(reversible)
Urea & Nonprotein Nitrogen Intoxication source
Improper supplement mixing or mismanagement - important to allow slow adaption to NPN sources
So, here are just simple slides showing the poison and antidote, for practice.
here we go
Function of Ca2+ channel blockers
Block calcium channels preventing smooth muscle in blood vessels from contracting, causing vasodilation. This causes decrease workload on heart.

It also blocks calcium channels on heart muscles, decreasing the force of contraction.
List some toxicity factors associated with the Environment.
Season: ethylene glycol
Temperature:influence metabolism, food and water intake
Light factors: biological rhythms influence susceptibility
Housing: crowding, stress, ability to get away from a toxicant
Construction materials: lead, formaldehyde
Heating systems: malfunctions may release carbon monoxide
Air circulation: ammonia gas Bedding: black walnut shavings > laminitis in horses
When is gastric lavage contraindicated?
The substance is caustic, corrosive or a volatile hydrocarbon. Large, chunky material may not be adequately retrieved by gastric lavage.
oxalic acid effects
inc acidosis, binds ca so get urinary ca oxalate crystals (further inc renal toxicity) & dramatically lowers blood ca levels
Toxicon: Carbon monoxide (CO) MOA
Mechanism of Action: CO toxicity causes impaired oxygen delivery and utilization at the cellular level. CO affects several different sites within the body but has its most profound impact on the organs with the highest oxygen requirement (eg, brain, heart). Toxicity primarily results from cellular hypoxia caused by impedance of oxygen delivery. CO reversibly binds hemoglobin, resulting in relative anemia. Because it binds hemoglobin 230-270 times more avidly than oxygen, even small concentrations can result in significant levels of carboxyhemoglobin (HbCO).
irritants or corrosives cause cellular destructin and inflammatin as they come in contact with
moisture in the respiratory tract
Who ran the church that people with ergot went to and became cured?
Hugh the Great
Acute, Chronic or Gas Arsenic posining?

Rapid hemolysis and death, reversible kidney damage(RBC fragments clog kidney.)
Gas: no antidote, supportive tx
Pyrethrins/pyrethroids
1. where are they metabolized?
2. rapid hydrolysis happens where?
3. oral administration of which one leads to enterohepatic recirculation?
1. liver
2. GI tract
3. pyrethrins and some pyrethroids
signs for opiote toxidrome?causes? Antidote?
slow RR, pinpoint pupils; morphine, heroin, ines/enes; naloxene
what class of drug is fluphenazine? what dangerous side-effect can it have?
high-potency typical antipsychotic; can cause hypothermia due to disruption of thermoregulation and inhibition of shivering mechanism
What is the appropriate dispo for a child who ingested a pretroleum distillate but demonstrate no sx of toxicity?
Obs for 6hours
What is local vs systemic?
-local is specific site
-systemic is multiple organs
oak

a. conditions of poisoning
b. toxic principles
c. clinical signs
a.
affects cattle, sheep, horses, pigs
consumption of oak buds can be markedly ↑ in late spring snowstorm
as leaves mature, become less toxic
ripe acorns less toxic than when green
b.
gallotannin (GI irritant): reacts w/ cell proteins to denature them --> cell death
most severe lesions in kidneys, liver, GI tract
acorns contain tannic acid
goats & wild ruminants better able to detoxify b/c they have a tannin binding protein in their saliva: neutralizes tannic acid
c. anorexia, depression, intestinal stasis, +/- PU/PD, black tarry diarrhea, teeth grinding & hunched back (colic), icterus, red urine, dehydration
animals may live 5-7 days after onset of clinical signs
How do salycilates affect the kidneys?
As salicylates compromise buffering capacity, they also impair renal function, l/t accumulation of sulfuric and phosphoric acids.
BEI Specimen collection:
END OF SHIFT
As soon as possible after exposure
SO2 and lung damage
forms sulfurous acid - causes reflex bronchoconstriction
What clinical signs are expected with methylxanthines?
Within 6-12 hours: polydipsia, vomiting, diarrhea, restlessness. Progression to hyperactivity, polyuria, ataxia, tremors, seizures. May also see tachycardia, premature ventricular contractions, tachypnea, hypertension, hyperthermia, coma. Death due to cardiac arrhythmias or respiratory failure.
San jose scale. Lime S
First hand sprayer was developed by John bean of California and D.B. Smith of New york. What crop and what insect pest they were protecting at that time?
Under what conditions is ion trapping likely to be successful?
Successful ion trapping:
1. compound is excreted predominantly unchanged through the kidneys
2. compound is a weak electrolyte with a suitable pKa
3. toxicant is primarily distributed to the extracellular space and is not protein bound
To reverse the effect of sedative overdose use
Flumazenil(Romazicon ) Adult dose: 0.2(2ml) IV ofer 15 sec. an additional dose of 0.3(3ml) may ge given in 30 sec. followed by 0.5(5ml) at 1 min intervals (max dose 3mg)
What is the lifetime limit risk of fatal cancer formula?
age x 10 mSv
How does an overdose of imidacloprid manifest?
Stimulates then blocks nicotinic receptors
Appears as muscle tremors/rigidity followed by muscle weakness & laxity.
What does Bromethalin rodenticide look like?
tan, pelleted, comes in paper ("place pack" envelope)
With DEET, what are the neurological signs?
Tremors, excitement, ataxia and seizures. It causes CNS excitement
Piperazine Toxicosis has CNS signs.
V/D
circulatory collapse
head pressing
hyperesthesia
convulsions
ataxia
muscle tremors
myoclonus

What is the main diagnostic sign?
myoclonus

- head neck forward, legs back
What is local toxicity?
seen at site of first contact (skin, lungs)
Rosary Pea

a. toxic principle
b. clinical signs
a. contains toxalbumin: abrum
b. same as for castor beans: acute onset gastroenteritis, multiple organ failure
The release of all this unused energy and lack of substantial ATP generation leads to what?
Increased demand for glucose
What 2 herbs contain saponins?
It can cause diarrhea.
Mu tong and chai hu
what can be given for at home maintanence for opiate withdrawl sypm?
sublinguial buprenorphine +/- naloxone
Methanol is slowly metabolized to formaldehyde; formaldehyde is rapidly metabolized to formic acid, which causes acidosis and ocular nerve toxicity
Name 5 methods of methanol toxicity management.
How should exposures to methylxanthines be managed?
a)Decon – induce emesis if no CI exist, administer AC/cathartic
•Chocolate may melt in stomach; emesis can be successful even after several hrs if no clinical signs
•Multiple doses of AC to interrupt EH recirculation
b)Tremor/seizure control
c)Propranolol for tachyarrhythmias
d)Atropine for bradycardia
e)Lidocaine for PVC
f)Catheterize bladder to avoid reabsorption of methylxanthine thru bladder wall; walk freq if possible
g)Supportive tx
With regard to mammalian bites, which of the following statements are correct?

A. Antibiotic prophylaxis is indicated in all human bites
B. Considerable evidence supports antibiotic prophylaxis for both dog and cat bites
C. Evidence fails to support prop
A. Antibiotic prophylaxis is indicated in all human bites

-Infection rate is higher in bites to hand
-Antibiotics for bites to hand
-Infection rates from human bites are higher than from cat bites
-Antibiotics for human bites
-Infection rate for cat bites are higher than dog bites
-Augmentin is optimal
-ceftriaxone or cefotaxime for pen-allergic for cat and dog bites
clindamycin or bactrim for human bites
How can you diagnose a hydrocarbon toxicosis?
History of exposure with clinical signs
Chest radiographs showing aspiration pneumonia, leukocytosis, fever
What is the different between animal grade and technical grade imidacloprid toxicosis?
products used on animals contains approx 0.29 to 9.1% imidacloprid while products used for agricultural applications contain up to 94% imidacloprid
List the Management principles in toxicology
1. stabilize 2. get data 3. decontaminate 4. decrease absorption of toxin (charcoal) 5. increase elimination of toxin 6. treat w antidote 7. determine appropriate disposition
What is the treatment for D3 toxicosis?
pred +/- furosemide for several weeks

+/- calcitonin if serum Ca++ is unresponsive
What are the possible steps for evidence-based determination of risk?
-collection and evaulation of relavent data
-collection and evaulation of relevant knowledge
-joining data with knbowledge to generate a conclusion
What is the tx of CO?
100% oxygen (decrease CO half-life to 80 minutes)
hyperbaric oxygen (decrease CO half-life to 20 minutes)
What clinical signs would be expected w/ ingestion of an:

a. acid corrosive?
b. alkali corrosive?
a. oral & esophageal irritation, pain on swallowing, mm burns, epiglottal edema --> dyspnea, esophageal necrosis & stricture

b.
-more severe than acids
-mm burns, esophageal necrosis/stricture: can occur w/o evidence of injury to oral cavity
-button batteries often just sit in esophagus & start to release acid, or may get stuck in stomach: usually require surgical or endoscopic removal
what is the antidote for ethylene glycol?
ethanol (+ thiamine and pyridoxine); fomepizole
KEEP OUT OF REACH OF CHILDREN
What is the active ingredient of Neem oil?
Signs and syptoms of coral snake bites are
slurred speech, dilated pupils, and dysphagia to flaccid paralysis and death
Of the types of bleach products commonly found in a home, which is the most toxic & which is the least?
Most = Mildew removers (usually have Warning label)
Least = Liquid bleach (usually just below pH needed for ulcer formation. No label)
What are pesticides designed for?
designed to be toxic to some form of life
Why do we give b12 in cns animals?
It is thought to be neuroprotective
What is the rate of exposure and how is it affected?
-concentration x frequency x duration
-affected by route of contact
-route of transport
-uptake and distribution
-bioavailability
-pattern and/or timing of exposure
Blood thinners are prescribed to individuals who have a history of what?
1) clots in the lungs or legs
2) atrial fibrillation
3) stroke
you notice pulmonary edema on an xray, but the medical hx of your patient reveals that they have no cardiac problems. likely?
could be opiods or salicylates overdose (cause leaky capillaries)
Pt with who have taken Low doses of PCP resemble
drunkenness (and rage)and is a psychiatric emergency that mimics schizophrenia
Why do you have to be careful about the disposal of unused portions of pyrethrins/pyrethroids?
reptiles and fish are very sensitive!
what should you do with a positive fingerstick lead level?
recheck with serum lead level since the fingersticks have a high false positive rate
How is the level of potassium regulated in the bloodstream?
Kidneys control amount of K+ in the bloodstream and eliminate any excess thru the urine.
What is the initial dose of the antidote for acetaminophen toxicity?
140 mg/kg followed by 70 mg/kg q4 hours for 17 doses
How much fluid do you need for an appropriate gastric lavage?
5-10 ml water/kg bw

careful not to overextend stomach
pt comes in with ekg showing prolonged QT interval and QT corrected, sinus tachycardia, and rightward shift. likely? tx?
TCA OD, Na Bicarb; can decrease CO2 ventilator, try to titrate to pH of 7.5
What is the MOa of amitraz?
it is an alpha 2 agonist - so it works similar to xylazine and domitor
What herbs can effect the thyroid due to high iodine content?
Kun bu, hai dai, hai zao
They can all effect thyroid hormone replacement therapy.
Source: NSAID
Acetaminophen
Strychnine
Seizures
Acute onset
beta blocker
glucagon
Theophylline
COPD patient
Tachycardia, Hypotension
Seizures
Theophylline
Charcoal
Phenobarb/Benzo for seizures
antidoes for beta-blockers?
glucagon
Name an ARB
Valsartan
pesticide ex
insecticides, rodenticides, organophosphates, carbamate, organochloride
CNS Stimulants
Anxiety/agitation, Hyperthermia(warm sweaty skin) MYDRIASIS, ↑HR ↑BP, psychosis, seizure.
CNS Stimulants
Intervention/ ANTIDOTE

Control CV and hyperthermia symptoms
Benzo for seizures
Cocaine
Sympathomimetic
Blocks the re-uptake of NE and Serotonin
Hyperexcitability
Mydriasis
Tachycardia
Hypertension
Seizures
Emesis with caution
Activated Charcoal
Control seizures
Monitor Acid-base
Organophosphate anticholinesterases
Atropine ± pralidoxime
Thallium
Mees Line: Green urine.
Yu jin
ok during pregnancy
Cyanide
pitted fruits prunus (cherries,peaches,almonds,apricots)
pomes (apples, pears)
Johnson grass, sudan grass, sorghum, corn
Elderberry
Eucalyptus sp
Emesis is NOT indicated
Benzodiazepines
Barbiturates
Caustic agents (acids or bases)
Beta-blocker
Brady, hypotension
HYPOGLYCEMIA
Pulmonary edema
Beta-blocker
Glucagon (inotropic)
Ca (High-dose Bb inhibits Ca-channels)
Insulin (inotropic), dextrose
Cynaide
Nitrites & thiosulfate (reducing agent
What system(s) is/are primarily affected by Soaps & Shampoos?
GI
Marijuana
THC
Toxicity increases with drying, heating, smoking, aging
Wide margin of safety
Depression
Ataxia
Dilated pupils
Nystagmus
Bradycardia
Hypothermia
Vocalization
Decontaminate - emesis, AC/SC
Diazepam for agitation
Supportive Tx: Fluids
Good prognosis
Whata re examples of mechanistic/predictive focus areas of toxicology?
-biochemical
-mutagenic
-carcinogenic
-genomic
-physiologic
-apoptotic
-necrotic
-inflammatory
Name beta blockers
1) atenolol
2) propranolol
Carbon monoxide (CO) poisoning tx
oxygen
Adaptation
A physiological response to the exposure of a chemical compound. Adaptation of a cell/organismis possible within a given exposure/ time range; beyond this threshold, toxicity may ensue.
penicillamine use
wilson's disease, long-term chelation therapy (ex. mercury poisoning) to lower blood lead levels
source: pesticides, chemical warfare
organophosphates and carbamates
When the immune system produces antibodies to endogeous antigens it is called
autoimmunity
This type of particle is Monoenergetic
-Heavy, charged particle(s):
2+ Charge
-7300 times mass of β particles
Alpha
Proudfoot and Syngenta survival curves are based on what concentration of paraquat?
plasma
What animal is resistant to rotenone?
Chickens
W/D from which substance produces yawning, lacrimation, piloerection?
Opiates
blue green algae toxins
anatoxin
(saxitoxin & neosaxitoxin)
Name 2 Digitalis drugs
1) digoxin
2) digitoxin
San qi
use with caution in pregnancy
what is the PB in TCA?
85-98%
Bracken fern- Pteridium aquilinum
hematuria-cow
ataxia-horse (Thiaminase activity-anti vit B1)
bright blindness-sheep (retinal atrophy)
synaptic junction (incoming)
Mode of action of 2PAM?
ion trapping
acification or alkalinization of urine to ionize the chemical and dec reabsorption, but not routinely recommended bc of adverse effects
nitrite administration
first give amyl nitrite inhilation, until iv admin of sodium nitite can be started
ADI
Allowable daily intake
ADI = NOEL/x

x is some safety factor
Type 2 immune reactions are autoimmune reactions(t/f)
true
Which drug stops excessive bleeding in childbirth?
Cafergot
How many bq is an exabecquerel?
1018 bq
Extrapyramidal dystonia antidote
benzotropine mesylate (cognentin) -- anticholinergic

diphenhydramine -- antihistamine
OP (organophosphate) and Carbamate insecticides
Atropine (receptor blocking)
5-Fluorourocil (5-FU)
Chemo drug
Bone marrow suppression in cats
Decontamination - emesis if <30 minutes, gastric lavage, activated charcoal
Seizure control - poor response to diazepam
Leukopenia treatment
what toxin smells like rotten fish
Zinc phosphide
T/F: Relay toxicosis is common with Cholecalciferol.
False
What is invasion?
-growth into surrounding tissues, traversing normal tissue boundary
Wha is the xenobiotic metaboliteof ethlene glycol (antifreeze) as an ultimate toxicant?
-oxalic acid
What are sx of arsenic poisoning?
GI
vomiting
“ricewater” stools
garlicky odor
capillary damage with dehydration and shock
ACE inhibitors are a type of _________.
vasodilator
Zhi ke
Highly acidic, could passibly cause crystalluria and hematuria, can cause uv sensitivity in light skinned individuals.
FAB fragments is the antidote for?
digoxin, digitalis
What is the most common method of mercury exposure?
Inhalation
freat acute ethanol intox
supportive therapy: protect breathing and ventilation if necessary; correct hypothermia; adequate nutrition; glucose for hypoglycemia; thiamine as precaution for Wernicke's encephalopathy; seldom use lavage or dialysis, and activated charcoal not adsorb
What is the toxic dose of TCAs?
10-15 mg/kg
Symptom is rotary nystagmus, what did I eat/smoke/whatever?
Phencyclidine (PCP)
These are derived from the bone marrow, are located in the skin, and act as APCs.
Langerhans cells
Q. T or F: Urinanry cadmium reflects both cumulative exposure and the concentration of cadmium in Kidneys? ON TEST
True
What was the late effect of Radium?
Osteogenic sarcoma
Pb poision
blood smear - basophilic stippling of RBCs
High ALA
lead lines along gingival margin
peripheral motor neuropathy
Fanconi syndrome - PCT defects
Saturnine gout
HTN
Metaphyseal bands
By what mechanisms are Pyrethroids metabolized?
Esterases
Mixed function oxidases
Glucoronidation
Many insecticides use what as a vehicle?
petroleum distillates
MOA of fluroacetate
Tightly binds to aconitase inhibiting the TCA cycle. This inhibits energy production
what is lye?
cleaning solution made of sodium hydroxide
What is anaplasia?
failure to differentiate (to an adult
phentype), a criterion of malignant neoplasm.
What is immune suppression?
-modulation of the immune system
-increase susceptibility to tumorgenic chemical
-also immune overactivity
fescue toxicosis mechanism of action
peripheral vasocontriction

suppress prolactin secretion
What is the tx for that?
phentolamine or labetalol
Where are opioids derived from?
opiate derivatives of opium
The higher the osmolal gap, the _____ the measured osmolaltiy?
lower
Hazard Identification (Hazard assessment)
examines the evidence that associates exposure to an agent withits toxicity and produces a qualitative judgment about the strength of that evidence, whether, it is derived fromhuman epidemiology or extrapolated from laboratory animal data.
whole bowel irrigation use
large quantity of toxic substance, late presentation, not absorbed by charcoal, oral overdose with delayed release medication bc of concretions, removal of drug packets (unless releasing drug-then surgery)
When are cathartics contraindicated?
When diarrhea or dehydration are already present, or in the case of ileus or obstruction. If animal has renal insufficiency or slowed gut transit, hypermagnesemia may result from magnesium sulfate administration.
Symptoms: flulike symptoms, dyspnea on exertion, confusion, lethargy, dizziness,
Toxicon: Carbon monoxide (CO)

Treatment: 100% oxygen or hyperbaric oxygen.
Clara cells are located in the region of the________.
terminal bronchioles
Q. Pyrethroids showed signs of what in the body?
Hyperactivity, paralysis
What is the average annual limit of exposure?
20 mSv
Activated charcoal may be necessary in the treatment of toxicity from what classes of household chemicals?
Anionic surfactants
Cationic surfactants
Disinfectants
Selamectin
1. brand name
2. what is it?
3, what is it used to control?
1. Revolution
2. semi-synthetic avermectin
3. broad-spectrum control- fleas, ear mites, hookworms, roundworms, ticks
Where are the c/s found in petroleum distillate toxicity?
pulmonary
CNS
GI
hepatotoxicity
renal toxicity
heart
MOA of macrocyclic lactones
Ivermectin is a macocyclic lactone --> it is a GABA agonist. therefore you get CNS depression
Why would you give activated charcoal to a dog that ingested Bromethalin 4 days ago?
decrease enterohepatic circulation
How is CO an ultimate toxicant?
-parent xenobiotic
-competes wih oxygen
-suffocation
metaldehyde spp affected
all spp affected - dogs most common
What herb should be avoided with Garlic?
Mu Dan Pi
Function of ARBs
Prevent angiotensin II from having any effects on the heart and blood vessels. It keeps blood pressure from rising.
Definition of LD50.
Lethal Dose (LD) or Concentration (LC) LD50= dose likely to cause death in 50% of a given species/age/sex group under specified conditions
What clinical signs can be expected with organochloride exposure?
Salivation, vomiting, tremors, ataxia, Tonic-clonic seizures, paddling, clamping of jaw.May last for 2-3 days
syrup of ipecac use
for emesis, cause vomiting w/in 30min via direct stimulation of GI or later stimulation of CTZ
Indications: Secondary drug to BAL & EDTA for use in the treatment of acute lead poisoning, to remove excess lead from the body, especially in small children. Used when lead concentration is > 45 ug/dl.
Drug: Succimer (Chemet ® )
Pit viper venom can
produce toxic effects on blood and other tissues
Q. Where does the greatest exposure of PCBs come from?
Atlantic farmed salmon
Acute or Chronic Hg poisoning?

Chest pain, SOB, vomiting, gastroenteritis
Acute-VAPOR abosrbed via lungs

tx: Dimercaprol
What is the prognosis for paraquat poisoning? What can potentially reduce mortality?
poor --> death

longterm corticosteroids in addition to cyclophosphamide
role of GI decontamination? (stomach pumping)
prevent further absorption, increase elimination
how does ethylene glycol affect calcium levels and the kidneys?
associated with hypocalcemia and calcium oxalate deposits in the kidneys
How is benzene a toxic solvent?
-sources include steel production, fuel, and solvent for rubber and inks, also starting material for chemical synthesis
-acute toxicity includes CNS depression leading to unconsciousness and death
-has hematopoietic toxicity including aplastic anemia and acute myelogenous leukemia
-caused by benzene metabolites
What is loss of viablity?
-loss og function (inability to metabolize at cellular level)
-inability to grow
-timing may change viability
-adaptation affects viability
red maple

a. clinical signs
b. lesions
c. tx
a. develop 2-3 days post ingestion
anorexia, depression, icterus, dehydration, weakness, tachycardia, brown mm, dark brown urine, coma, death, splenomegaly (2º to anemia)
causes methemoglobinemia, methemoglobinuria, hemolytic anemia --> pigment nephropathy
b. dark brown tissues, icterus, splenomegaly, swollen dark kidneys (prox. tubular epithelial necrosis, Hg cast formation), Heinz bodies
c. if recent ingestion: give ~ 1 lb. AC
else tx methemoglobinemia w/ methylene blue: animals usually don’t do well
What is the tx for 5HT syndrome with agitation, seizures, or rigidity?
add benzos
BEI Specimen collection:
DURING SHIFT
After at least 2 hours of exposure
List some Toxicity factors that are associated with the Host.
Biotransformation and Bioactivation
Phase I-oxidation, reduction, hydrolysis
Phase II-conjugation with endogenous molecules

Influenced by:
Parenchymal organ disease
Toxicant localization in tissues with little PI/ PII activity
Age and metabolic activity
Species-specific variation, individual variation
Gender and hormone differences
What is the mechanism of strychnine?
Blocks inhibitory actions fo glycine (an inhibitory neurotransmitter) in the spinal cord. Especially important is the action of glycine on Renshaw cells. Renshaw cells normally inhibit motor neurons after they fire, preventing a positive feedback loop. After strychnine poisoning, sensory input causes muscle contractions which cause more sensory input which cause harder contractions, etc. until muscle is in tetanus.
Limitation of pyrethrum to use as insecticides against ag pests?
Volatile and readily photo degradable
What general clinical considerations for the seizuring patient are important in regards to rhabdomyolysis and myoglobinuria?
Myoglobin is toxic to renal tubule cells and can cause secondary renal failure.
Who conducts the studies ongoing today of the atomic bomb survivor casualty commission?
Radiation effects research foundation (RERF)
What toxicokinetic properties make Imidacloprid a potential toxin for animals?
Widely distributes on skin to kill fleas
Can be orally absorbed.
What is one of the most common causes of animals poisoning?
rodenticides (mainly anti-coagulants)
What the MOA of Rotenone?
Stops NAD from changing into NADH --> loss of ATP
Which anticoagulant is safer, 1st or 2nd generation?
1st generation: requires multiple doses to kill (warfarin)

2nd generation: 1 dose (brodifacoum)
10-100x more potent
What is acute exposure?
-1 time exposure over 24 hrs or less
rhubarb

a. toxic principles & effects
a.
leaf blades contain oxalic acid, CaOx, KOx
oxalate interferes w/ energy metabolism --> death
also contains anthraquinone glycosides: cathartic
What is another independent action of organophosphates?
they phosphorylate neuropathy target esterase causing neurotoxicity - there is no treatment
nitrate/nitrite

a. clinical signs
b. dx
c. tx
d. prevention
a.
-varies from acute death to signs exhibited over days to weeks
-rapid onset d/t O2 deficit & ↓ BP
-tachycardia, weak heart beat, hypothermia, muscle tremors, weakness, ataxia
-tachypnea, severe cyanosis, anxiety, excess salivation, diarrhea, frequent urination
-abortions, stillbirths: fetus doesn’t tolerate methemoglobin well
b.
-dark brown blood
-feed or water samples: diphenylamine test or Aquacheck water quality test strip
-postmortem: enucleated eye &/or aspirated aqueous humor, CSF
c.
-1% or 2% methylene blue IV: can cause methemoglobinemia in animals that do not already have methemoglobinemia
-mineral oil drench OR 3-5 gallons of cold water (preferred) w/ ABs ↓ rate of nitrate --> nitrite
-give gallon of vinegar to ↓ rumen pH --> ↓ conversion of nitrate --> nitrite
-vasoconstrictors (epi, norepi) may be helpful
d.
-maintain animals on good plane of nutrition
-avoid excess application of manure or nitrogen fertilizers: wait 24-48 hours to put animals out
-don’t overstock pasture
-delay harvesting any stressed forages
emesis is not suggested for OD. why?
increased chance for aspiration, Mallory Weiss tears, and prolonged emesis
Ethylene glycol is metabolized to oxalic acid; oxalate binds with calcium and forms calcium oxalate crystals, which deposit in renal tubules
Name 5 methods of ethylene glycol toxicity management.
What samples should be collected antemortem?
Blood (whole or serum), urine, stomach contents, suspect bait, hair
Regarding submersion injuries, which of the following is correct?

A. Complete recovery in 48 hours is typical if they never require CPR
B. Electrolyte measurements should be routine
C. Prophylactic antibiotics are usually indicated
D. The Heimlich maneuv
A. Complete recovery in 48 hours is typical if they never require CPR

-Electrolyte abnormality only seen in aspiration of high solute concentrations (Dead Sea)
-Heimlich only useful to clear particulate matter
-Bacterial pneumonia rare
-No prophylactic antibiotics
-Prolonged CPR in asystole after ice water submersion reasonable
-Asystole in warm water submersion is a sign poor prognosis for CNS recovery
What routes of absorption do household hydrocarbons typically go through?
Most are absorbed well Orally, Dermally or via Inhalation
What are the c/s of ACHE inhibitor toxicity in cats?
depression, ataxia, tremors, behavior change (agression), hyperactivity, hyperesthesia, miosis/mydriasis, tachypnea/dyspnea
What are the clinical signs of bromethalin stoxiciy?
Acute CNS signs. Tremors, hyper excitability, running fits
What produces the acute effects of Zinc Phosphide Toxicosis?
Phosphine gas (PH3)
-produced in the stomach: responsible for free radical production & possibly blockage of mitochondrial cytochrom oxidase

(zinc causes later hepatic and renal damage)
How is specificity an inplication for in vivo vs in vitro toxicities?
-high organ specifity, only affects liver cells and no others
-test in vitro using epithelial cells and find much les toxicity
-in vitro use the same cells to be comparable or in vivo will just have higher toxicity
How do you tx B-blocker toxicity?
IV glucagon increases cAMP in cardiac myocytes using glucagon receptors instead of B-receptors (to bypass the B-blockade)
Bufo Toad

a. species most affected
b. toxicity
c. clinical signs
d. tx
a. dogs
b. toxicosis occurs in animals that bite or mouth various species of toads that contain bufotoxin (cardiac glycoside)
c.
-develop w/in minutes of mouthing toad
-profuse salivation, head shaking, ataxia, vomiting, polypnea, hemorrhagic diarrhea, seizures
-monitor ECG: can see sinus arrhythmia, tachycardia, occ. V fib
d.
-wash buccal mucosa w/ swab or hose to dilute toxin
-IV diazepam
-IV atropine
-propranolol
-digitalis specific Fab fragment (Digibind) effective
measured lab portion of the osmolal gap procedure is carried out by?
freezing point depression, which is inversely proportional to the amount of sodium.
SC are made with smaller particle size.
What are the 2 most important consideration to decrease pesticide drift?
Food poisoning is a term used for
any illness of sudden onset suspected of being caused by food eaten within the previous 48 hours.
How does the toxicity of a Fipronil toxicosis manifest?
GABA receptor blocker mostly affects invertebrates, BUT...
Expected signs in mammalians include muscle fasciculations, temors, convulsion, lethargy, ataxia.
Xylazine (Rompun)
-in what spp is it used as an emetic?
-route in administration
-how long until it takes effect?
-side effects
-cats (not dogs)
-IV, IM, or SQ
-5 minutes
-CNS and respiratory depression, bradycardia, possible hypotension
what test is indicated for ingestion of strong alkaline solution and why?
upper GI imaging and endoscopy looking for perforation due to the near-instanteous liquifactive necrosis of the esophagus
How is tissue repair/ adaptation ot injury an implication of in vivo vs in vitro toxicity?
-response to toxicity is the ability to do tissue repair
When used by someone who has atrial fibrillation, digoxin prevents what?
Prevents the ventricles from beating too rapidly.
What are 2 good examples of when whole bowel irrigation is useful?
iron overdose or body packers
If the stinger is left in the wound after a sting by a honey bee, you should:
Scrape the stinger from the wound
T/F: many OPs have been banned in the US
false: many organoCHLORINES have been banned in the US
What are the 3 rules of thumb?
1- % --> ppm (4 places right)

2- 100 g/ton --> 110 ppm
1 g/ton --> 1.1ppm

3- 1 lb/acre --> 7 mg/kg BW exposure
1 lb/acre --> 230 ppm forage
Why is it difficult to get the correct dose of blood thinners?
10% of population don't respond appropriately to warfarin due to a genetic predisposition.
A child has ingested his mother's iron tablets. he had had abdominal pain and bloody stools, earlier, but he is now 12 hours out from ingestion and is asymptomatic. What should you do with him?
Admit him. Iron poisoning often has a "quiescent" phase prior to manifestation of altered mental status and metabolic acidosis. He needs iron levels checked and will likely need treatment with deferoxamine.
A dog comes in for indiscriminate eating. The owner doesn't know what it ate, because there were only a few pieces of soggy cardboard left hanging out of his mouth. This just happened within the last 6 hours. You're a dumb vet and you run a CBC and Chem b
Not such a dumb vet after all.

It is likely D3 toxicosis-- Phosphorus spikes within the first 12 hours followed by a Calcium elevation at 24 hours post exposure
What is the LD50 for TCA? at what pt are there few fatalities? at what point is death likely due to overdose?
<20mg/kg hardly any fatalities; LD50 is 35mg/kg; and death is likely at >50mg/kg
Why doesn't the EG kit test work for cats?
not sensitive enough to detect the low levels that are toxic in the cat
What does the change in pH to 7.5 by adding Na bicarb to a TCA poision do?
it helps to correct the delays in conduction to correct the ventricular dysrhythmias
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