Toxicology Exam Flashcards

Terms Definitions
Warfarin
Bleeding
Warfarin
K
FFP
Identify.
Philodendron
Copper
penacillamine
Beta-blocker
Brady, hypotension
HYPOGLYCEMIA
Pulmonary edema
Beta-blocker
Glucagon (inotropic)
Ca (High-dose Bb inhibits Ca-channels)
Insulin (inotropic), dextrose
Serotonin syndrome
Cyproheptadine
organophosphate ex
parathion, malathion
Mecury, Arsenic, Gold
Dimercaperol
Methemoglobinemia-inducing agents
Methylene blue
Phosgene
Farmers, plastic manufacturers.
Bronchitis, emphysema, pneumonia.
overdose with pneumomediastinum?
sympatho
Most insecticides are _____toxicants
neurotoxicants
c/s of paraquat poisoning
anorexia
depression
diarrhea
respiratory distress
death in weeks following exposure
Antidote for zinc phosphide
Nope
Equation for Cardiac Output
CO=HRxSV
A2 Carcingogen
Suspected Human Carcinogen
false + for cocaine?
none
toxidromes
symptoms resulting from a poisoning
Perivascular infiltration of monocytes, lymphocytes, and lymphoblasts is characteristic of which type of hypersensitivity reaction?
type 4
What color poison is Tabun?
red
Mee's Lines
Heavy Metals
Arsenic and Thallium
Name the first generation anti-coagulant rodenticides
Warfarin
Pindone/Pival
Chlorophacinone/Mouse Out
Diaphacinone/RoKill
Methanol
Distributes to total body water
Metabolized at one fifth the rate of ethanol
Toxicity related to amount of Formic Acid produced
slaframine signs
SLUD
profuse salivation

uriation, diarrhea, bloat,
Methylene Chloride
Construction, coffee manufacturers, garment printers.
Lung tumors, liver tumors.
overdose with dry flushed skin?
anticholinergic
What is common name of Guthion?
Azinphosmethyl
Toxicon: Phenothiazines MOA
Mechanism of Action: "Anti-transmitter" actions: block histamine, serotonin, norepinephrine and dopamine receptors. Block of alpha-adrenergic receptors.
A rare, progressive, reversible disorder caused by several species of ticks that release a neurotoxin that causes weakness, incoordinatin, and paralysis
tick paralysis
Which Greek committed suicide right before his death sentance?
Demosthenes
Glucagon antidote for
B blocker overdose
and hypoglycemia
Most common c/s of cholecalciferol rodenticide toxicity

-other c/s
diarrhea
PU/PD

-anorexia
-depression
-abdominal pain
-vomiting
-dehydration
-muscle weakness
-constipation
Fumonisins (mycotoxin)
Inhibition of conversion of sphinganine and sphingosine to sphingolipids
ELM - Equine Leukoencephalomalacia
Liquifactive necrosis of white matter
Depression
Blindness
Ataxia
Aimless wandering
Head pressing
Coma
Death
Swine - Porcine Pulmonary Edema
Tx: None, once signs begin
Describe a typical Zinc Phosphide gopher bait.
gray
grain
fishy/garlic
drug overdose
poisoning from a pharmacological substance in excess of that usually
prescribed or that the body can tolerate.
Which has an antagonist available? Benzodiazopines or barbiturates?
Benzodiazepines
Examples of chemical asphyxiants.
CO, HCN, H2S
Name the plant.
Lily of the Valley
methyprylon fits into which toxidrome?
opiate, sed-hyp
Poison
any agent capable of producing a deleterious response in a biological system.
lavage disadvantages
less effective than emesis (indicated if emesis too slow or contradindicated), discomfort of catheter, possible stomach perforation, some posions may be too large to enter small terminal pores of lavage tube
secondary agent for treatment of copper & arsenic poisoning.
Drug: Penicillamine
Phencyclidine (PCP) is a
dissociative analgesic with sympathomimetic and CNS stimulant and depressant effects
Name three types of autoimmune diseases
AIDS
rheumatoid arthritis
Lupus
Carbon Monoxide Poisoning
>10% Carboxy Hb
Nausea, vominting dyspnea with Hyperventilation, Mydriasis, vertigo,
CV signs prominent ↓ BP, syncope ↑HR, arrhythmias
Carbon Monoxide Poisoning
>10% Carboxy Hb
Intervention/ ANTIDOTE

Hyperbaric Oxygen and decontamination
Humidifed 100% O2 in mild overdose is ok
Range (air) = 0.325 E3/2
For 226Ra, Range (air) = 3.4 cm

Range (tissue) ~ 1/1000 of range (air)
For 226Ra, Range (tissue) = 34 μm
* what type of particle is being described above?
Alpha
Acute Arsenic, Chronic Arsenic, Gas Arsenic?
Violent N, laryngitis, bronchitis, hemorrhagic gastroenteristis(rice water stool), garlic breath, capillary damage(shock and dehydration), sensory neuropathy
Acute
Tx: Dimercaprol
Give an example of toxins/toxicants that cause a chronic toxicity response
heavy metals
What is the prognosis of fluroacetate toxicosis
grave
Activated Charcoal effectively binds
Acetominophen, Salicylates, Ipecac, Arsenic, and Organophosphates
OPs and pyrethrins are both ___ (chemistry).
esters
What are the general chemical structures of toxins/toxicants?
-aromatic amines
-halogenateds
-hydrocarbons
Chronic selenium poisoning source
forages, feed additives
obligate indicator plants (require Se for growth) - astragalus
facultative indicator plants - aster
Which calming herb is contraindicated w/ gastritis or gastric ulcers?
Yuan Zhi
Functioni of analgesics
decrease in sensation of pain
cyanide toxicity S/S
lactic acidosis, increased respiratory rate/depth, venous blood bright red, cytotoxic hypoxia, convulsions, respiratory arrest
Describe zero-order elimination.
A saturated process proceeding at maximum amount the body can handle per unit time. Reaction rate is independent of [A]. Kinetics may change to first order after process is no longer saturated.
DDT, Carbaryl, endrine
Example of insecticides developed by analogue synthesis
iron poison treatment
IV deferoxamine by continuous infusion preferred to IM injection. dose determined from serum iron levels
Toxicon: Benzodiazepines MOA
Mechanism of Action: potentiates the activity of GABA. In the CNS this results in sedation, striated muscle relaxation, anxiolysis, and anticonvulsant effects. Stimulation of peripheral nervous system (PNS) GABA receptors may cause decreased cardiac contractility, vasodilation, and enhanced perfusion.
The venom of the coral snake is
mainly neurotoxic
Carbon Monoxide
(smoke, PAINT THINNER)
Headache, dizziness
Cherry-red lips
Hypotension
Carbon Monoxide
(smoke, PAINT THINNER)
Dx: [carboxyhemoglobin]
Rx: 100% O2 (or hyperbaric)
Rx: intubate for smoke inhalation
What is the half life of 224Ra
3.62 days
These types of particles can damage DNA and can even cause a cause a double-strand break
alpha particles
Urinary alkalinization moa
Increases urinary pH --> Increases renal elimination
What is the first thing that's necessary to diagnose a poisoning (excluding c/s)?
minimum database
Advantage is a flea product. What is added to it to make it 'advantix'
pyrethrin
What is unique about Ibuprofen toxicosis clinical signs?
biphasic
GI <6hours

Renal 12hr-5days
What does toxicity cause?
-death
-loss of viability
-loss of function (metabolize, use ATP, or oxygen)
-inability to grow (can't replicate, may increase body weight)
-over response to stimuli (e.g hypersensitivity through immune system)
toxidrome
a toxic syndrome; a group of typical signs and symptoms consistently
associated with exposure to a particular type of toxin.
Amphetamines & other stimulants
For hypertension: Phentolamine or nitroprusside
For tachyarrhythmias: Propanolol or esmolol
Diuretics may cause what in 1/2 the population?
Impotence
Procarcinogen
Must be metabolized in order to become carcinogenic.
Describe zero order kinetics.
Saturated process proceeding at maximum amount the body can handle per unit time
Rate= k[A]m M=0 for zero order, therefore, any [A] = 1 (because any number to the zero exponent=1) and the reaction rate is independent of [A]
Kinetics may change to first order after process is no longer saturated
What is 4-aminopyridine used for? What's the commercial name?
Bird control - Avitrol
Othmar Zeidler (1874) a german grad student
What is prill?
Hydrogen Sulfide chemistry
in sewer gas or refinery gases, inhibits cytochrome oxidase
What is toxicology
A subset of pharmacology that focuses on the detection, properties, effects and regulations of toxic substances and poisions.
A form of amnesia often seen in alcoholics, characterized by a loss of short-term memory and an inability to learn new skills
Korsakoff's psychosis
What incident resulted in the founding of the FDA?
The mascara incident
18,500 persons with detailed shielding information complete
57,000 included by estimation of dose
16,207 of the 75,991 subcohort were within 2000 m of hypocenter (substantial exposure)
Dose system of 1986
Which drugs will you give you a false positive for methamphetamine use?
Chlorpromazine
Propranolol
Pseudoephedrine
Selegilin
Possible c/s of anti-coagulant rodenticide toxicity

-if subacute
depression, v/d, anorexia, ataxia, melena, weakness, dyspnea, hemorrhage (may cause sudden death if in pericardium, thorax, mediastinum, abdomen, or cranium)

-pale mm, anemia, dyspnea, weakness, hematemesis, epistaxis, bloody feces
what do TCAs cause on EKC?
Wide QRS, R' AVR
Chlorophenoxy Compounds
AKA Agent Orange
Herbicide that causes excessive GH action
Chronic toxicity due to dioxin (teratogen and carcinogen)
What can exposure to pesticides may result in?
-neurotoxicity
-reproductive effects including endocrine systems (endocrine disruptors)
-teratogenic effects
-carcinogenic and oncogenic effects
-mutagenic effects
-hematological effects including anemia
-immunological effects including suppression and activation
-transgenerational effects
What is a risk?
-expected frequency of occurance of undesirable effect
What are chemicals inducing Cacliuym influx into the cytoplasm via voltage gated channels?
-maitotoxin and hydroxide radical
What is the tx?
1. To prevent further metabolism: Fomepizole or ethanol
2. To tx acidosis: IV sodium bicarb
3. Hemodialysis
Function of Barbiturates
-promote and at high doses stimulate GABA receptors in the CNS
What are some measures used to reduce absorption of toxicants?
dilution
emesis
gastric/rumen lavage
adsorbents
cathartics
gastrotomy or gastric endoscopy
when is an anion gap abnormal?
when it's above 15
Arsenicals occur in 2 forms. What are they?
Arsenites and arsenates
What is meant by "activated" charcoal?
Carbonaceous compounds are treated with steam and acid to produce a highly porous material capable of trapping a wide range of organic substances.
Toxicon: Morphine & similar narcotics MOA
Mechanism of Action: opioid receptor agonist
What will determine how much of a toxicant will be distributed to a specific target organ?
Time-dependant toxicokinetic processes
What are the sensitive cells that rapidly divide?
Fetal cells
sex cells
thyroid cells
What system(s) is/are affected by household fertilizers? What are the clinical signs associated with them?
GI - vomiting, diarrhea, anorexia
Which ACHE inhibitor is not approved for use in cats? What is the exception?
chlorpyrifos

except for flea collars
MOA of metaldehyde toxicosis
Causes direct GI irritation and CNS excitement by decreasing GABA, norepi, and serotonin which will lead to seizures
T/F: Anticoagulant Rodenticides have a direct effect on capillaries.
True

*damage them = rupture easily
How is ethylene glycol and propylene glycol toxic solvents?
-ethylene glycol is antifreeze
-metabolized by alcohol dehydrogenase then aldehyde oxidase to beocme oxalic acid
-proylene glycol is additive in food and cosmetics
-metabolized by same enzymes to become pyruvic acid
-used in lacquers, varnishes, resins, printing ink,, textiledyes, and gasoline additives
-can cause reproductive toxicity
What are chemicals inducing calcium influx into the cytoplasm from mitochondria?
-oxidants of intramitochondrial NADH: alloxan, t-BHP, NAPQI, divicine, fatty acid hydroperoxides, menadione, and MPP+
-others: phenylarsine oxide, gliotoxin, .NO, and ONOO-
sodium fluoroacetate & Fluoroacetamide source
compound 1080 used for coyote & rodent control
Levels of digitalis that are too high can cause?
-loss of appetite
-nausea
-vomiting
-headaches
What is the result of biotransformation of toxicants?
-enhances excretion of substance

-a substance may be biotransformed into a more (bioactivated) or less (detoxified) toxic metabolite

-agents that must be bioactivated have delayed onset of signs by a few hours

-w/ GI tract absorption & IP injection, blood goes directly to liver: much of substance is biotransformed quickly (1st pass effect)
on a UDS, what if a certain drug is positive, then it's probably positive, unlike many drugs in the panel.
cocaine
Name five things that influence biotransformation?
1. Parenchymal organ disease 2. Toxicant localization in tissues with little PI/PII activity 3. Age and metabolic activity 4. Species-specific variation and individual variation 5. Gender and hormone differences
Describe the symptoms associated with each phase of acetaminophen toxicity.
Phase 1 (0-24 hr) - Assymptomatic
Phase 2 (24-72 hr) - RUQ pain, N/V, elevated transaminases
Phase 3 (72-96 hr)- Coaggulopathy, jaundice, encephalopathy
Phase 4 (4d-3wk) - Resolution of symptoms or organ failure
Give an example of antidotal treatment:
Inhibit conversion of compound to toxic form
Ethanol out competes methanol, which causes it to not be converted to a toxin by alcohol dehydrogenase
Cells differ in many ways including (7)
*energy consumption
*rate of cellular division
*active and passive transport characteristics
*realationship to cell barriers and extracellular matricies
*presence of intracellular components
*repair mechanisms
*biotransformation capacity
How does the lipophilic nature of Organochlorines affect their toxicokinetcs?
Absorbed by ALL routes
Distributes into ALL tissues
Stores in fat
Gets into milk
What is the classical syndrome of OP poisoning? When is this generally not seen?
SLUD (salivation, lacrimation, urination, defecation)

not seen in cats or bulls except following oral exposure
What toxicosis should you suspect in your chickens that have soft shelled, abnormal eggs and weak, deformed legs?
Thiram (Carbamate)

*sheep are also susceptible (anorexia, dyspnea, abortion, depres;leth)
What is the nomenclature of neoplasms?
-indicating cell origin and suggesting malignancy
-benign ends in -oma: adenoma,fibroma...
-malignnat ends in carcinoma ot sarcoma: adenocarcinoma,, leimyosarcoma...
-exceptions include melanoma, glioma, and astrocytoma
What is acrolein? What is its parent toxicant? enzyme catalysing toxication? toxic effect?
-nonionic elecrophile
-allyl alcohol and allyl amine
-ADH and MAO
-hepatic necrosis and vascular injury
urea & non protein nitrogen source intoxication signs
colic, abd pain, bloat
tremors, ataxia
Name some side effects caused by blood thinners.
-nosebleeds
-bleeding in the gums
-bleeding while shaving
-easy bruising
For what type of toxicant might dilution be effective?
corrosives

need rapid dilution: use water or milk ASAP
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 recirculationb)Tremor/seizure controlc)Propranolol for tachyarrhythmiasd)Atropine for bradycardiae)Lidocaine for PVCf)Catheterize bladder to avoid reabsorption of methylxanthine thru bladder wall; walk freq if possibleg)Supportive tx
What are the advantages and disadvantages of fomepizole over ethanol?
Fomepizole is not sedating, but is more expensive.
What's the rule about giving activated characol and inducing emesis?
Give the activated characol first, becasue if you give it second, it will bind the ipecac and not the toxin
Q. What 3 things did Heptachlor epoxide lead to?
1. breast cancer
2. non hodgkins lymphoma
3. parkinsonism
At what times the concentration of the labeled dose is Imidacloprid still safe, as per an FDA requirement?
5 times the labeled dose!
What is the prognosis for ACHE inhibitor toxicity?
depends on the agent

OP: long-term recovery is dependent on re-synthesis of ACHE

Chlopyrifos: assoc w/longterm effects

aggressive therapy needed in many cases
what animals should not be treated with Selemectin?
Collies and dogs with white feet
How is exposure a property of solvents?
-volatile solvents present as vapors (route of entry via respiratory system and penetration into systemic circulation via diffusion)
-partition coefficient affects toxicity onset time
-percutanous route of entry includes local irritation and affects integrity of skin barrier
What are ddx for neurological signs in pigs?
organic arsenic poisoning, salt poisoning, botulism, lead or mercury toxicosis, vitamin A def., pseudorabies
What herbs contain amylase?
Mai ya, shen qu, shan yao, dan dou chi
Physostigmine is RARELY used to treat anticholinergic agent OD bc of risk of seizure, great increase in pulmonary secretions, and/or intractable bradycardia. When do you consider this risky tx?
You may consider if severe dysrhythmias haven't responded to sodium bicarb and antiarrhythmic agents (such as lidocaine)
The concentration and toxicity of the chemical are affected by the following:
Route of entry into the bodyReceived dose of the chemicalDuration of exposureInteractions that transpire among multiple chemicalsIndividual sensitivity
How should water hemlock exposures be managed?
Animals usually are found dead, but can try to control seizures with a barbituate. To prevent further problems with herd, dig up or burn plants or use an herbicide.
In absorbed dose, D= e/m, what does e and m represent?
e= energy deposited
m= mass
Nitenpyram
1. how and where is it absorbed
**2. halflife
3. where is it excreted
4. MOA
1. rapidly in the GI (high bioavailability)
2. dog: 2.8hrs; cat: 7.7hrs
3. renal (~90%)
4. competitive nicotinic receptor antagonist
What is the mechanism of action of alkyl N-arylcarbamates?
-inhibitors of cell and nucleus division
What are some major factors concerning the:

a. absorption
b. metabolism
c. excretion

of ethylene glycol?
a. rapidly absorbed, half life of 2.5-3.5 hrs in dogs
b. occurs in liver
oxidation by alcohol dehydrogenase to glycoaldehyde: rate limiting step
glycoaldehyde --> glycolic acid --> glyoxylic acid --> oxalic acid --> oxalate --> CaOx crystals
c. excreted unchanged in urine
a patient has overdosed on a synthetic narcotic (or a long acting narcotic). What must be done to compensate for this in tx with antidote?
normally with short acting or non-synthetic you give 2mg IV (except in addicts). With these, you must take 2/3 of whatever dose reveresed the symptoms and apply that per hour.
What is traditionally used as a predictor for adverse outcomes with TCA overdoses?
Widening of the QRS duration of more than 100 ms.
Why are cats more sensitive than dogs to hydrocarbon toxicosis?
Because they often have the added ingestion factor from grooming themselves.
If urine is collected w/i 24 hrs of exposure to paraquat, which test will be prognostic? How are the results of this test interpreted?
dithionite test

no color to light blue (means concentration <1mg/L ) = survival
navy blue to dark blue (means concentration >1mg/L) = fatal outcome
How is the fenton reaction a good pathway?
-metals bind to other molecules by cholation
-for iron--> use deteroxamine
-bathocuprome for copper
-use scavangers of oxygen such as superoxide dismutase
what are the 2 ways to get an anion gap from cyanide poisioning?
cyanide poisioning from nitroprusside use or cyanide inhaled in residential fire smoke.
After how long post exposure to a hydrocarbon is an animal likely to NOT develop aspiration pneumonia? Nor a clinical toxicosis?
Over 1 hour post exposure = no aspiration pneumonia
Over 6-12 hours post exposure = No toxicosis
What is a major nephrotoxicity from asitolochic acid?
Guang fang ji, han fang ji, guan mu tong.
Which would be more likely to have a higher concentration of OC's: a fish-eating bird of prey living in an OC contaminated habitat or a bloom of algae in an OC contaminated environment?
Bird of prey --> due to OC's bioaccumulation properties, concentration of OC's in animals' bodies as they climb higher on the food chain.
How much Na bicarb do you give to somne poisioned by TCA?
1-2mEq/kg IV to start. Then you titrate arterial pH to 7.5. If pt is ventilated, can decrease CO2 as well
Iron
Deferoxamine
APAP
Nausea
Liver damage
APAP
N-acetylcysteine
streptokinase
aminocaproic acid
Snake bite
Dyspnea
Toxin-induced DIC
Snake bite
IMMOBILIZE
Cleanse
Antivenin
Benzene
Aromatic Hydrocarbon
Industrial solvent that causes CNS depression
Acute effects seen in CNS
Chronic effects on bone marrow
Emulsifiable Pesticide.
Worst form.
Source: paints & dyes
lead
Bradycardia
B blocker
Ca channel blocker
Alchohols
CNS and respiratory depression
Acidosis
Hypothermia
Hypoglycemia
Hypotension
Abdominal pain/gastritis
Tx: cold water gastric lavage
Treat metabolic acidosis w/ fluids
Thermoregulation
common anticholinergic meds
atropine
antihistamines
Cadmium
Smelting, electroplating, soldering, welding.
Acute: Pulmonary edema.
Chronic: Emphasema, lung cancer, kidneys.
Protien in urine and discolored hair.
eschar
protective coagulum that limits further penetration of acid burn
Acetaminophen overdose may cause
liver damage
Which neurotransmitter sets the circadian rhythms?
Melatonin
interaction with orbital electron--> full energy of photon
photoelectric effect
When are emetics contraindicated?
acids/alkalies
corrosive toxins
petroleum distillates
hazardous for animals who've already vomited, exhibiting coma, seizures, or lacking glottis control
treatment for people w/opiate poisoining?
naloxone
enterotoxin
an exotoxin that produces gastrointestinal symptoms and diseases such as
food poisoning.
Stage 1 Hypertension
140-159 systolic
or
90-99 diastolic
antihistamines fits into which toxidrome?
anticholinergic
Systemic Effects
Adverse effects associated with generalized distribution of the chemical throughout the bodyby the bloodstream to internal organs.
heavy metal poison ex.
iron, lead, mercury
source: colorless, odorless gas produced by incomplete combustion of organic compounds, malfunctioning exhaust systems, cigarette smoke, improperly vented gas water heaters, kerosene space heaters, characoal grills, hibachis, sterno stoves
Carbon monoxide
Spider bite
Widow: open Ca-channels, NT flood
Brown: dermonecrotic
Abdominal pain
Jaundice
DIC
Spider bite
Black widow: Ca-gluconate, methocarbamol (relaxant)
Brown recluse: steroids, colchicine, dapsone
opiate OD antidote
what receptors
Naloxone
mu-1, mu-2
kappa, sigma
What system(s) is/are affected by Alkaline Household cleaners?
GI
What does organochlorine insecticide toxicity cause?
serious neurotoxicosis
Carbon Tetrachloride, Chloroform, Trichloroethylene
Halogenated Aliphatic Hydrocarbons
Industrial solvents that cause CNS depression
No treatment
What are anticholinerative insecticides? symtoms ot toxicity? Delayed toxicity?
-organophosphorus esters (parathion,paraoxon) and carbamate esters
-symptoms of poisons are due to cholinestrase inhibition
-muscarinic symtpoms: tightness in chest, wheezing, saliva
-nicotinic symtoms:involuntary twitching, hypertension
CNS symptoms: anxiety, restlessness, insomnia
-death due to asphyxia scondary to respiratory failure
-delayed neurotoxicity: seen with organophosphorus esters but not carbamate esters
What is the most potent B-blocker?
propanolol
myasthenia gravis drugs fits into which toxidrome?
cholinergic
Slug and snail baits, mechanism may include inhibiting GABA, signs can be rapid or take up to 3 hours to develop, salivation, restlessness, anxiety, tremors, seizures, aggressive decontamination, tremor/seizure control, supportive care, good prognosis in
Metaldehyde
Carbamate
In what class of carbamate carbaryl belongs?
atropine use and chem
organophosphate intox; antagonized muscarinic receptors
bovine bonkers, treatment of low quality feeds, interaction of amino group with reducing sugar to produce imidazole, rapid onset, nervousness, ear twitching, tremors, seizures, nursing calves at risk, remove feed, keep quiet
Ammoniated feed
Amphetamines
Toxicity Mechanism
Mechanism of Action: CNS and peripheral stimulant. Cause the release of catecholamines (dopamine, norepinephrine & serotonin) from nerve terminals. The signs & symptoms of amphetamine overdose are generally similar to those of cocaine; however, while effects of cocaine last for 10-20 minutes, the duration of amphetamine action is much longer, lasting as long as 10-12 hours.
Asthma caused by inhaled external antigens is called
extrinsic asthma
How wide is the synaptic cleft?
50 nm
-weighted for radiation type
-weighted for tissue at risk
Doubly weighted dose
What is the recommended ratio of charcoal to ingested toxin?
10:1
For how long does Chlorofacinone depress the amt of vit. K dependent clotting factors?
3-4 weeks
symptoms of salicylism? Treatment?
tinnitus, respiratory alkalosis followed by metabolic ; alkalinize urine w/ NaHCo3 and K
What toxin is in the preventick collars?
Amitraz
What systems are affected by D3 toxicosis? (think-- what can calcium mess up?)
Cardiac
Renal
GI
What is delayed toxicity?
-happens many years later
antidote
a substance that will neutralize a specific toxin or counteract its effect on the
body.
What is the standard tx for anticholinergic OD?
physostigmine
Side effects of amphetamines
1) tachycardia
2) hypertension
3) convulsion
4) insomnia
5) psychosis
Da huang
contra indicated in pregnancy and intestinal obstruction, IBDS, and appendicitis and abdominal pain of unknown origin.
Copper toxicity
sheep-most affected (builds up in liver until stress causes release)
ruminants
severe Gastroenteritis (erosions and ulcerations in abomasum)
icterus
Central nervous system
What common cosmetic product is considered for excellent repellent?
apomorphine use
emesis w/in 1-3 min of sc injection
Prevention of glycine release, retroaxonal transport, anaerobic conditions, spores environmentally stable, tremors, rigidity, sardonic grin, pump-handle tail, asphyxia, antibiotics, antitoxin, tranquilizers/muscle relaxants, poor prognosis
Tetanus, Clostridium tetani, tetanospasm
Lithium overdose causes
CNS effects, blurred vision, confusion and seizure , coma
Type 3 hypersensitivity rxn is also known as
Arthus reaction
Iron
Medicinal anemials Prenatal supplements
Acute; Mainly in kids
sever GI distress--> Necrotizing Gastroenteritis, with Hematemsis
bloody diarrhear, Dyspnea, shock, Coma
Iron
Medicinal anemials Prenatal supplements
Gastric Lavage
DeFEROxamine IV

FEROUS--> IRON
Part of photon energy is transferred to an electron, and the photon scatters with less energy
Compton effect
What is the effect of methamphetamines and cocaine on the CNS?
Increased BP
Hemorrhage
Vasospasms
Seizures
Intracranial infarcts/hemorrhages
The clinical signs and treatment of acid cleaner toxicosis is the same as for what other household toxicant?
Alkaline cleaners
What is urine used to detect?
drugs and pesticides
Bromethalin toxicity causes signs that are typical of lesions in which section of the spine?
T3 - L3
What is the central concept of toxiclogy?
DOSE RESPONSE
How do you make Paraffin-embedded sections for histological slides?
-tissue sampling
-fixation
-tissue processng (dehydration in alcohol, clearing with
xylene, and embedding in paraffin)
-sectioning
-staining
What is DES-4,4'-quinone? What is its parent toxicant? enzyme catalysing toxication? toxic effect?
-nonionic electrophile
-DES
-peroxidases
-carcinogenesis
organophosphorus carbamate insecticide treatment
atropine (tx SLUD)
oximes (mimics binding site on cholinesterase enzyme & so binds Ach & increases elimination.
What 2 "REN" herbs contain [cyanophoric glycoside] and need special preparation?
Xing Ren
Tao Ren
What is considered the cornerstone of heart failure drug therapy?
ACE inhibitors
bleomycin and lung damage
oxygen free radicals damage tissue
what is the antidote for methanol?
ethanol (+folate); fomepizole
Name a prominent symptom of cyanide poisoning.
Bitter almond breath
syrup of ipecac contraindications
coma (risk of aspiration), convulsions (risk of aspiration), age less than 9 mo (vomiting response not well dev), nontoxic ingestion (emesis has its own risks and discomfort), ingestion of caustic substances (don't expose esophagus a 2nd time), ingestion of petroleum distillate hydrocarbons (risk of aspiration)
What is 4-aminopyridine used for? What's the commercial name?
Bird control - Avitrol
the lower the viscosity
the higher the risk of aspiration
what type of epithelium os present in tracheobronchial region?
cilliated columnar
What is the occupational guideline for He
20mSv per yr.
How far did the radiation travel from the hypocenter?
1-2 km
What toxicokinetic properties make Nicotine toxic?
Easily absorbed orally AND dermally
What substance is found in some pyrethroids that makes it more toxic?
alpha cyano moiety
What is T1/2?
half life- time required for plasma concentration of a checmical to decrease by 1/2 (time course of toxicants in organisms)
How does warfarin work?
it inhibits epoxide reductase, and therefore doesnt allow K dependant clotting factors to activate
What systems are affected by theobromine?
CNS, GI, Cardiac, Renal
What is hypertrophy?
1.Increase in cell size, resulting in an increase in the
size of the organ, both physiologic and pathologic.
2.Generally involving non-dividing cells such as skeletal
and cardiac muscle cells.
3.Reversible
What is caspase?
-a protease that has affinity for cysteine aspartate
How to treat anticholinergic OD with agitation?
benzos or antipsychotics
Define Hypertension
Defined in an adult as a systolic pressure of 140mmHg or higher and/or a diastolic pressure of 90mmHg or higher.
What are the types of herbal toxicities?
Nephrotoxicity, Hepatotoxicity, Fetotoxicity.
which bundle of the heart is more sensitive to tricyclic antidepressant overdose?
right bundle
False; worst toxicity is by aspiration
Carbon monoxide preferentially binds to hemoglobin to form _____.
What is the most common cause of death from a toxin?
Carbon monoxide
Source: toliet bowl cleaning products, automotive battery, rust removal product, metal cleaning product, cement cleaning product, drain cleaning product
caustic agents (acids or bases)
General principles for managing drup abuse include
scene safety, airway, breathing, circulation, history, substance id, focused exam, initiatin ot IV, admin, of antidote , prevention, transport
Q. Cotinine has a plasma 1/2 life of how long?
16 hours
What properties do the aliphatic and multicyclic Organochlorines have in common?
Lipophilic
Very stable
Able to biomagnify
For tx of which toxicity is phenothiazine contraindicated and why?
pyrethrin/pyrethroid toxicity bc pyrethrins/pyrethroids are assumed to cause extrapyramidal stimulation
what do we find pyrethrin in?
Topical flea/tick treatments and chrysanthemum
treatment for organophosphate intoxication
remove clothes and wash skin to prevent further absorption, then give atropine
What s metastasis?
-growth of cancer cells at a second, separate sites, involving spreading by the circulation
What are the various factors that inhibit activity of ATP synthase during mitochondrial ATP synthesis?
-ATP synthase (DDT)
-adenine nucleotide translocator
-phosphate trasnporter
-uncouplers
organic arsenic

a. conditions of poisonings
b. clinical signs
c. dx
d. tx
e. px
a. organic less toxic than inorganic
b. misformulated feed: used as feed additives to improve production in swine & poultry rations & to tx dysentery in pigs
b. pigs: ↓ wt. gain, incoordination, blindness, posterior paralysis, quadriplegia; animal remains alert w/ good appetite
c. hx of arsenicals added to feed in improper dosage
d. no specific tx
e. neurotoxic effects usually reversible if feed is withdrawn w/in 2-3 days of onset of ataxia
once paralysis occurs, nerve damage is irreversible
blindness is irreversible
What is the antidote?
1. at < 40C bromocriptine
2. at >40C, bromocriptine and induced neuromuscular paralysis and aggressive external cooling
What are the contraindications for chuan xiong?
During pregnancy, excessive menstrual bleeding,
what's a possible physiologic reason why you might get a false negative on a UDS.
decreased clearance by kidneys (indicated by increased creatinine)
Under what conditions is ion trapping likely to be successful?
Successful ion trapping:1. compound is excreted predominantly unchanged through the kidneys2. compound is a weak electrolyte with a suitable pKa3. toxicant is primarily distributed to the extracellular space and is not protein bound
syrup of ipecac disadvantages
slow onset of action (20min or more), variable & incomplete emptying of stomach contents, own potential adverse effects, activated charcoal must be delayed until emesis stops
What are the two classes of cathartics?
Osmotic cathartics and bulk cathartics.
Which of the following statements regarding drugs of abuse panels are correct?

A. A positive amphetamine screen is specific for methamphetamine
B. A positive test confirms intoxication
C. Generally more helpful clinically in adults than in children
D. Me
E. Rarely contributes significantly to the evaluation, management, or outcome of emergency department patients

For psych only
What is the mechanism of action of Amitraz?
Alpha 2-agonist (like Xylazine!)
What happens with dermal exposure to acids or alkalies?
what do you do?

which is worse: acids or alkalies?
pain & edema

wash with water

more penetrating injuries with bases, saponification of skin fat occurs
In what species is amitraz used?
Swine and cattle and dogs
tick collars
What does cellular target of metals depend on?
-metal species and lipid solubility
What is the consequance of inhibiting ATP synthesis?
-constant influx of of Na+
-auumulation in cells causing swelling and eventually lysis
What are some plants that cause vomiting & diarrhea?
pokeweed (saponins), Saponaria spp., Ranunculaceae family (glycosides): buttercup, baneberry, marsh marigold, Clematis spp
What are 3 types of toxic reactions to herbs?
Drug poisoning
Allergic reaction
Idiosyncratic
Monkshood

a. species most commonly affected
b. common presenting complaint
a. cattle; emerges in early spring
b. GI signs: often present for bloat
How should exposures to 5-FU be managed?
Decontamination: emesis if less than 30 minutes or gastric/enterogastric lavage and AC/C. Seizure control may require days of treatment - diazepam not usually effective. Give GI protectants for GI mucosal sloughing - sucralfate, misoprostol, omeprazole. Analgesics - butorphanol, Antibiotics (broad spectrum), monitor and treat leukopenia (appears 5-20 days post exposure) with Filgrastim (Neupogen), a granulocyte colony stimulating factor.
First IGR developed for commercial use?
What is the biological origin of Avermectins?
What's the difference in methaqualone overdose and barbituate overdose?
About the same, only
Methaqualone has more pronounced motor problems (ataxia - failure of muscle coordination)
can lead to severe musclular hypertonicity and seizures
Carcinogens are directly linked to lung cancer (T/F)
false; they are causally linked to lung cancer
How do DEET toxicities manifest?
Well, DEET is not really absorbed very well, so toxicosis is rare.
May cause dermatitis or ocular effects
If it is absorbed systemically, it can cause encephalopathy with ataxia, confusion and temors being seen.
What does Vitamin K reductase do?
it is required for the re-conversion of inactive vitamin K to its active quinone form
What are the clinical signs of fluroacetate?
CNS stimulation, running in circles, seizures, then coma
What is the relative toxicity of EG metabolites?
Glyoxilic > Glycoaldehyde > Glycolic > EG
What is the fenton reaction? Significance?
-takes oxygen from peroxide and makes it ionic for cleavage into water
-in the presence of metals, it generates bad OH
-these metals can bind to enzyme and become unreactive and can't participate in reaction
How do anti-seizure meds decrease propagation of action potentials?
1) decease Na+, Ca2+ influx (delay depolarization/prolong repolarization)

2) increase Cl- influx (hyperpolarize membrane)
Rhododendron

a. when during the year do most toxicoses occur & why?
a. most toxicoses occur in winter & early spring when other forage is unavailable (evergreen)
How should water hemlock exposures be managed?
Animals usually are found dead, but can try to control seizures with a barbituate. To prevent further problems with herd, dig up or burn plants or use an herbicide.
In which of the following situations of known methanol ingestion are both administration of fomepizole and performance of hemodialysis indicated?

A. pH/PCO2 7.10/10, methanol 0 mg/dl, ethanol 0 mg/dl
B. pH/PCO2 7.10/10, methanol 10 mg/dl, ethanol 300 mg/
c. pH7.1, pCO2 10, methanol 30, ethanol 30
Contraction of the smooth musculature and adema are two conditions that together reduce what?
The cross sectional area of the air passageway in the lungs which in turn reduces the flow of air.
What are the 3 main types of Disinfectant cleaners?
Phenolic compounds with soap or detergent
Pine-oil based compounds with soap or detergent
Cationic surfactants straight or mxed with nonionic detergents
What is lindane used for and in what spp?
flea control for small animals
treatment for head live in humans
What are the stages of clinical signs that are associated with EG toxicosis?
(1) <12hours: CNS
(2) 12-24 hours: Cardiopulmonary
(3) 24+ : Renal
What is the pathway for DNA repair?
-DNA has dimer
-dimer recognized by a nuclease at site of damage and is cut
-dimer excised
-gap filled by DNA polymerase
-nick sealed by DNA ligase
What are the special instructions for taking nitroglycerine?
-take one tablet, wait 5 minutes
-take another one if chest pain still there
-if pain persists for another 5 minutes, take a 3rd
-if chest pain doesn't go away after this, call ambulance right away
What is the difference between LD50 and therapeutic ratio?
LD50 is the dose likely to cause death in 50% of a given species/age/sex group under specified conditions. The therapeutic ratio is the ratio of LD50 to ED50 (units are %).
Why were there no excess of leukemia even after massive doses of Radium?
-because target cells for leukemia in bone marrow are outside the short range of the radium alpha particles
ACHE inhibitors
1. how are they absorbed
2. where are they metabolized
3. when do signs appear?
4. some OPs require ___ before inhibiting ACHE
1. rapidly from skin and GI tract (bc lipophilic)
2. liver (do not bio-accumulate)
3. rapid (minutes to hours after exposure)
4. requrie metabolic activation
What does the season have to do with the toxicity of a synthetic drug?
seasons may affect hormone levels/ metabolic activity

*testosterone is highly correlated with cytP450 activity
What blood activating herbs are contraindicated in pregnancy?
Hong hua, huai niu xi, tao ren, chuan niu xi, yi mu cao, mo yao, chuan xiong
What is a general treatment for a comatose patient?
If in a coma, give glucose, insulin, and naloxone ... in case the patient is a (1) diabetic (2) drug addict
How do you test in vivo for subchronic toxicity?
-90 days, most common test
-look for NOAEL, no observed adverse effect lvl
-use 2 species
To reduce the amount of DDT in the formulation.
what is the difference between WP and SC?
How does a failing heart try to compensate for its weakened pumping action?
It beats faster = more strain on the heart
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