Toxicology Final Flashcards

Terms Definitions
Heparin
Bleeding
Heparin
Protamine sulfate
Identify.
Pokeweed
Arsenic
penacillamine
Arrhythmia Drugs
Digioxin
TCA
Methemoglboin
methylene blue
Narcotics are
CNS depressants.
Parathion/Malathion
Organophoshphate: irreversible AchEinhibitor

Tx: Pralidoxime (organPO4 only becaue irreversible) to regenerate AchE, and Atropine as a muscarinic antagonist
Theophylline
Propranolol or Esmolol
Disease from silica
Silicosis
Antimetabolite chemotherapeutic, interferes with DNA and RNA synthesis, ingestion of owner’s medication, bone marrow suppression, decontamination, seizure control, GI protectants, analgesics, antibiotics, filgrastim, prognosis guarded to poor
5-fluorouricil, 5-FU
Anticholinergics
(ipraTROPIUM, atropine)
Dry mouth
Urinary retention
QRS widening
Anticholinergics
(ipraTROPIUM, atropine)
Physostigmine (cholinesterase inhibitor)
Main affect of Bromethalin
neurotoxic
What factors influence biotransformation?
n
Name a local anesthetic
lidocaine
Formaldehyde
Nasal cancer, contact dermatitis.
overdose with mydriasis?
sympathomimetic, anticholinergic
water
dilute: topical toxicant, ocular exposure,orally ingested poison
T lymphocytes constitute what percentage of circulating lymphocytes
70%
OPIODS Analgesic
Lehtargy, Sedation ↓ HR ↓ BP hypoventilation(resp depression)miosis, coma, respiratory failure
OPIODS Analgesic
Intervention/ ANTIDOTE

Ventilatory support
Naloxone/natrexone frequent intervals
Lead
Source: Pipes, paint, toys, gasoline
T1/2=1-2 mth is soft tissue, years on bones
Children at higher risk
Blood: microcytic anemia(-Hb synth)
PNS neuropathy
CNS encephalopathy(pot. fatal) and cerebral edema, decreased IQ, aggression
GI-pain and decreased appetite
STILLBIRTH, GOUT
Dx: >10=reduce expsoure, >25 tx a child, >50 tx an adult, >120 encephalopathy
TX: MAIN=PREVENT FURTHER EXPOSURE
Ca EDTA, DIMERCAPROL(SEVERE), DMSA/SUCCIMER, DEXAMETHASONE(FOR CEREBRAL EDEMA)
Lead toxicity
Calcium EDTA (complex formation)
Bilateral, symmetrical tetanic seizures stimulated by bright lights, sounds, or touch are very strong indicators of ____ toxicosis
strychnine toxicosis
How to tx iron OD?
Deferoxamine
Nickel
Mining, refinery, SS production, electroplating.
Cancer of lung and nasal. Can cause asthma.
Nickel carbonyl is most toxic form.
carbamazepine fits into which toxidrome?
anticholinergics
polythiol resins use
interfere with enterohepatic circulation in mercury poisoing
Symptoms:agitation & hyperactivity, euphoria, chest pain, dry mouth,hyperthermia, nausea & vomiting, mydriasis, anorexia
Amphetamine overdose

Treatment: sedation and observation, Use benzodiazepine sedation (nonspecific sympatholysis) to initially manage hypertension
Aggressively cool hyperthermic patients
Tricyclic antidepressant toxicity causes
peripheral atropine-like anticholinergic effects and depressant effects on myocardial function (prolong QRS)
Acetylcholinesterase Inhibitors

Organophosphates
S&S:
Diarrhea, Urination, Miosis, Bradycardia, Bronchostriction, Excitation (Muscle and CNS)
Lacrimation Salivation, Sweating
Acetylcholinesterase Inhibitors

Organophosphates
Intervention/ ANTIDOTE

: Respiratory support:
Atropine

2-Pam (pralidoxime)
irreversible AChE Inhibitors
Methanol
in windshield washer

tx: IV NaHCO3 for met. acidosis
Folate-B vit complex (converts Formate to co2 and h20)
ADHinh= FOMEPIZOLE, OR ETOH(OUTCOMPETES OTHERS)
OP (organophosphate) insecticide toxicosis
Pralidoxime/2-PAM (functional restoration)
drugs that use charcoal?
teophylline, pheonbarbital, carbamazepine, quinine, dapsone, salicylate
Malathion and chlorpyrifos are what class of pesticide?
organophosphates
Bromethalin signs
paralysis, muscle tremors & seizures
Name the chief CNS inhibitory neurotransmittor.
GABA
Cyanide mechanism
Inhibits cytochrome oxidase enzyme system. Cells cannot use O2.
acetaminophen OD tx
Tx with N-acetylcysteine
(acetylcysteine is a precursor of glutathione), replinishes glutathione stores to combine with toxic metabolite of acetaminophen
ethanol +folate is the antidote for?
methanol
The newer preferred treatment of cyanide poisoning is _____, which binds cyanide to generate the non-toxic cyanocobalamin.
Hydroxycobalamin (Cyanokit)
ethylene glycol chemistry
metabolized to glycolic acid`-> glyoxylic acid-> oxalic acid
wilson's disease
copper accumulates due to a ceruloplasmin deficiency, rheumatoid arthritis
Symptoms: (irritability), tremors, pink discoloration of the hands & feet, Gingivitis,
Toxicon: Mercury

Treatment: ABCs. activated charcoal. administer chelation therapy (BAL)
Ingested iron may produce
lethal gastrointestinal hemorrhoge, bloody vomitus, painless bloody diarrhea, and dark stools
give two examples of antigen -presenting cells (APCs)
macrophages
B cells
The RWF, or biological effectiveness factor depends on?
Radiation type
What system(s) is/are affected by bleach products? What are the clinical signs?
GI
Vomiting
Abdominal pain
list some 2nd generation anti-coagulant rodenticides
brodifacum
D-con, Havoc, Enforcer
bromedialone
difethialone
pindone
diphacinone
assassin, Tomcat
what drug is best for seizures concerning strychnine toxicity?
Methocarbomol
What is mean by the term biotransformation and what role does it play in exposures to toxicants?
n
Which type of caustic ingestion is worse, acid or alkali?
alkali
How are free-radicals fomed?
-absorption of radiant energy
-reduction-oxidation (redox) reactions
-enzymatic metabolism
zearlenone source
fusarium mycotoxin - corn, wheat, barley oats
What is the generic reference to morphine-like drugs/actions?
opioids
Carcinogen
Cancer causing agent. Does not follow dose-response curve. Long latency period and lack of threshold.
on comprehensive drug screens, do you get more false positives or negatives?
negatives
Threshold
the lowest dose at which a particular response may occur. It is unclear whether exposure to toxicchemicals at low (subthreshold) levels may produce any health response.
What kind of formulation contains a water soluble pesticide dispersed in oil carrier
Invert emulsion
ethylene glycol found in
antifreeze, solvent for paints, lacquers
Toxicon: Digoxin MOA
Mechanism of Toxicity: inhibits Na/K ATPase; cardiac arrhythmias (delayed after-depolarizations w/ abnormal automaticity, depolarization & conduction block, 1st - 3rd degree AV node conduction block, enhanced vagal tone); CNS effects
Memeory cells have Ig__ and Ig__ on their surface
IgM
IgD
Which port was Peter the Great stopped at on the Volga River?
Constantinople
Little boy was dropped in which city in japan?
Hiroshima
Methyl Mercury
seed fungicide, and in sea water (predatory fish), and research use to kill cells

Toxicity: irreversible, loss of balance, ataxia, sensory deficiets, vision defects, deafness, dysarthria

Tx: Selenium reduces toxic effects, if co-adminstered
In what spp can lindane not be used?
cats
symptoms for cyclic antidepression syndrome? Causes? Treatment?
hypotension, tachycardia, wide QRS/QTc, seizure; Amitriptyline, Citolopram, and Venlafaxine; make blood pH basic (hyperventilate/NA bicarb)
Treatment of Iron Toxicity
Milk to induce emesis
Gastric lavage
Deferoxamine orally or IV
what does pralidoxime (2-PAM) do?
regeneration of acetylcholinesterase (muscarinic and nicotinic sites)

*otherwise: takes ~20+days to generate new enzye (1-5%/day)
What is immune mediated hypersensitivity?
-effect at dermal level
buttercup

a. toxic principles
b. clinical signs
c. tx
a. ranunculin (nontoxic glycoside): found in all parts of plant: forms protoanemonin: irritant volatile oil
+/- anemonol (alcohol)
drying destroys toxicity
b. ingestion: gastroenteritis, vomiting, bloody diarrhea, +/- hematuria, rarely convulsions & death
c. symptomatic, supportive (emetic, AC)
What is the tc for warfarin OD?
Vitamin K1
What are anti-anxiety and sedative-hypnotic drugs used for?
1) sedation
2) hypnosis
3) insomnia
What are the 5 primary areas of concern when prescribing herbs?
Diagnosis
Preparation
Dosage
Interaction
Inherent toxicity
TCA (fxn like anticholinergic), how does it cause heartblock.
rapid sodium channel
What clinical signs are seen with tetanus toxin?
Generalized musculoskeletal stiffness, abnormal blinking from fine motor tremors of eyelid/elevated third eyelid. Sardonic grin - contraction of muscles of lips. Progresses to severe muscular rigidity, "sawhorse stance," fixed stare, erect ears, reluctance to eat or drink due to "lockjaw," elevated tail "pump-handle tail," flared nostrils. Recumbancy due to muscle rigidity and convulsions possible. Death due to contraction of muscles of respiration (asphyxia).
lead symptoms
acute lead poisoning is rare, usu from chronic exposure in lead-related industries; hypochromic micryocytic anemia, renal toxicity, lead palsy, Gi constipation, anorexia, and abdominal pain, lead encephalopathy in children
hemoperfusion use
for removal of chemical toxins esp if agent is lipid soluble or higly bound to plasma protein (more effective than hemodialysis)
EDTA is treatment for what type of poisioning?
Lead poisioning
Properties that determine chemical reactivity are
chemical pH, direct-acting potential, indirect-acting potential ,and allergic potential of chemicals
What three levels do toxicologists study?
Enzyme, cellular, and systemic
The longer the wave length the ______ the energy, and the ______ the frequency
low. low
MOA of amphetamines
1. Increase presynaptic release of NTs (NE, Dopamine)

2. 5-HT2 agonist and D2 antagonist --> Hallucinations
Severity and duration of the coagulopathy caused by anti-coagulant rodenticide toxicity primarily depends on what?
the specific anti-coag ingested
How would you gauge the effectiveness of therapy when treating cholecalciferol rodenticide toxicity?
monitor serum Ca
CS of zinc phosphide toxicity
Nonspecific - GI, pulmonary, excitement of the cns and rapid death
Foal: Onset of clinical signs 10hours. Mydriasis, blindness, bradycardia, convulsions.

Name the toxicosis.
Ivermectin

*blindness is reversible
What is the mechanism of action of aryloxyalkylcarboxylic acids and benzoic acids?
-growth stimulents
-auxins
What are mechanisms that oppose the distrbution of toxin to target?
-protein binding
-specilized barriers
-distribution to storage sites
-association with intracellular binding protein
-export from cells (PgP)->efflux
strychnine source
rodenticide - seed baits - often dyed to indicate toxicity
What effects are caused by amphetamines at high doses?
agitation, acute psychosis, hypertension, tachycardia,
seizures
How do beta blockers decrease the workload of the heart?
decrease HR---->decrease BP----->decrease workload
mercury (Hg) toxicity, tx w
dimercaprol (BAL) or penicillamine (chelating agents)
entail
to cause or involve by necessity or as a consequence:
What is the mode of action of Diflubenzuron?
Chitin synthesis inhibition
Antidotal treatment for heavy metal poisioning?
Chelators
BAL - British Anti-Lewisite
EDTA
complexes with the metals making them inert
how small must a particulate be to go into the depp lung
0.5 microns
What is the drug give to alkalinize urine to treat aspirin overdose?
NaHCO3 in D5W
List some screening tools used to differentiate/detect chemical compounds
gas chromatography/mass spectrometry (GC/MS)
inductively coupled argon plasma emission spectroscopy (ICPAES)
inductively coupled plasma mass spectrometry (ICP/MS)
Which animals are most sensitive to Vit D toxicity?
Young animals, and cats
What should you suspect if your dog comes back from running covered in orange-yellow dye?
dinitroanaline herbicide (pendimethalin)
What is diffusion-limited compartments?
-those in which uptake is proportional to membrane permeability and total membrane area
What are critical events in irreversible cell injury?
-inability to reverse mitochondrial dysfunction
-distrubances in membrane function
What is the tx for amph-induced hyperthermia?
**phentolamine or nitroprusside
**for very high temperatures: induce neuromuscular paralysis
Function of beta blockers
reduce the heart's tendancy to beat faster by reducing the effects of chemical messengers that increase heart rate.

allows the heart to maintain a slower heart rate & lowers BP
Carbon monoxide (CO) pharm effects
a. forms carboxyHb which cannot carry oxygen and interferes w the release of oxygen from oxyHb = arterial O2 content is 50% of normal
b. reduces oxygen carrying capacity (content) of blood but not the PaO2
c. CO also directly toxic to cellular cytochromes
duration of cocaine?
2-3 days (light use), 8 days (heavy use)
Describe how ocular exposures occur and how they should be treated.
Oular exposures usually only involve the superficial layers of the cornea or conjunctiva. Immediate irrigation should be performed with body-temperature tap water LRS or normal saline for 20-30 minutes.
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
Ingestion of Methanol can affect the
CNS, the gastrointestinal tract, and the eyes.
Why can't beta particles' energy loss in matter be descried as for alpha particles?
-Relativistic effects must be considered
-Electrons interact with particles of same mass
-Radiative or bremsstrahlung energy loss occurs when electrons slowing in matter
Why do convulsions typically result from a toxicosis of Ion Channel Insecticides?
Acute toxicity of Ion Channel Insecticides BLOCKS Cl channels (like GABA), preventing inhibition of ganglia while ENHANCING Na channels, resulting in repetitive firing & depolarization. All of this stimulates the nervous system.
What are the clinical effects of imidacloprid toxicosis and how is it treated?
generally mild and self-limiting (vomiting, salivation)

tx symptomatically and supportive
what is alkaline diuresis used for?
salicylates, phenobarbitol (K is the key)
Does atropine alleviate all the signs of OP toxicosis?
only muscarinic signs

-- nicotinic signs will decrease w. time
What is epidermiolofical determination of causality?
-if knowledge is robust, causation can be inferred from observational (non-experimental) studies, where allocation of test subjects or items is not under the control of the investigator
What does membrane injury lead to during cell ischemia?
-increasde calcium influx
-leads to increased calcium in mitochondria (irreversible)
-increased exit of enzymes (ireversible)
Paracelcius said what?
Anything can be a poison if the dose is high enough.
You consult the Rumack nomogram and find that for a single acute ingestion your patient needs the ____ antidote for acetaminophen posioning. You should give 140mg/kd DL, then 70 every 4hours for ___doses by (IV/PO)?
NAC (N-acetylcystein), 17 doses, PO
False; despite osmolal gap, no acidosis occurs
Name 3 methods of isopropanol toxicity management.
How should dermal exposures be managed and what are some considerations for treating dermally exposed patients?
Bathing is standard method of decontamination. First, animals should be stabilized and assessed prior to bathing. Liquid hand dish detergents are the best soaps to use. Repeated bathing and rinsing may be required. If sticky or viscous material present, Goop or Go Jo hand cleaners may be needed followed by hand dish soap. Clipping or shaving the hair may also be required.
Ethylen glycol toxicity is caused by the buildup of metabolites,
especially glycolic and oxalic acids after metabolism.
Effects of CO on blood transport
There is an increase in oxygen affinity of hemoglobin with CO bound(220x more affinity than O2 for Hb). The result(CarboxyHb) is a decrease in oxygen delivery to tissue.
So, what little oxygen that is bound to hemoglobin will not dissociated at the tissue. THIS RESULTS IN HYPOXIA.

ACUTE: Brain and heart affected, fatal at 80%
CHRONIC: POSSIBLE CV PROBLEMS

HA AND HYPOXIA ARE INITIAL PROBLEMS
tx; remove co and then hyperbaric O2
What is the point of supportive therapy?
to maintain normal body temperature (tx hyper/hypothermia)
to control CNS activity (tx depression, hyperactivity)
CV and respiratory support
what is meant by dose dependent relationship?
A measurable biologic effect is proportional to the amount of chemical received assumining:

1-chemical interacts with a molecular or receptor site to produce a response

2-the production of the response is correlated to the concentration of chemical at that receptor site

3-the concentration of the chemical at the receptor site is related to the dose of chemical received
What are the vasrious grades of tumor differentiation?
-grade 1- well differnetiated
grade 2-moderatly
grade 3- poorly
grade 4- anaplastic
What is the tx for anticoagulant rodenticide toxicosis if > 1/10 of lethal dose is ingested?
decontaminate GI tract

vitamin K1: will correct coagulopathy but may require 12-48 hrs before coag times normalize
loading dose, then BID to TID, PO preferred
warfarin: 7-10 d.
brodifacoum: 21-30 d.
reevaluate OSPT 36-48 hrs after cessation of tx
high doses (esp. if given IV) may cause Heinz body anemia
if ACT still ↑ after 1 mo. of tx, animal may not be absorbing vitamin K completely

blood or fresh plasma transfusions
-transfusion indicated if PCV < 20: need active clotting factors from fresh whole blood
IV fluids: careful w/ IV catheters: if dog chew it out  hemorrhage
supplemental O2
Under what circumstances might you use gastrotomy or gastric endoscopy?
rarely indicated

may be required to remove FBs from stomach: endoscopy preferred

metal ingestions: lead weights, pennies, zinc bolts, etc.

large quantities of drugs which form coalesced masses: ex. meprobamate
what are the drugs that can be dialized?
EMP-SL: EMPty Small volume-Low protein: Ethylene glycol, methanol, phenobarbitol, salicylate, lithium
(T/F) There is no antidote to ethanol poisoning; treatment is supportive care.
Discuss the mechanism of methanol toxicity.
the number one cause of fatality from drug ingestion.
Notes: In the US: Approximately 500,000 cases of TCA toxicity per year are reported.

Fatality before reaching a healthcare facility occurs in approximately 70% of patients attempting suicide with TCAs. Tricyclic antidepressants are the number one cause of fatality from drug ingestion. Only 2-3% of TCA overdoses that reach a health care facility result in death.
Hemodialysis is useful for toxin with what type of properties?
1. Low molecular weight
2. Low plasma protein-binding
3. Small Volume of distribution
4. Poor endogenous clearance
What is the MOA of anti-coagulant rodenticide toxicity?
interferes with the vit K epoxide reductase enzyme, which ultimately results in decr levels of vitamin K-dependent flotting factors (II, VII, IX, X) and Vitamin K1
What is the MOA of Diphenyl aliphatics
These are organic chlorines, and act by keeping the sodium channels open. You gget repeated firing of neurons in the CNS, then subsequent CNS depression
How are cell culture models used for in vitro testing?
-human vs animal
-cell type specific vs mixed cell
What happens at high doses of propanolol?
It blocks Na channels and causes cardiac conduction block as well as enters the CNS, causing seizures and coma
You have a patient being treated with warfarin prophylactly. The pt takes the wrong amount and gets a massive bleed. How would you couteract the effects of warfarin? why could this administration be a problem?
vitamin K (increase clotting cascade); vit K is fat soluble, so if you plan to give warfarin again after crisis has resolved, even though you may stop tx with vit K, you may still get inhibitory effects
What clinical signs are expected with strychnine toxicosis?
Clinical signs have a rapid onset and progression. Initially nervousness, apprehension, anxiety, increased respiratory rate, excessive salivation, but no vomiting. Followed by ataxia, muscle spasms and stiffness. No paddling or running usually, just rigidity with few periods of relaxation btw seizure episodes. Death usually due to inhibition of respiration or physical exhaustion.
What is the most important thing to to/remember when treating a toxicity?
stabilize the patient first!! (tx the patient not the toxin)
Why with Vit D toxicty do we see hyponatremia and hypokalemia?
It competes for reabsorption in tubules with calcium. The body would try to reabsorb as much calcium as possible and would pee out the na and k
What are some tests used to dx anticoagulant rodenticide toxicosis?
ACT, OSPT, APTT should all be prolonged (OSPT becomes prolonged 1st)
-↑ ACT (100%), ↑ OSPT (94%), ↑ APTT (93%)
-if ingestion just occurred, ACT will still be normal

PIVKA Test (Thrombotest): very sensitive, but hard to interpret, expensive

continued bleeding from venipuncture site is a clue

clin path findings (in order of ↓ frequency): anemia (PCV < 35%), hypoproteinemia, thrombocytopenia, ↑ FDPs, hyperfibrinogenemia

rads findings (in order of ↓ frequency): pleural effusion, pulmonary infiltrates, loss of abdominal detail, widened cranial mediastinum, normal, extraluminal tracheal compression
when can you look at a DONE NOMOGRAM?
6 hours post ingestion minimum, must be single dose OD only, (not very accurate, it over predicts toxicity)
If something has a high risk factor does it have a lot of risk associated with it?
No, there isnt a lot of risk associated with it
what is the equation for the calculated (not measured) osmolal gap?
2 Na + glucose/20 + Bun/3 + Ethanol/5 *if known
What is the problem with the c/s of pyrethrin/pyrethroid toxicity?
you canNOT distinguish it from OP or carbamate toxicity based on the c/s alone
What do you NOT want to do if a corrosive has been ingested?
do NOT neutralize it with vinegar or sodium bicarb
Bradypnea
opiates
Cadmium
Succimer
Manganese
Resembles Parkinsons
TCAs
HCO3-
Plasma alkalinization
organophosphates
phosphorus-containing organic pesticides.
Beryllium
Sensitizer
scars lungs
lung cancer
Antidotes to Fe
deferoxamine
Flumazenil DOC for ----
Benzodiazepines
List nicotinic effects
Muscle weakness
Fasciculations
Paralysis of muscles of respiration
treatment for body packers?
golytely
salicylates
urine alkalinzation, dialysis, activated charcoal
Mercury
Gold extraction, chlorine production.
Acute: Respiratory system.
Chronic: CNS.
Mercuric Chloride most toxic.
dioxin causes
dermatitis amd chloracne
penicillamine disadvantage
allergy (1/3 of ptnts)
A capsule containing threadlike, venomous stinging cells found in some coelenterates.
nematocyst
What color poison is Succinylcholine?
blue
Paraquat
Turns O2 to superoxide radicals
diffuse pulm fibrosis
Zinc phosphate
Seizures
Pulmonary edema
Liver +/- kidney involvement
Acute onset
treatment for alchol-induced werickes encephalopathy?
thiamine
ddx for hypercalcemia
cholecalciferol toxicosis, hypercalcemia of malignancy (esp. LSA), pseudohyperparathyroidism, primary hyperparathyroidism, feed mixing error (↑ vitamin D in feed)
Name a diuretic
HCTZ = Hydrochlorothiozide
hydroxycobalamine can reverse which OD?
cyanide
Arsenicals exert what effects on protein?
Coagulation
organophosphate treament
maintain adequate respiration, dec absorption (emesis, activated charcoal), atropine, pralidoxime (2-PAM)
Involuntary rhythmic movements of the eyes
nystagmus
Mammal bite
Penetrating trauma, large bite size
Mammal bite
Debride
Tetanus (IG if < 3 vaccine doses)
Rabies ppx (non-rodents, unknown animal status)
Augmentin (doxy/metronidazole if allergic)
TRUE/FALSE: Nicotine has a general toxicity that is not specific to insects.
TRUE!
Metaldehyde
Slug and snail baits
Inhibits GABA
Rapid or can take up to 3 hours
Salivation
Anxiety
Tremors
Seizures
ACIDOSIS
Acetaldehyde oral odor
Tx: decontamination (gastric lavage)
Activated charcoal
seizure control
Good prognosis
Threshold for CO fatality
>0.1% in air
What is neoplasia?
-process of carcinogenesis
-genotoxic event
-mutated cells (intiating and promotion)
When is [Da Huang] contraindicated?
Pregnancy
Nursing
Intestinal d/o
Appendicitis
abdominal Pain
Name an indication for amphetamines
diet suppressioni
Name the plant.
Lily of the Valley
what is the antidote for opiates?
naloxone
Dose
the amount of a substance administered at one time. exposure dose, absorbed dose, administered dose,total dose, external dose, internal dose, and biologically effective dose
Kurstaki
Why Bt has less effect on locust?
hydrocarbon treatment
supportive care and management. emesis contradicted (risk of aspiration), activated charcoal ineffective (not significantly adsorbed), lavage considered if early and with protected airway
Symptoms: hyperventilation, respiratory alkalosis, A severe metabolic (ketolactic) acidosis, Excretion of hydrogen ions produces acidic urine. Ototoxicity, tinnitus, tachycardia, CNS depression, seizures, nausea & vomiting, GI hemorrhage, prolonged bl
Treatment: ABCs. Gastric lavage, activated charcoal, Hemodialysis, Sodium bicarbonate , Monitor glucose levels closely.
Type one reactions recsult in clinical malfestations such as
asthma
rhinitis
urticaria
anaphylaxis
Q. Mercury increases the release of, and followed by complete blockade of which CHEMICAL?
Acetylcholine
How many Bq is a gigabecquerel?
109 bq
List some common agents that cause anticholinergic toxidrome
Scopolamine
Antipsychotics/Antidepressants
GI antispasmodics
Antihistamines
Jimsonweed
Deadly nightshade
T/F: LD50 has no relationship to chronic toxicity
true
treatment for people w/ low blood sugar?
dextrose
Cyanide
Present in fruit seeds and burning plastic
CN combines with FE3+ of cytochrome oxidase
Venous blood is bright red
Organochlorines have a (high/low) LD50; acute toxicities are (common/rare).
HIGH LD50

Rare

*biomagnification possible with chronic toxicities p 43
What are examples of regulatory focus areas of toxicology?
-FDA
-EPA
-OSHA
-DOT
decontamination
the process of minimizing toxicity by reducing the amount of toxin
absorbed into the body.
What herb contains Ginkgo Bilboa seeds?
Bai Guo
Which is more safe? Barbiturates or benzodiazepines?
Benzodiazepines
What species has a relatively poor ability to excrete organic acids in urine?
dog
calibrate
to determine, check, or rectify the graduation of (any instrument giving quantitative measurements).
Azadirachta indicaMelia azadirach
Name the variety of Bacillus thuringiensis commonly used as insecticides?
acetone
mild CNS depressant, odor o this in breath and urine strongly suggest intox with isopropanol
Define the TI
TI = Therapeutic Index is TD50/ED50
The larger the number the safer the drug
An acute and sometimes fatal psychotic reaction caused by cessation of excessive intake of alcohol over a long period of time: also known as DT's
Delirium tremens
After thry are release from the marrow acrophages appear in the tissues as what?
histiocytes
What is the percentage of 4.8 Mev Alpha Particle
94.5%
MOA of hemodialysis
Directly removes toxins from patient's plasma
Why not use liquid dishwasher or powdered mustard?
they're ineffective
What animals are more susceptible to the development of anti-coagulant rodenticide toxicosis?
-hypo-prothombinemic juveniles
-patients with deficient clotting factor prod'n due to liver failure or GI malabsorption syndrome
-concurrent administration of highly protein-bound drugs
-other disease states
What is a good first line antibiotic to treat skin lesions associated with D limonene?
Ampicillin
How is the brain sampled?
Whole:

1/2 in formalin
1/2 frozen
What is chromium toxicity?
-multiple valence forms
-cofactor for insulin
-glucose tolereace factor
-renal toxicity and cancer for respiratory tract
What is the xenbiotic metabolite of benzo[a]pyrene (BP)?
-BP-7,8-diol-9,10-epoxide
-BP-radical cation
lead tx
chelators (exchange Ca for Lb & enhance excretion)
Ca EDTA
SUCCIMER
dimercaprol
penicillamine
Herbs that contain IRON?
Dai Zhi Shi
Long Gu
Mu Li
Functions of Potassium
1) helps control heart rhythm
2) essential for normal work of NS and muscles
lead (Pb) toxicity labs
hypochromic microcyctic anemia with increased urinary excretion of delta-aminolevulinic acid (DAA)
what's the opiate triad?
miosis, mental status changes, respiratory depression
What is active ingredient of Black Leaf 40?
Nicotine (Nicotine sulphate)
gastric lavage use
when emesis is too slow or contraindicated, after early isopropanol exposure
Treatment for anticholinesterase overdose?

Type of mechanism?
Give atropine
Type: blockade of receptors responsible for toxic effects
Hydrocarrbon ingestin may involve the paqtients
respiratory, gastrointestinal, and neurological systems.
Type 1 In a type one reaction, the first exposure to the antigen induces the production of this type of antibody
IgE
How many rads in aborbed energy of air
0.87 rad
Ca antidote for
hypocalcemia caused by HF acid and fluoride salts
What treatment(s) is/are recommended for OC toxicoses?
Limit exposure = TIME
Enhance metabolism (for OC's with Short T1/2)
Enhance excretion
3% hydrogen peroxide:
-MOA
-route of administration
-how long until it takes effect?
-causes vomiting thru gastric irritation
-PO
-vomit w/i 10-15 minutes post-tx
Water Hemlock
Base of stem is where the toxin is
Inhibits inhibitory neuron
Most toxic plant in the US
Rapid onset and progression
Tremors and violent seizures
Ground usually dug up around cow
Usually found dead
If patient present early enough - vigorous decontamination and seizure control
What are the clinical signs of strychnine toxicosis?
ellicitable seizures, opisthotonos
This poison frequents the top 5 list of toxicoses in cats and dogs.
Ethylene glycol
What is biochemical uncoupling?
-interferance in synthesis of ATP, oxidative phosphorytlation
-such as dinitrophenol (uncouples synth of ATP, releases heat causing hypothermia
Where is calcium stored for release?
-mitochondria and endoplasmic reticulum
What is one of the most common drug class to OD on?
TCAs
What is the typical indication for secobarbital (Seconal)?
Used for insomnia
Shan zhu yu
contra in patients with difficult of painful urination, because it is stabilizing and binding
what test should you order to get a anion gap?
BMP
Discuss the use of beta-adrenergic blockers in treating LQTS.
Beta-adrenergic blockers are effective in cases related to polymorphisms in LQTS genes 1/2, but are usually less effective (and may be contraindicated) in cases related to polymorphisms in LQTS gene 3
What factors account for the environmental persistence of organochlorines?
Organochlorides are highly lipophilic and tend tend to reside in fat. They're persistant in the environment and have residue concerns in food animals. May need to test fat, or lean out before slaughter. Lidane is still available as a prescription for lice and scabies - animal preps taken off market, but may still be available.
Toxicon: Tricyclic antidepressants MOA
Mechanism of Action: TCAs affect the cardiovascular, central nervous, pulmonary, and gastrointestinal systems. The toxic effects on the myocardium are related to the blocking of fast sodium channels, which involves the same mechanism as type IA antiarrhythmics (eg, quinidine). CNS toxicity results from the anticholinergic effects and direct inhibition of biogenic amine reuptake.
Both neuroleptic syndrome and serotonin syndrome:

A. Are characterized by hyperreflexia and clonus
B. Have specific test to confirm diagnosis
C. Occur soon after initiating drug administration
D. Typically occur after overdose
E. Are characterized by aut
E. Are characterized by autoimmune instability and neuromuscular abnormalities

-NMS – occurs after the administration of dopamine antagonists or from abrupt withdrawal of dopamine agonists
-Can occur at any time
-Not typically due to
overdose
-Serotonin syndrome – from stimulation of serotonin receptors
-Typically soon after
initiation of drug or 2nd
serotonergic agent
-Not typically due to
overdose
Atropine and Muscarinic blockers
↑HR ↑ BP, Hyperthermia (hot dry skin) delirium, Hallucinations, Mydriasis
Atropine and Muscarinic blockers
Intervention/ ANTIDOTE
Control CV symptoms and Hyperthermia+ Physostigmine (Cross BBB)
What kinetic factors affect the absorption of Pyrethroids?
Pyrethroids are polar molecules, therefore their absorption is influenced by their polarity and the solvent their mixed with.
In every urine test for paraquat, what means positive?
it turns blue
What factors will decrease toxicity of anticoagulants?
Pregnancy and enzyme inducers
T/F: activated charcoal does NOT bind strychnine very well.
False

Activated charcoal binds charcoal very well.
What is the pathway of tumor metastasis?
-primary tumor formation
-localized invasion
-intravasation
-transport through circulation
-arrest in microvessels of various organs
-extravasation
-formation of micrometastasis
-colonization-formation of macrometastasis
What are various chemicals that can cause mitochondrial DNA damage and impaired transcription during ATP synthesis?
-antiviral drugs: zidovudine, zalcitabine, didanosine, and fialuridine
-thanol (when chronically consumed)
iron toxicosis: SA

a. conditions of poisoning in SA
b. absorption
a. human multivitamins
b. well regulated: 2-15% net absorption
absorption of ferrous ions into mucosal cells
transfer to plasma: facilitated by binding to transferrin
ferrous iron in plasma oxidized by ferroxidase I (ceruloplasmin)
O2 free radicals produced by conversion of Fe (II) --> Fe (III)
What is the action of octreotide?
long-acting analog of somatostatin that antagonizes pancreatic insulin release
What are 2 main classes of cathartics?
saline cathartics: sorbitol
-good media for bacterial growth, harder to obtain than osmotic cathartics

osmotic cathartics: preferred
-magnesium sulfate (Epsom Salt): can get at drug store; don’t use if injury to BBB: low risk of CNS depression
-sodium sulfate
quinolones may give a fp for ____ on a UDS?
opiates
What information should be obtained as part of a history?
Breed, sex, age, weight, previous health history, identity of agent and route, concentration and amount of agent, time of exposure, type of clinical signs, tx administered and response to tx., animal's environment
What is the treatment for TCA overdoses?
GI decontamination
Sodium bicarb for prolonged QRS, seizures, acidosis, hypotension or dysrhythmias
Antidysrhythmics for arrhythmias
What is the general mechanism of action of sodium fluoroacetate (compound 1080)?
Fluoroacetate is metabolized to fluorocitrate (the ultimate toxic metabolite) which inhibits aconitase in the Krebs cycle. Blocking of the Krebs cycle causes energy depletion, citrate and lactate accumulation and acidosis. Interference with cellular respiration and metabolism of carbs, fats and proteins.
Null cells lack ________ and participate in ______.
*characteristic surface markers of T and B cells
*Nonspecific immune system functions
What implications does a two-stage excretion have on the clearance of Organochlorines?
Two stage clearance means rapid initial stage followed by SLOWER, long-term excretion
What is the most likely source for Nicotine in an animal?
Smoking/antismoking product
No longer widely used as insecticide
How do you dx bromethalin rodenticide toxicity?
history of exposure
c/s
**white matter edema
detection of bromethalin or its metabolites in fat, brain, or liver
What kind of vitamin K doe we use in anticoagulant toxicosis
K1 only!!
How is toxicity a property of solvents?
-involves central nervous system
-disorieentation progression to loss of consciousness
-respiratory or cardiovascular collaspe
-physical interaction between solvent and cells of CNS
-organ specific toxicities of some solvents due to repeateed exposure to tolereable lvls of solvents
-can cause metabolic bioactivation (species difference in p450 enzymes)
-based on saturation kinetics (partition coefficient and lipphilicity)
What is mercury (II) ion? What is its parent toxicant? enzyme catalysing toxication? toxic effect?
-cationic electrophile
-elemental Hg
-catalase
-brain injury
What are the 1st & 2nd generation anticoagulant rodenticides?
1st generation: warfarin, dicoumarol

2nd generation (more potent): diphacinone, brodifacoum
when is activated charcoal not useful
in metallic od, lithium, pestacides, etoh
What are some general factors affecting absorption of a toxicant?
route of exposure
conc. of substance at site of contact
chemical & physical properties of substance
Name eight factors asociated with the envioronment that affect toxicity.
1. season 2. temperature3. light facotrs 4. housing5. constructions 6. heating systems 7. air circulation8. bedding
What are the mode of action of Toxaphene and Strobane?
Na and K ion imbalance.
what's the difference in mechanism between ingesting a caustic acid vs. ingesting a caustic base?
(1) BASE - alkaline ingestion causes tissue injury by liquefactive necrosis (saponification of fats and solubilization of proteins). OH ion of base reacts with tissue collagen and causes it to swell and shorten

(2) Acid ingestion causes tissue injury by coagulation necrosis (desiccation or denaturation of superificial tissue proteins)
This results when the cells lining the alveoli and alveolar capilaries allow protein rich fluid to leak into the tiny spaces betwen the capillary and alveolus.
ARDS adult respiratory distress syndrome
What are some important facts about DDT?
Organochlorine
Banned for general use in USA in 1970's
May have contaminated other insecticides
Acts on Na channel
May still be used outside of USA
What is the problem w/lindane toxicity?
it can't be distinguished from OP, carbamate, pyrethrin, or pyrethroid toxicity based c/s alone
why do we see muscarinic signs with nicotine toxicity?
The nicotinic receptors are stimulated, and then in turn, stimulate the muscarinic receptors
What causes the CNS excitation associated with metaldehyde toxicosis?
decrase in serotonin (5HT), GABA and NE concentration
What occurs during the pathway of apoptosis of cells?
-caspase activation inhibition of mRNA translation
-condensation of cell and organelles
-chromatin condensation and DNA fragmentation
-loss of membrane asymmetry
-membrane remains impermeable
-cell falls apart into apoptotic bodies
What is the difference b/t the effects of aspirin and acetaminophen?
Acetaminophen only inhibits synthesis of CNS prostaglandins, does not have peripheral side effects ASA.
cyanide toxicity, tx w
d. tx ( must be rapid) = nitrite + thiosulfate
e. tx w nitrite to convert Hb (Fe++) to MetHb (Fe+++) because CN likes Fe+++, MetHb competes w cytochrome oxidase for CN, MetHb converted to cyanometHb with restoration of cytochrome oxidase, cyanometHb acted on by rhodanese in presence of thiosulfate to form thiocyanate which is eliminated by renal excretion can treat w hydroxycobalamin which reacts w CN to form cyanocobalamin, hydroxycobalamin used to treat CN poisoning from sodium nitroprusside
Name three emetics, the route of administration, and any side effects.
Hydrogen peroxide (3%) - oral, works within 20 minutes.Apomorphine hydrochloride - via conjunctival sac, IV, IM, SQ. CNS depression possible.Xylazine hydrochloride - good in cats, IM, sedation.
What is the general mechanism by which imidazoles are produced, resulting in “bovine bonkers?”
1. Treatment of higher quality forages
2. High temperatures
3. Too much ammonia
4. Amt of grain left in straw can ↑ sugar content  more rxn w/ amino group  prod of imidizoles
5. Alfalfa, Bermuda grass, forage sorghums, orchard grass, brome, & fescue have all been assoc w/ BB
the highest concentration of a toxicant is always found in the target organ
false; is NOT always found in the target organ
What is the difference in the toxicities of Type I and II Pyrethroids?
"T" syndrome from Type I = tremors and hyperexcitability
"CS" syndrome from Type II = Tonic clonic seizures
What are the two different types of syndromes and what c/s are associated with each?
Type I: tremors/T syndrome- tremors, prostration, altered startle reflexes
Type II: choreoathetosis/CS syndrome- incr salivation, vomiting, ataxia, dyspnea, hypo/hyperthermia
What is the difference between a poison and a toxin?
poison: ANY solid, liquid, gas that interferes with the normal life proesses of that organism

toxin: toxicants/poisons originating from a BIOLOGICAL source
What is Pb (lead) ions as an ultimate toxicant?
-parent xenobiotic
-CNS damage in children
What neprotoxic herbs are banned by the FDA?
Guang fang ji
Han fang ji
xi xin
wei ling xian
mu tong
guan mu tong
Wind speed and height of spray above target crop.
What is the distinctive chemical bond that distinguishes phosphorothioates?
Where does radium go once it is ingested?
It is incorporated on bone surfaces into the mineralized portion of bone
What is a negative result for the Atropine test to diagnose ACHE inhibitor toxicity?
if the muscarinic signs that are observed in the animal diminish (normal atropine rxn) with the pre-anesthetic dose (means it is unlikely to be either OP or carbamate toxicity)
What is the difference b/t dose and dosage?
Dose: amount per unit time or animal

Dosage: amount per unit per 1000 grams
Phenytoin tx of pregnant female results in:
baby born w cleft lip & palate and seizures
A 33 y/o F presents 7 hours after ingesting, according to her boyfriend, “about 30” Extra Strength Tylenol. She is asymptomatic. Acetaminophen level testing is ordered, but results will not be available for 2 hours. Which of the following treatment st
B. Administer the initial dose of N-acetyl-L-cysteine

-Decontamination with charcoal not effective after 2 hours
-APAP rapidly absorbed
Peak serum levels within 2 hours
-Therapy based on serum levels
-100% effective in preventing hepatotoxicity if given within 8 hours
What is a general scheme for tx of GI toxicosis?
recent ingestion: emetic, AC +/- saline or osmotic cathartic
symptomatic & supportive tx: fluids, etc.
sucralfate: coats GI tract, protects from ulceration
H2 receptor antagonists (ex. cimetidine): ↓ acid production in stomach
metoclopramide: controls vomiting
What do you NOT do if you are treating a child who ingested lots of toliet bowl cleaner?
Do not administer emetics because you may subject their oropharyngeal pathway to futher damage.

DO: Do gastric lavage, diluation with water, give antibiotics if suspected perforations, and give H2 receptor antagonists to reduce exposure of injured tissues to acid secretion, glucocorticoids to prevent esophageal strictures.
What do patients need to do if their potassium levels are effected by certain drugs?
Need to monitor K+ levels when they take these drugs and they should recceive regular checks for kidney function.

-decrease amphetamine
-increase K+ intake
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