Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
26 Cards in this Set
- Front
- Back
Acetaminophen toxicity
|
increased drug > lots through p450> increase NAPQI > liver toxicity
NAPQI usually can be broken down by GSH but that is overwhelmed at excess NAPQI |
|
Acetaminophen Tox Management
|
use NAC (N-aceytlcystein): substitutes for GSH, replenish GSH levels, act directly as antioxident
Kids: more resistant due to higher turnover of GSH |
|
Acetaminophnen and alcohol
|
Eth induces CYP2E1, more Rx shifted to P450 route, and more NAPQI produced
|
|
Salicylates (aspirin) toxicity
|
metabolized normally through conjugation::: toxicity by: uncouple oxid phosph. leading to low ATP and metabolic acidosis, direct stimulation of resp. center >> resp alkalosis, GI irritation, decreased PT, platelet dysfunction
In chronic tox, will see cerebral edema |
|
Salicylate (aspirin) tox management
|
alkalynize urine, GI decon, activated charcoal
|
|
Alcohol toxicity
|
mainly metabolized by ADH, some by 2E1... excessive acetic acid production, acidosis
supportive treatment |
|
Methanol toxicity
|
Methanol via ADH to formaldehyde then via Ald Dehydrog. to formic acid (a much stronger acid)
|
|
Methanol tox mgmt
|
oxygen, lavage, induce emesis, sodium bicarb, folic acid to convert formic acid to CO2 and H20) ethanol or fomepizole)
|
|
Ethylene Glycol Tox
|
acid lead to anion gap and acidosis, calcium oxalate crystals formed >> tubular necrosis
|
|
Ethylene Glycol Tox Mgmt
|
lavage, charcoal, alkalinize urine, block ADH with fomeprizole or Eth, folic acid, hemodialysis
|
|
Isopropanol tox (rubbing alcohol)
|
CNS tox intially, high ketone (acetone) levels, abd pain, NO ACIDOSIS DESPITE ANION GAP, may progress to hypotension and coma
|
|
Isopropanol tox (rubbing alcohol)
|
removal and adsorption, supp care, hemodialysis
|
|
Carbon tetracholoride tox
|
CNS depression, hepatic, renal tox
No spec. treatment |
|
Gasoline
|
worst tox by aspiration, do NOT induce vomiting>>> lung inflammation, arrhthmias, CNS depression
|
|
CO tox
|
formation of COHb, Dx: cherry red cyanosis seen only post-mortem, living pts usually cyanotic and pale
|
|
CO treatment
|
100% O2, hyperbaric chamber
|
|
Lead tox
|
8% GI absorption in adult, 50% in children, resp tract absorption quick, most moves to bones and teeth, slow turnover:::/// Path: constip, metallic taste, delayed devp, encephalopathy, anemia... by inhibiting enzymes by binding sulfhydryl groups (heme biosynthesis)
|
|
Lead tox treatment
|
Chelation.
CaNa2EDTA: for lead Dimercaprol (BAL): arsenic and mercury. DMSA: lead, arsenic, mercury. Penicillamine: copper Dferoxamine: iron |
|
Mercury tox
|
peripheral peeling rash, CNS tremor, personality change (erethism: shyness, depression with explosive anger or blushing)
Mech: inhibits sulfhydryl enzyems, inhibits ChAT >> motor dysfunction |
|
Mercury tox mgmt
|
Elemental: DMSA, penicillamine, dimercaprol.//
Organic Hg: above but not dimercaprol which causes redistribution of chemical to brain!!! *** |
|
Arsenic Tox
|
binds SH groups, substitues phosphate groups: Sx: acute: GI, hypotension, metab. acidos./// chronic: neuropathy, skin changes
Trt: dimercaprol |
|
Cadmium Tox
|
tissue irritation , GE, pulmonary edema, liver and kidney damage w/ GSH depletion. Trt w/ CaNa2EDTA
|
|
Thalium tox
|
colorless, odorless, tasteless: acts as K+, impairs cation-activated enzyems: ATPases, ADH..>> Mitchondrial swelling, cell death
TRT: purssian blue radiogardase |
|
Radioactive metals(Cs, U, Po)
|
Cs: substitue K+ or Na+
Po: alpha particles damage DNA U; dirty bombs TRT: prussian blue radiogardase |
|
Cyanide Tox
|
binds ferric iron (cyt oxid in mitochondria), inhibits oxid. phosph. >> lactice acidosis and hypoxia.// sx: venous blood red, almond breath, elev respiration, agitation, coma, death
|
|
Cyanide Tox Mgmt
|
Amyl nitrite (inhaled) then sodium nitrite (IV): oxidizes iron to Fe3+ >>> less inhibition of oxid. phosph.//
sodium thiosulfite(IV)convert cyanide to thiocyante |