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29 Cards in this Set

  • Front
  • Back
Do not induce emesis w poisoning caused by…?
petroleum distillates, alkali/acids, convulsants
Lung damage is caused by…?
1. SO2
-- forms sulfurous acid
-- causes reflex bronchoconstriction

2. NO2
-- lung damage via direct irritation
-- causes pulmonary edema
-- “silo-fillers lung”

3. paraquat
-- herbicide
-- pulmonary fibrosis

4. asbestos
-- mesothelioma and pulmonary fibrosis

5. cotton
-- byssinosis

6. bleomycin
-- oxygen free radicals damage tissue
High O2 concentration damages…?
retina and CNS vis formation of superoxide ion
Carbon monoxide (CO) damage?
1. forms carboxyHb which cannot carry oxygen
-- interferes w the release of oxygen from oxyHb
-- arterial O2 content is 50% of normal

2. reduces oxygen carrying capacity (content) of blood but not the PaO2

3. CO also directly toxic to cellular cytochromes
Phenytoin tx of pregnant female will cause…?
baby born w cleft lip & palate and seizures
Halogenated HC’s…?
directly mutagenic
Polycyclic aromatic HC’s…?
mutagenic after metabolized by CYP450
Benzene exposure?
bone marrow depression
-- aplastic anemia
-- leukemia
MOA of strychnine?
blocks postsynaptic inhibition caused by glycine released from Renshaw cells
-- no inhibition of muscle activity
-- tonic extension of muscles causes stiffness
-- excitability of muscle increased
toxicity of phosgene (COCl2)?
a highly toxic suffocating gas
Tx organophosphate poisoning w…?
atropine (first drug given) + pralidoxam (2-PAM)
Tx carbamate insecticide poisoning w/…?
atropine alone
S/S of mercury toxicity?
loose teeth
neuropathy (tremor in fingers, arms & legs)
Hg deposits in lens
personality changes
can’t concentrate
Tx of mercury toxicity?
dimercaprol (BAL) or penicillamine = chelating agents
S/S of lead (Pb) toxicity?
peripheral neuropathy consisting of wristdrop (painless weakness of extensor muscles)
gastric colic
lead encephalopathy w/ severe toxicit
renal damage after years of exposure

-- hypochromic microcyctic anemia
-- increased urinary excretion of delta-aminolevulinic acid (DAA)
Tx of Pb toxicity?
Tx w/ EDTA

lead interferes w/ heme synthesis, so heme precursors accumulate
S/S Arsenic toxicity?
garlic odor or sweet breath
cutaneous dilation (“milk and roses” complexion),
hyperkeratosis of palms and soles
transverse white lines in fingernails (Mee’s lines)
Tx of arsenic toxicity?
dimercaprol (BAL)
S/S Fe overdose?
seen in children whose mother is taking Fe during pregnancy

severe gastric distress w bleeding, including bloody diarrhea
Tx of Fe overdose?
gastric lavage
deferoxamine into stomach
deferoxamine i.v.
What can cause cyanide toxicity?
smoke from burning plastic, fumigants, metal polishes, electroplating solutions

Has “bitter almond” smell
MOA of cyanide toxicity?
1. reacts w ferric iron of cytochrome oxidase in mitochondria to inhibit cellular respiration

2. prevents reuction of ferric iron to ferrous iron in cytochrome a3, so no electron transport
-- same effect as no oxygen
S/S of cyanide toxicity?
-- lactic acidosis
-- increased respiratory rate/depth
-- venous blood bright red
-- cytotoxic hypoxia
-- convulsions
-- respiratory arrest
Tx of cyanide toxicity?
Tx ( must be rapid) = nitrite + thiosulfate

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 THISULFATE to form thiocyanate
-- thiocyanate 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
S/S of ASA OD?
1. Tinnitus

2. Acute phase of mild poisoning --> respiratory alkalosis
-- uncouples oxidative phosphorylation - ↑ CO2 production, hyperpyrexia, sweating
-- increased rate/depth of respiration via increased CO2 and direct effect on medulla

3. More severe poisoning --> combo respiratory AND metabolic acidosis
-- large increase in CO2 inhibits medullary respiration center in the presence of continued production of CO2 and low plasma HCO3 = acidosis
-- salicylate also interferes w citric acid cycle - ↑ [lactate/pyruvate] = acidosis
Acetominophen OD?
Assoc w/ ↑ AST/ALT
Tx acetaminophen OD?
-- acetylcysteine is a precursor of glutathione
-- replinishes glutathione stores to combine with toxic metabolite of acetaminophen
Toxicity of plant materials?
S/S excessive ACh stimulation - tx w atropine

S/S atropine poisoning
-- hot, red, dry skin, fever, dry
-- Tx w physostigmine
dioxon toxicity?
causes dermatitis and chloracne