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14 Cards in this Set
- Front
- Back
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6 important questions to ask in a tox situ
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1) Does the toxin affect oxygenaquisition/utilization
2) If so is this effect systemic or local 3) Does the toxin deplete glucose or other essential substrates 4) Does the toxin lead to cellular injury via free radical formation or lipid peroxidation 5) Does toxin form an active metabolite which is more harmful than parent 6) Does toxin reveal any underlying metabollic/enzymatic defects |
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Tox mech of carbon monoxide
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Binds to hemoglobin with a higher affinity than O2 leading to decreased oxygen delivery. Also effects cytochrome oxidase leading to lower energy production by cells.
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Glipizide
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Diabetic Hypoglycemic drug. If taken by child, can become very hypoglycemic. Antidote is glucose
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What agents can cause hypoglycemia and what is the main clinical symptom
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Hypoglycemic agents (sulfonylureas), beta blockers, alcohol, quinine and salicylates.
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Tox mech of acetominophen
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Metabolized to NAPQI via p450 in liver. Is a reactive compound. Normally detoxified by glutathione. If not enough glutathione is present, reactive NAPQI will damage liver cells.
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What does G6PD do?
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Reduces NADP+ to NADPH. NADPH is required for glutathione production which is an important antioxidant. Lack of G6 makes RBCs more suseptible to oxidant effects, causing damage to hemoglobin and even cell death.
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Isoniazid (or gyromitra mushroom) Tox and antidote
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Get seizures or coma. Isoniazid inhibits pyridoxine phosphokinase, preventing the conversion of vit B6 to pyridoxal-5-phosphate which is an essential cofactor in GABA creation. No GABA = seizures.
Treatment = give B6 gram for gram with the amount of isoniazid taken. |
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Neuronal effects of Thallium
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Can cause acute and chronic sensorimotor axonopathy.
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Neuronal effects of Arsenic
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Can cause sensorimotor axonopathy, acute sensorimotor myelinopathy as well as CNS symptoms.
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What is the most common cause of a toxin-induced seizure
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Alcohol withdrawal.
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What is the antidote for Seizures
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Benzodiazepines. Antidote for any hyperstimulated CNS state.
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SLUDGE
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Ach muscarinic effects:
Salivation, Lacrimation, Urination, GI distress, Emesis. |
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NMS and criteria for diagnosis.
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Involves disequilibirim in dopamine.
Recent use of antipsychotic drugs (ziprasidone, haloperidol, fluphenazine)/dopamine altering drugs = Essential criteria Fever (>38/100.4) without other cause = Major criteria Muscle rigidity = major criteria Elevated > 1000 U or 3X normal CK = Major criteria Autonomic instability = Major criteria Leukocytosis (elevated WBC count > 12,000) = minor criteria |
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Most common presentations of Serotonin Syndrome
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Cognitive: confusion, disorientation, agitation, coma
Auto disfunction: Hyperthermia, sweating, tachycardia/pnea, hypertension NM abnormalities - Myoclonus, hyperreflexia, muscle rigidity, tremors. |
