Tox Test 1 Packet 1

Front 1

what are the top substance in poison exposure in adults

Back 1

analgesics
sedatives/hypnotics/antipsychotics
cleaning substances
antidepressants
bites/envenomotoxins

Front 2

what are the top substance in poison exposure in children

Back 2

cosmetic/personal care products
cleaning substances
analgesics
foreign bodies
topicals

Front 3

most adult fatality is due to what?

Back 3

drug OD

Front 4

what are the properties of Genotoxic substances

Back 4

carcinogenic in nature, can exist as pro or proximate carcinogens that later become ultimate/primary carcinogens leading to tumor cell formation/proliferation

our body may have pro/proximate carcinogens that do no harm but when other factors become involved they can accelerate to form ultimate carcinogens

Front 5

what are the properties Non Genotoxic substances

Back 5

don't produce tumors alone but will assist genotoxic substances to form cancer cells

carcinogenic helpers that help genotoxic carcinogens form cancer cells

Front 6

what cells have the ability to recover and repair

Back 6

liver cells

Front 7

how does reversible toxicity occur

Back 7

some drugs cause a toxic effect which is quickly reversed due to rapid elimination/degredation

Front 8

how can some toxins cause irreversible toxicity

Back 8

toxins that cross BBB and cause brain cell damage (brain cells are not readily regenerated) and chelate

Front 9

what are the allergic reactions

Back 9

food toxin: IgE anaphylaxis
PCN: IgM hemolytic anemia
Sulfonamides: IgG skin eruption
Poison Ivy: T lymphocytes and macrophage activation activation

Front 10

what is idiosyncratic reactions

Back 10

toxicity due to an unknown mechanism or of unknown origin

Front 11

what is dilution/irrigation

Back 11

giving milk/water to decrease toxin concentration for absorption and increase urinary excretion

Front 12

what is chemical absorption (activated charcoal) properties

Back 12

inert compound
prevents systemic absorption

activated charcoal binds to toxin and gets excreted

Front 13

what is purgation

Back 13

give a laxative (osmotic cathartics) that get rid of content

Front 14

what is gastric lavage

Back 14

insertion of tube into stomach

pump stomach

Front 15

what are the side effects of gastric levage

Back 15

esophogeal perforation
increases vagal (PSNS reflexes stimulated)

Front 16

what kind of pts is gastric levage used for

Back 16

pts after intaking large amount of chemicals w/in 1 hr

Front 17

what is Emesis

Back 17

stimulates medullary chemoreceptors to trigger vomitting

Front 18

what drugs are used for Emesis

Back 18

Ipecac
Apomorphine

Front 19

what can you not perform Emesis on

Back 19

corrosive substances (corocin) they may cause necrosis and gastric perforation

CNS stimulants (meth/amphetamines/halucanogens) worsen pt condition may cause seizures

pertroleum substances may cause pneumonitis (pulmonary dysfunction)

Front 20

what is one thing Emesis is primarily used for

Back 20

pesticide intoxification

Front 21

what is whole bowel irrigation

Back 21

flush GI w/ polymeric material (polymethyl glycol)

prevents transfer of chemicals b/t irrigating fluid and blood

good to remove Li and iron

Front 22

what can activated charcoal not remove

Back 22

lithium
iron
potasium

Front 23

what is chemical inactivation

Back 23

not useful even though many chems are weak acids/bases so try to fix by neutrolizing (weak acid treat w/ Na bicarbonate)

just as effective to give milk/water

Front 24

how can we increase elimination of toxins

Back 24

since toxin may already be absorbed some chemicals get metabolized to form toxic species so we can try to inhibit the biotransformation

we do this by giving a substrate prone chemical to compete w/ enzyme metabolism

ethanol for methanol
thiosulfate for cyanide

use drugs to induce liver metabolize the chemicals this takes a long time

Front 25

how can we increase urinary excretion

Back 25

forced diuresis
alkalination of urin w/ sodium bicarbonate to remove weak acids
acidifying urine to remove base

Front 26

how is forced diuresis accomplished

Back 26

increase urine flow by volume loading this can cause volume overload and hypernatremia

Front 27

why is acidifying the urine not done in the ER

Back 27

may cause medical side effects (myoglobin percipitation and renal tubule obstruction)

Front 28

what is dialysis side effects and what is it used for

Back 28

may cause anticoagulation
not good against small or plasma bound toxic species (will still pass)
used to remove Li, methanol, ethylene glycol, salicylates

Front 29

what is hemoperfusion

Back 29

filter blood using a canister of activated charcoal or resin

Front 30

what does alkalyzing the urine remove

Back 30

phenobarbitol
salicylates

Front 31

what does activated charcoal bind to

Back 31

TCA
cocaine
digitalis
nicotine
salicylates
acetominophen
phenothiazines
phenobarbital
theophylline

Front 32

what is the most used procedure to remove toxins

Back 32

dillution/irrigation

Front 33

what is used to remove enteric tablets and volatile hydrocarbons

Back 33

purgation

Front 34

what is a side effect of emesis

Back 34

may cause asphyxiation/aspiration

Front 35

what is a side effect of hemoperfussion

Back 35

may cause thrombocytopenia and hypokalemia