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41 Cards in this Set
- Front
- Back
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Do you need to know dosages for everything?
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No - unless you use them everyday - you should always be LOOKING THINGS UP!! - so just don't memorize them.
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What is step 1 in assessing an exposure situation?
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Figure out if it is truly a POISONOUS or MEDICAL problem.
(eg - Silica Gel Packet... not poisonous) |
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What is step 2 - assuming this IS a poison call?
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Figure out how much poison we are talking about
or the MAX amt of possible exposure |
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How important is LD50 in clinical management?
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Not very --- only really applies to test organism - not translatable, and not sure of the array of fx leading up to death.
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Non-Poisonous, Poisonous, or Really Poisonous and Deadly?
A. Water Based Paint B. Cat Litter C. Glow Jewelry D. Shampoo, Conditioner, Shaving Cream, Soap |
A. No Biggy (though latex base may have small conc. of ethylene glycol)
B. No Biggy (bacteria aside) C. Looks scary, smells scary... nothing really bad unless it hits your eyes. D. All Detergents - so maybe some stomach upset at worst |
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Non-Poisonous, Poisonous, or Really Poisonous and Deadly?
E. Plaster, Chalk F. Pointsettias G. Book Matches H. Crazy Glue |
E. Just Calcium, no biggy... unless its plaster in an old house (Pb paint)
F. No biggy, eat it like salad (dog or cat) G. No biggy - really crazy low doses H. No biggy |
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What are some emergency - Toxic in Small Doses substances at home?
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The rest of these cards, bwahaha
(TSD = Toxic in Small Doses) |
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TSD
Camphor |
500mgs can cause Seizures
Neurotoxin - Rapid Acting 1 gram/5mLs in Camphorated Oil (no longer available) Found in Vicks, Vaporub, Mothballs |
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TSD
HF |
burns, *electrolyte disturbances
F looking for Ca --> hypocalcemia and pain, low Mg causes cardiac arrhythmia Toxic via ALL routes, even dermal - Wear Gloves! wheel cleaners, glass etching |
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TSD
Lindane |
Insecticide in Shampoos/Lotions for Scabies
Rapid acting Neurotoxin (messes with Na/K pumps) - as little as 1 tsp ingested can kill a child. FYI - MILK enhances Lindane absoprtion! |
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TSD
Gun Blue (Selenious acid) |
Gun Cleaner (pH=1)
Ingestion of few drops = ill, 15mL = death Dermal not a huge issue Inorganic Selenium - shock, seizure, hypotension, CV arrest. |
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TSD
Benzocaine |
Oral, Topical Anesthetics (Orajel)
*Causes Methemoglobinemia (w/o Heinz bodies in cats) |
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Define:
Gastric Decontamination |
Any technique that prevents the absorption of a drug or chemicial
(decrease blood concentration, amt absorbed, and reduce severity of poison) |
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Gastric Decontamination
...what are your options? (5) |
Gastric Emptying
Activated Charcoal (AC) Cathartics Emetics Gastric Lavage |
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Gastric Emptying -
Emesis techniques? (4) Contraindications for Emesis? |
H2O2, Apomorphine, Xylazine, Gastric Lavage
not for rabbits, rodents, horses, rums not for those with CNS depression/seizure do NOT use Emesis if substance burned on the way down! do NOT use Emesis for foreign bodies. do NOT use if aspiration risk (gasoline, kerosene) |
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What's the deal with H2O2?
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H2O2 (3% - general 1st Aid H2O2)
works PO in abt 10 mins |
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What about Apomorphine?
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Also an emetic - hits CRTZ.
use for DOGS only! hits in 2-10 mins (IV is immediate) |
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Xylazine?
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A-2 agonist, stimulates CRTZ (emetic)
good in CATS! (unreliable in dogs) *risk of hypotension - use low doses |
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Gastric Lavage.
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if Unconscious or Anesthetized
no proof that lavage is any better than emesis or vice versa |
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What does Activated Charcoal work for?
(and what does it NOT work for?) |
Binds Nonpolar and Large Molecules
NOT for - alcohols, hydrocarbons, metals, inorganics, caustics **note - caustics and hydrocarbons... no good for emesis or AC, hmmmm |
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What can you use with AC to make it move along faster?
What shouldn't you use? |
Cathartics (sorbitol)
Mineral Oil (interferes w/adsorption) |
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When should you give more than 1 dose of AC?
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if the toxin is Enterohepatically recirculated (generally - anti-convulsives)
multiple doses - don't use cathartic |
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Contraindications for AC?
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Caustics
High risk of Aspiration (gasoline, kerosene) |
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Tell me about Whole Bowel Irrigation -
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use PEG solution
isotonic, so use it like a hose - flush the system out until clear rectal effluent (no risk of ion disturbance!) Use for Sustain-Release meds, or things AC can't bind (metals - Li, Fe, K) |
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Okay so what do you wanna do if:
Dog eats 20 SR Li tablets 1 hour ago? |
PEG
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Okay so what do you wanna do if:
Dog ingests gasoline |
Watch, Wait, Support
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Okay so what do you wanna do if:
Puppy eats silica gel packets |
He's fine
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Okay so what do you wanna do if:
Cat eats 2 acetaminophen tablets 8 hours ago |
AC wouldn't hurt, but 8hrs ago, probably won't help....
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Okay so what do you wanna do if:
Bulldog hopped-up on Cocaine |
Can give AC
do NOT give emetic/lavage (animal can seize at any moment) |
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Define
Antidote |
A remedy counteracting the effects of poison. It may affect the toxin's action, concentration, or binding.
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Antidote for:
Acetaminophen Poisoning |
N-AcetylCysteine (NAC) within 8hrs
you have low Glutathione... NAC is a glutathione precursor that binds toxic metabolite (NAPQI) |
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Antidote for:
Toxic Alcohols in Dogs (Methanol, Ethylene Glycol) |
Antizol (Fomepizole) within 3-6hrs
good for DOGS, not cats Complete inhibition of Alco-DH stops production of metabolites that would damage kidneys, CNS (eyes, brain) |
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Antidote for:
Toxic Alcohols in Cats (Methanol, Ethylene Glycol) |
Ethanol infusion ASAP, high levels
(but give them a gin and tonic on your way into the hospital) adverse - CNS depression, hypoglycemia |
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Antidote for:
Benzodiazepines |
Flumazenil (Romazicon)
needs high doses, expensive.. really not that helpful overall |
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Antidote for:
Organophosphate (Pesticides, Chemical Warfare) |
Pralidoxime (2-Pam) -- given ASAP
Reverse inhibition of AchE ie - Anti-AntiAchE of OPs 2-Pam ineffective after aging (OPs can irreversibly bind, need to hit before this happens - otherwise must make new AchE) **many insecticides have a Hydrocarbon Vehicle |
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Antidote for:
Anticoagulant Poisoning |
Vitamin K1 - PO or SQ, do NOT give IV
for SYMPTOMATIC animals reverses inhibition of synthesis of II, VII, IX, X |
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Antidote for:
Heavy Metal Poisoning (Lead) |
Succimer (Chemet) (and keep hydrated)
for As, Pb, Hg, Ag, Tl (NOT Fe, Ca, Mg) DiThiol group binds metals - Chelator! Metal may rise at first (redistribution - but keep treating) |
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Antidote for:
Fe and Al poisoning |
Deferoxamine given IV slowly for no more than 24hrs (get Fe under 300ug/dL)
Binds Fe to form Ferrioxamine - chelates through kidneys (makes urine pink) |
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Antidote for:
Venoms |
Antivenins
Scorpions - nothing approved Rattlers, Corals -- specifics available Black Widows -- give equine IgG Give if seeing effects (swelling, coagulopathies) |
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Antidote for:
Opioid Toxicity |
Naloxone
Opioid-R antagonist |
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Antidote for:
Digoxin toxicity (digoxin, digitalis, Bufo toad) |
Digoxin Fab Antibodies (Digibind)
binds free Digoxin heartblock - hyperkalemia --- so adverse effect is hypokalemia Very Very Expensive |
