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34 Cards in this Set
- Front
- Back
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Parathion/Malathion
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Organophoshphate: irreversible AchEinhibitor
Tx: Pralidoxime (organPO4 only becaue irreversible) to regenerate AchE, and Atropine as a muscarinic antagonist |
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Carbaryl
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AchEinh
Tx: Atropine-musc. ant |
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DDT, Methoxychlor, Chlordane
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Chlorinated insecticides-not in use anymore
tx: Activated charcoal or gastric lavage, dont induce vomitting, Can give anticonvulsants for seizures |
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Pyrethrins
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Houshold insecticides-bronchospasms!
tx: activated charcoal, O2, bronchodialators for broncospasm |
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Methanol
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in windshield washer
tx: IV NaHCO3 for met. acidosis Folate-B vit complex (converts Formate to co2 and h20) ADHinh= FOMEPIZOLE, OR ETOH(OUTCOMPETES OTHERS) |
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Ethylene Glycol
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antifreeze
metab. to oxalic acid(binds Ca and forms crystals, rips nephron apart) and also gives hypocalcemic tetany and oxalicaciduria(diagnostic!) Tx: IV Ca2+, Prydoxine Folate and Thiamine for metabolism, and Fomepizole/EtOH for ADHinhibition |
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Isopropyl Alcohol
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Industrial solvents, rubbing Alcohol, CAN LEAD TO COMA OR DEATH DUE TO EXCESS CNS DEPRESSION
Tx: NO ANTIDOTE, gives O2, activated charcoal ASAP, Sx tx |
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Lead
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Source: Pipes, paint, toys, gasoline
T1/2=1-2 mth is soft tissue, years on bones Children at higher risk Blood: microcytic anemia(-Hb synth) PNS neuropathy CNS encephalopathy(pot. fatal) and cerebral edema, decreased IQ, aggression GI-pain and decreased appetite STILLBIRTH, GOUT Dx: >10=reduce expsoure, >25 tx a child, >50 tx an adult, >120 encephalopathy TX: MAIN=PREVENT FURTHER EXPOSURE Ca EDTA, DIMERCAPROL(SEVERE), DMSA/SUCCIMER, DEXAMETHASONE(FOR CEREBRAL EDEMA) |
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Acute Arsenic, Chronic Arsenic, Gas Arsenic?
Violent N, laryngitis, bronchitis, hemorrhagic gastroenteristis(rice water stool), garlic breath, capillary damage(shock and dehydration), sensory neuropathy |
Acute
Tx: Dimercaprol |
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Acute, Chronic, or Gas Arsenic?
Dermal hyperkeratosis and oxfoliative dermatitis, vesicles of feet, peripheral neuropathy, Milk and Rose complexion, increased risk of Cancer, fatty liver |
Chronic: Dimercaprol
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Acute, Chronic or Gas Arsenic posining?
Rapid hemolysis and death, reversible kidney damage(RBC fragments clog kidney.) |
Gas: no antidote, supportive tx
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Describe the most toxic form of arsenic vs. the most publicly available form of arsenic?
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most toxic=gas
Most available: trivalent |
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Acute or Chronic Hg poisoning?
Chest pain, SOB, vomiting, gastroenteritis |
Acute-VAPOR abosrbed via lungs
tx: Dimercaprol |
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Acute of Chronic Hg poisoning ?
mouth(gingivitis, loose teeth), GI, renal, systemic(Mad Hatter's) |
Chronic-Metal/salts
tx: PENICILLAMINE |
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Methyl Mercury
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seed fungicide, and in sea water (predatory fish), and research use to kill cells
Toxicity: irreversible, loss of balance, ataxia, sensory deficiets, vision defects, deafness, dysarthria Tx: Selenium reduces toxic effects, if co-adminstered |
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CO
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Px: HA! and Hypoxia
Tx: Remove CO, hyperbaric O2 |
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Cyanide
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Hydroxycobalamin(b12), release CN from cytochrome system
Often associated with CO from burning wood or plastic Px: BITTER ALMOND BREATH, SOB/hypoxia sx's, coma |
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BAL-british antilewisite=Dimercaprol
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As, Hg, sometime Pb
A/E: painful IM injection, stinks |
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EDTA
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SEVERE Pb POISONING
can produce a rebound of serum metals levels after d/c, and hypocalcemia if given by mistake. Can be nephrotoxic Note: Succimer is better for Pb poisoning |
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Penicillamine
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MeHg, Cu(WILSON'S DZ), Pb
BAD A/E: aplastic anemia, autoimmune disease, allergy, nephrotoxic |
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Deferoxamine
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Fe
BAD A/E: massive histamine release-flushing, uticaria, anaphylaxis, Neurotoxic, nephrotoxic, coagulopathies, hepatotoxic |
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Succimer
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FIRST ORAL CHELATOR, NTK!!!!
-Pb(BEST OF Pb), As, Hg Note: more effective than EDTA for Pb only MILD A/E: diarrhea and increased AST/ALT |
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Chlorella
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natural, whatever, high clorphyll binds to toxic metals
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Effects of CO on blood transport
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There is an increase in oxygen affinity of hemoglobin with CO bound(220x more affinity than O2 for Hb). The result(CarboxyHb) is a decrease in oxygen delivery to tissue.
So, what little oxygen that is bound to hemoglobin will not dissociated at the tissue. THIS RESULTS IN HYPOXIA. ACUTE: Brain and heart affected, fatal at 80% CHRONIC: POSSIBLE CV PROBLEMS HA AND HYPOXIA ARE INITIAL PROBLEMS tx; remove co and then hyperbaric O2 |
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Methylmercury
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selenium is treatment
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Ozone
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forms free radicals and causes emphysema and bronchitis, pulm edema acutely
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Cyanide
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Source: Smoke-burning plastic or wool, often ass'd with CO, industrial-plastic and metal plating, foods, terrorist attack
Binds CytC oxidase-inhibits ETC, inhibits use of O2 in ATP synthase Sx's BITTER ALMOND BREATH!!!!!! HA, N, Tachypnea, apnea, L.O.C, seizure, coma Tx: HYDROXYCOBALAMIN(B12), give regardless of CO expsoure, will free up CytC oxidase |
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sulfur dioxide-SO2 pathology
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thickens airways. comes from combustion of fossil fuels
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NO2
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silo fillers disease-farmers, produces emphysema or delyaed onset chemical pneumonitis, due to chronic NO2 produced by fermenting anerobes in the green fodder.
Also, in natural gas stoves |
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Asbestosis
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shipyards, insulation. NO ANTIDOTE, PREVENTATIVE CLOTHING AND MASKS
produces pulm. fibrosis dif't than silica, pleural plaques, effusions after 5-10 yrs, Mesothelioma-15-20 years later |
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BoTox
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C. Botulinum, home canning! Honey in infants
Tx: botox antitoxin, prevents paralysis, but must be given early RESPIRATORY SUPPORT-can recovery completely if given in the acute phase(only N/V) Infant prevention: avoid honey |
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Polychlorinated biphenels (PCB's)
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sources: flame retardants, insulation, plasticizers, farm raised salmon
complications: CHLORACNE(ACNE LIKE ERUPTION) and liver damage, decreased IQ in fetal exposure |
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Dioxin-TCDD
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byproduct of industrial processes of germicide and herbicides, also found in AGENT ORANGE(fucked up vietnam with this fucker)
almost 100% mortality A/E: CHLORACNE! LIVER DAMAGE, RISK OF GI AND LYMPHATIC CANCER, CV RISK |
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WHAT IS ACTIVATED CHARCOAL?
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non-specific chelator, limits drug absorption, not as efficacious if drug is rapidly absorbed. Number one tx for swallowing a toxic substance
Use wood pulp, has huge amt of surface area, will bind all GI lumen contents, and u can shit it out! |
