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30 Cards in this Set

  • Front
  • Back
The mechanism of Ethanol as a CNS depressant is due to its ability to do what to cell membrane structure?
Fluidizes/disorders cell membrane, disrupts GABA receptor
Though there is no treatment for ethanol intoxication, the preventative drug against future ethanol abuse is ___, which works to inhibit ____, causing __ __.
Disulfiram, inhibits acetaldehyde dehydrogenase, causing "immediate hangover"
Methanol toxicity treatment includes lavage with __, infusion of ___ to maintain blood level of 100-150 mg/dl, ___, an inhibitor of ADH, and in extreme cases, ____.
Bicarbonate, ethanol, Fomepizole (Antizol), hemodialysis
T/F: Glycols, like those found in antifreeze, are treated for toxicity using the same methods as for Methanol toxicity, except the use of bicarbonate.
The toxic effects of ethylene glycol are due to:
Their metabolism. Gloxylate-->Oxalate
Oxalate serves as a calcium chelator, affecting the heart, GI tract, and kidneys.
PEG (propylene glycol) is broken down to ___ by ALDH, making it a relatively safe solvent.
lactic acid
Cyanide produces its deadly effects by combining reversibly with ___ of the cytochrome oxidases, resulting in ___ ___. Because there is not place for oxygen to go, venous blood appears __ __.
Fe3+, cytotoxic hypoxia, bright red
The two steps to Cyanide poisoning treatment are:
1. Give amyl nitrite or sodium nitrite to oxidize Fe2+ of Hb to Fe3+ (give CN more of what it wants to get it off of Hb)
2. Give thiosulfate (CN binds thiol and is excreted as thiocyanate)
Once absorbed, lead binds to ___ and is widely distributed, first going to the __ __ and then to the __.
RBC, soft tissue, bone
Major target of lead toxicity:
CNS, especially in fetus/growing child.
Treatment of lead toxicity includes:
1. Remove lead source
2. Chelation therapy using EDTA/versene (IM or IV) or Succimer (oral)
Lead, Mercury and Arsenic all have similar mechanisms of action, namely forming covalent bonds with ___ containing enzymes.
Sulfhydryl, disrupting cellular metabolism.
While lead concentrates in __, mercury concentrates in ___.
bone, hair
Treatment of Mercury or Arsenic poisoning involves:
Chelation therapy with dimercaprol (BAL), which removes Hg from SH groups of essential proteins. Also can use D-penicillamine (Cuprimine), or Succimer
The 3 steps in poison treatment include:
1. Decontamination
2. Rapid support and stabilization
3.Reduce further absorption
When do you NOT induce emesis (vomiting)? Why?
When someone ingested a corrosive substance, stimulants, depressants or hydrocarbons it is best not to induce vomiting mainly because those substances can then be absorbed through the lungs and produce an extreme reaction.
What should you use to induce emesis?
What is inducing emesis indicated for?
Ingestion of agents that are non-toxic before they're absorbed, like iron.
When NOT to use gastric lavage?
When someone ingested a corrosive substance or hydrocarbons because can cause secondary pneumonia
When to use gastric lavage?
gastric lavage in hysterical and comatose, especially ethanol intoxication
Activated charcoal should NOT be co-administered with Ipecac because:
They bind each other and cease to function.
Activated charcoal does NOT bind these 3 agents:
CN, iron, alcohols (eth/meth, glycols)
The use of specific antidotes to bind to or counter the effects of the toxin or its metabolites, as in lead, methanol, CO, opiate, and venom poisoning:
Chemical inactivation
Acetominophen, Salicylates, Ipecac, Arsenic and Organophosphate poisoning are all effectively treated with:
Activated charcoal
The 3 ways to enhance toxin elimination are:
Alkaline/Acid diuresis, Hemodialysis, Hemoperfusion
Passage of blood through a column of charcoal/absorbant resin removes larger, fat soluble and protein bound molecules is called:
Hemoperfusion is most effective when:
The Volume of Distribution is HIGH and toxin has high affinity for sorbent
Removes (filters) fluid and small water soluble molecules from blood:
Hemodialysis is most effective when:
Toxin has a LOW volume of distribution, low protein binding and small mw
A line of the bones and gums, as well as CNS effects are both side effects of:
Chronic Lead toxicity