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35 Cards in this Set
- Front
- Back
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Mech of CO Poisoning
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Forms CarboxyHb that can't carry O2
Reduces ability of OxyHb to dissociate O2 |
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Threshold for CO fatality
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>0.1% in air
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CO Poisoning Treatment
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100% O2 or Hyperbaric O2
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Sulfur Oxides
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Air pollutants that form sulfurous acid on contact with moist membranes
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Ozone/Hydrocarbons
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Air pollutant found in polluted urban air and upper atmosphere
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Particulate Matter
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Pneumoconiosis and Asbestosis from dust inhalation
Bronchial cancer associated with Asbestosis |
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Nitrogen Oxides
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Air pollutants that are deep lung irritants capable of producing pulmonary edema
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Carbon Tetrachloride, Chloroform, Trichloroethylene
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Halogenated Aliphatic Hydrocarbons
Industrial solvents that cause CNS depression No treatment |
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Benzene
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Aromatic Hydrocarbon
Industrial solvent that causes CNS depression Acute effects seen in CNS Chronic effects on bone marrow |
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Parathion, Malathion, TEPP, Dichlorvos
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Organophosphate Insecticide
Irreversible AChE inhibitors Phosphorylate enzyme "ages" by losing alkyl group |
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Delayed Toxicity of Organophosphates
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Axonal degeneration and demyelination unrelated to AChE inhibition
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Treatment for organophosphate poisoning
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Atropine and AChE reactivator Pralidoxime within 24 hours
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Carbaryl, Baygon
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Carbamates- garden insecticide
Reversible AChE inhibitors |
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Treatment of Carbamate Poisoning
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Administer Atropine but Pralidoxime is contraindicated because enzyme not phosphorylated
(Additive affect of carbamate in inhibiting AChE) |
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Chlordane, DDT, Lindane
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Chlorinated Hydrocarbons- insecticide
Acute CNS stimulation by targeting Na and Ca Chronically stored in body fat |
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Pyrethrins
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Botanical Insecticides
Contact dermatitis or asthmatic rxn is common as lethal dose is large CNS excitation/convulsion by inhibition of ion channels |
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Paraquat
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Herbicide that produces superoxide anions
causes respiratory distress due to fibroblast proliferation |
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Treatment of Paraquat Poisoning
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Gastric lavage, hemodialysis or cyclophosphamide (to inhibit fibroblasts)
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Chlorophenoxy Compounds
AKA Agent Orange |
Herbicide that causes excessive GH action
Chronic toxicity due to dioxin (teratogen and carcinogen) |
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Ethanol
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Distributes to total body water
Zero Order Kinetics CNS Depressant |
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Prevention of Ethanol Toxicity
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Disulfiram (Antabuse) blocks ALDH
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Methanol
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Distributes to total body water
Metabolized at one fifth the rate of ethanol Toxicity related to amount of Formic Acid produced |
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Treatment of Methanol Toxicity
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Lavage with Bicarb
Ethanol to delay breakdown time Hemodialysis Fomepizole- inhibits ADH so no formic acid |
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Ethylene Glycol
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Metabolized by ADH and ALDH into glycolic acid then to oxalate, a calcium chelator
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Treatment of Ethylene Glycol Toxicity
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Ethanol to compete for enzymes and Fomeprizone
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Cyanide
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Present in fruit seeds and burning plastic
CN combines with FE3+ of cytochrome oxidase Venous blood is bright red |
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Cyanide Poisoning Treatment
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Step 1: Use Amyl or Sodium Nitrite to oxidixe Hb Fe2+ to Fe3+
Step 2: Supply thiosulfate to remove CN from Hb |
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Lead
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Binds rbcs and widely distributed to soft tissue and bone
Binds sulfhydryl groups of proteins Interferes with divalent cations |
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Lead Poisoning Treatment
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EDTA (Versene) IV or IM
Succimer orally |
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Mercury
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Forms covalent bonds with sulfhydryl groups
CNS and GI Tract involved |
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Treatment for Mercury Poisoning
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Dimercaprol IM
Crosses BBB Also Penicillamine or Succimer orally |
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Arsenic
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Binds SH groups to disrupt cellular metabolism
Treat with Dimercaprol followed by penicillamine or succimer |
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3 Phases of Acute Iron Poisoning
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1. Corrosive effect on GI Tract
2. Quiescent Period (6-24hrs) 3. Edema, Acidosis, Convulsions, Coma |
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Treatment of Iron Toxicity
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Milk to induce emesis
Gastric lavage Deferoxamine orally or IV |
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Activated Charcoal effectively binds
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Acetominophen, Salicylates, Ipecac, Arsenic, and Organophosphates
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