Term
What metal has no known necessary physiological role in the body, can be ingested or inhaled, and binds to hemoglobin? |
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Definition
Lead (may be asymptomatic but there is no level of lead that is acceptable) |
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Term
true or false:
2 compounds having the same LD50 will have the same dose response curve |
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Definition
False
2 compounds can have same LD, doesn’t mean that they will have the same dose response curve |
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Term
True or false:
The lethal dose affecting the population is true for all individuals |
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Definition
False
For individuals, LD may be different, but if you look at population you will get even distribution. You should consider that when talking about toxic effects, there is a lot of interpatient variability |
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Term
What is the equation for therapeutic index? |
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Definition
lethal dose 50 / effective dose 50 |
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Term
What is the shape of the dose-response for essential minerals and vitamins? |
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Definition
U-shaped (too much or too little vitamins and minerals is bade for you)
need to consider if a drug is a linear or U-shaped dose response |
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Term
What is one of the major causes of liver toxicities in the US? |
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Definition
acetaminophen, Tylenol (therapeutic index is not that big; fairly toxic) |
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Term
Toxicity is (disproportional or proportional) to exposure? |
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Definition
Toxicity proportional to exposure: local vs systemic Immediate vs delayed Reversible vs irreversible |
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Term
*What is most frequently affect in systemic toxicity? |
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Definition
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Term
Most poisons are (unintentional or intentional)? |
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Definition
unintentional (85%)
environmental exposures, occupational exposures, therapeutic drug errors, misuse of a substance, bites and stings, food poisoning -Therapeutic errors – 10.5% of total exposures |
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Term
Where do exposures usually occur?
Is it mostly (acute or chronic) exposures? |
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Definition
90% occur at home
91% acute |
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Term
What age do most human exposures occur in? More in boys or girls? How do most exposures occur? |
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Definition
53% of human exposures involve children under the age of 6 Evenly divided by gender Nearly 80% occur by ingestions |
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Term
Of the following poisons that are associated with the largest number of human fatalities, which ones usually occur together?
Cocaine Opiods (Morphine, Heroin, Codeine) Benzodiazepines [diazepam, Xanax (alprazolam)] Acetaminophen Cardiovascular drugs [Beta blockers (propranolol), Calcium Channel Blockers] Alcohol Antidepressants (Zoloft, Celexa, Prozac, Lexapro) |
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Definition
alcohol and antidepressants |
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Term
What is the treatment approach for acute poisoning? |
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Definition
ABCDE
Airway Breathing Circulation Disability (CNS dysfunction) Exposure |
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Term
How do you decrease absorption of the poison? |
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Definition
Enhance elimination by
induce vomiting with ipecac syrup Gastric lavage (stomach pumping) Activated charcoal, oral suspension, large surface area for adsorption of organic compounds Cathartic (laxative) agents hemodialysis antidote(s) |
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Term
What is the leading cause of death due to poison in the US? |
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Definition
Carbon monoxide poisoning (unintended-CO is odorless, colorless)
hospitals generally do not measure blood CO level |
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Term
How does carbon monoxide poison people cellularly? |
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Definition
Carbon monoxide has a higher affinity for hemoglobin than oxygen and forms carboxyhemoglobin --> oxygen depletion |
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Term
How does carbon monoxide affect people's organs? |
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Definition
With moderate CO exposure, breathing remains normal Gradual hypoxia causes vasodilation which increases cardiac output Fainting occurs more often than difficulty breathing
(takes very little CO to cause symptoms) |
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Term
What is a clue in diagnosing someone with carbon monoxide poisoning? |
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Definition
cherry-red color of Hb(CO), pink skin |
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Term
A patient has bright red venous blood: increased saturation of Hb with O2; O2 not utilized in tissues, less unloading of O2 from Hb, oil of bitter almonds odor; difficulty breathing, irregular heartbeat, uncontrolled movement, convulsions, coma
What poisoning would you suspect? |
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Definition
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Term
How would you treat cyanide poisoning? |
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Definition
Administer antidote(s) - Sodium nitrite and sodium thiosulfate to compete with cytochrome oxidase for cyanide and eliminated, then gastric lavage if ingested
(death in seconds to minutes due to respiratory arrest) |
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Term
**Methanol is converted to _________ by alcohol dehydrogenase which causes? |
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Definition
formic acid'
blindness, metabolic acidosis, coma, death |
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Term
*Overdose of acetaminophen causes ______ by being modified by _______ |
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Definition
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Term
*How would you treat an overdose of acetaminophen? |
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Definition
increase production of glutathione |
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Term
Where is arsenic metabolized and eliminated? |
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Definition
Toxicity proportional to accumulation in the body: metabolized in the liver and eliminated mostly in urine |
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Term
Where are arsenic levels a major concern? |
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Definition
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Term
If a patient has abrupt onset of gastroenteritis (pain, nausea, vomiting, diarrhea); hypotension and metabolic acidosis, Muscle weakness & aching; edema; renal & liver damage; “pins & needles” with stocking-glove distribution, and small "corns" on their palms, what type of poisoning do you suspect this person to have? |
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Definition
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Term
*How do you treat arsenic poisoning? |
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Definition
chelation therapy with succimer |
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Term
*How do you treat lead poisoning? |
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Definition
succimer (same to treat arsenic)
Thiol group will chelate heavy metals |
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Term
How would you diagnose someone for lead poisoning? |
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Definition
blood levels of lead (and also affects CNS-clumsiness, falling, etc.) |
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Term
Why is succimer effect in treating metal poisoning? |
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Definition
Does not release metal in urine
Does not increase excretion of essential metals, e.g., Zn, Cu, Fe
Does not enter cells |
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