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Emergency toxicology

Clin Chem Exam 2

Emergency Toxicology Deal with drugs in suspected overdose cases and concerned mainly with qualitative screening
What is the most common cause of gaseous poisoning? Carbon monoxide
Carbon monoxide replaces what in hemoglobin? Oxygen
Primary toxic effect of Carbon monoxide? Cellular hypoxia and anoxia
CO + hemoglobin -------> Carboxyhemoglobin
Specimen for carbon monoxide detection? Whole blood
Sodium hydrosufite reduces what? MetHgb, oxyHgb but not carboxyhgb to deoxyhgb
What Inactivates the respiratory enzymes, inhibits cellular respiration and causes a quick death? Cyanide
Diagnosis of cyanide poisoning "Oil of bitter almond" breath
Volatiles? Ethanol, methanol, ethylene glycol
What enzyme converts ethanol to acetaldehyde? ADH
Dram SHop Law Used to deter drivers from driving while intoxicated
Methanol is metabolized to?? formaldehyde and formic acid causing metabolic acidosis
How many mL of methanol is toxic? fatal? toxic: 10mL Fatal: 60-240mL
MEthanol assay yields what color? Violet
Common ingredient of antifreeze? Ethylene glycol
Treatment of ethylene glycol poisoning? Ethanol, sodium bicarbonate
What does ethylene glycol do in toxic amounts? Depresses CNS
Lab findings for Ethanol? POSITIVE alcohol, INCREASED osmolal gap, UNCHANGED anion gap
Lab findings for methanol, isopropanol, ethylene glycol NEGATIVE alcohol, INCREASED osmolal gap, INCREASED anion gap
The coagulative destruction of the skin or mucous membrane Burns
Site of major injuries from acid ingestions? The stomach because gastric juices are unable to neutralize and lesions are produced
Site of major injuries of alkali ingestion? Esophagus & oropharynx.
Reinsch test: dull black Arsenic
Reinsch test: blue or purple black Antimony
Reinsch test: shiny black Bismuth
Reinsch test: silver gray Mercury
Most common metallic poisoning in children? Iron
Clinical toxicity of iron? >20mg/kg
Hyperphosphatemia Found in renal failure and lymphoblastic leukemia
Hypophosphatemia Found in people ingesting antacids and alcohol withdrawals
Toxic effects of phosphorus? fatty liver, tissue necrosis, garlic breath
What does APAP stand for? N-acetyl-p-aminophenol
Toxicity of tylenol? NAPQI binding to deplete glutathione stores
Therapeutic range for tylenol? Toxic? Lethal? <200mg/L.........toxic: >300mg/L..........Lethal: >600mg/L
Treatment of acetaminophen poisoning? Mucomyst (N-acetylcysteine)
Salicylates therapeutic range 10-30 mg/L
Screen test for salicylate poisoning? FeCl3 using Trinder's reagent----->purple at 540nm
ToxiLab A detects? (5) Basic & neutral drugs pH 9, acetaminophen, morphine, strychnine, amphetamine
ToxiLab B detects? (3) Acidic & neutral drugs pH 4.5, phenobarbital, dilantin
ToxiLab drug ID is based on? Matching unknowns with standards for migrating pattern and color characteristics
Created by: aenewsom
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