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18 Cards in this Set

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DRUG/TOXIN
POSSIBLE SYMPTOMS
MECHANISMS
TREATMENT
ORGANOPHOSPHATES
ASPIRIN (High Dose)
ARSENIC
LEAD
Muscarinic
Nicotinic
- increase sweating
- miosis
- excessive salivation
- wheezing
- GI Cramps
- Bradychardia
- UI = Incontinence
- Skeletal muscle
- cramps
- weakness
- paralysis
- respiratory arrest
- symp ganglion
- tachycardia
- elevated BP
Difficulty Breathing
- Increase ACh at the NMJ synapse:= bronchoconstriction
- Increase secretions: impair air exchange
- Weakness & paralysis of skeletal muscle incl diaphragm,
Excessive salvation
Parasymp
Or
Sympathetic via ganglia
Diplopia/Blurred Vision
Parasympathetics
Muscle Fasciculation
Excess of Ach @ NMJ = early sign of excessive stimulation = succinylcholine depolarizing NMJ
- Periodic Headache
- Nausea
- Dizziness
- Tiredness
- Blurred vision
- Sweating
- Confusion
- Miosis
- Serum = decreased cholinesterase levels
Seen with slow repeated exposure to low tox organophosphates
1. Decontaminate – stop from spreading to others

2. Atropine – muscarinic Antagonist = Blocks PNS effects (no effect on Musc)

3. Pralidoxine – regenerates Ach by kicking off organophosphate
= needs to be done BEFORE it covalently binds
Exposure: Flowers, nerve gas, pesticides, flee killer, pet care products
- Ringing in ears
- Respiratory
- CNS
- GI (nausea and vomiting)
- Fever
-Make urine more alkaline – b/c ionized forms are charged and cannot be reabsorbed = enhances renal excretion
-Possible use of sodium bicarbonate or hemodialysis
- pH disturbances
Uncouples oxidative phosphorylation
Exposure:
-Pigment manufacturing plant
-Eating paint
-Pesticides
-Herbicides
-Rat poison
-From the metallurgic industry
-Well water (Bangladesh)
-Malicious intent
-Acute Symptoms: Severe diarrhea, liver, renal necrosis & schock
-Chronic: Neurologic symptoms predominate, although liver & kidney may also be affected
1.Abdominal Cramping
2.Diarrhea
3.Pancytopenia (decr RBCs and platelets)
4.Gait difficulties
5.Peripheral Neuropathy (getting worse)
-Acroparesthesias (glove-stocking distribution of paresthesia)
-Decreased sensation & motor strength
-Absent deep tendon reflexes
-Wasting in arms and legs
6.Rain-drop pigmentation
Hyperkeratosis/hyperpigmentation & thickening on palms and soles
-Aldrich-Mess white lines on nails
1.Penicillamine
2.Succimer Chealators
Can be from exposure to:
- Gasoline
- Paint (toys from China)
- Glaze
- vomiting
- irritable
- weakness of extremities
- abdominal pain
Typical symptoms of Lead:
- foot drop
- motor weakness
- retinal stippling
- lines in gums
Binds to disulfide groups  leading to denatureation of enzymes

- inhibits ferrochelatase and delta aminoevulinic acid dehydrogenase = interfering with iron utilization in heme synthesis
1. Remove source of exposure
2. Chelation therapy with:
a. EDTA
b. Dimercaprol
c. Succimer