Medical Toxicology 2: Pesticides, Metals, Solvents, and Food

What lipophilic drug is an organochloridne pesticide?

DDT

What drugs causes hyperexcitability of the CNS by preventing closing of axonal sodium gates after activation?

DDT

What is the treatment for DDT toxicity, characterized by paresthesia, vertigo, dizziness, headache, and in high doses: seizure, agitation, vomiting, mydriasis, and unconsciousness?

Supportive

What is the treatment for seizures in DDT toxicity?

Diazepam

What is the treatment for bradycardia in DDT toxicity?

Atropine

What drug is an irreversible organophosphate pesticide that inhibits acetylcholinesterase leading to cholinergic effects?

Parathion

Respiratory failure is the most common cause of death in what drug that inhibits acetylcholinesterase?

Parathion

What is therapy for acute toxicity of acetylcholinesterase inhibitors to antagonize Ach effects?

Atropine

What is therapy for acute toxicity of acetylcholinesterase inhibitors to reactivate AChE that may be attempted within 48hrs but is NOT for carbamates?

Pralidoxime

What is treatment for botanical insecticides such as nicotine (excitation/paralysis), rotenone (GI distress), pyrethrum (CNS excitation [seizures] + peripheral neurotoxicity)?

Supportive

Which toxins alter lipid membrane fluidity via oxidative damage, disturb ion channels, and membrane bound enzymes leading to CNS depression (respiratory paralysis, low BP, arrhythmias, mucus membrane/skin irritation, and liver/kidney disease?

Solvents

Which toxins include paints, dyes, sprays, etc.?

Solvents

What is treatment for CNS depression from solvent toxicity?

Supportive

Which drugs are halogenated aliphatic hydrocarbons AKA halogenated solvents that function as potent CNS depressants and cause hepato-/nephro-/neuro-/cardio-toxicity with chronic exposure?

Perchloroethylene, trichloroethylene, carbon tetrachloride, chloroform, trichloroethane

What drug causes peripheral neuropathy with chronic exposure?

Trichloroethylene

What drug is carcinogenic with chronic exposure?

Perchloroethylene

What is treatment for halogenated aliphatic hydrocarbon/halogenated solvent toxicity?

Remove agent + vital sign support

What drug is an aromatic hydrocarbon?

Benzene

What drug contains Clastogen (causes chromosomal breakage) and causes hematotoxicity/hematologic cancer (bone marrow damage/leukemia)?

Benzene

What is treatment for benzene toxicity, characterized by fever, headache, vertigo, and narcosis?

Remove agent + vital sign support

What disease generally leads to GI distress, fever, and neurological problems and is treated supportively with IV fluids and ions?

Microbial food contamination

What organisms are filter feeders that consume algae and concentrate toxins leading to shellfish poisoning?

Bivalve mollusks

What shellfish toxin causes amnestic shellfish poisoning?

Domoic acid

3 multiple choice options

What shellfish toxin causes diarrheal shellfish poisoning?

Okadaic acid

3 multiple choice options

What shellfish toxin causes neurotoxic shellfish poisoning?

Brevetoxin

3 multiple choice options

What shellfish toxin causes paralytic shellfish poisoning?

Saxitoxin

3 multiple choice options

What toxin activates AMPA/KA receptors leading to NMDA receptor activation?

Domoic acid

What toxin causes GI effects initially before neurological symptoms and short term memory loss day later, with severe cases causing arrhythmia, coma, and seizure?

Domoic acid

What is treatment for domoic acid amnestic shellfish poisoning?

Supportive

What toxin increases protein phosphorylation as well as sodium and fluid secretion in the intestinal lumen, causing a profound diarrhea with risk of dehydration with main symptoms of N/V/D?

Okadaic acid

What is treatment for okadaic acid diarrheal shellfish poisoning?

IV fluids

What toxin activates voltage-gated Na+ Channels leading to numbness and tingling in mouth, paresthesia, dizziness, vertigo, ataxia, headache, seizures and GI upset?

Brevotoxin

What is treatment for brevotoxin neurotoxic shellfish poisoning?

Supportive

What toxin blocks Na+ channels, having a similar effect to tetrodotoxin, leading to paresthesia in the mouth that can cause respiratory paralysis and death as it spreads to arms and leads, causes temporary paralysis, slurred speech, confusion, choking feeling, dry mouth, shortness of breath, and coma?

Saxitoxin

What is the emergency treatment for Saxitoxin respiratory paralysis in paralytic shellfish poisoning?

Intubation/Supportive

What toxin inhibits RNA polymerase and can cause renal-/hepato-toxicity, GI upset, jaundice, coma, and death?

Amatoxins

What toxin comes from mushrooms?

Amatoxins

What is treatment for amatoxins mushroom poisoning?

Supportive care, close monitoring, and liver transplant