Lecture 20: Basic Approach to Tx of Poisoned Animals 3

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15 Terms

1
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What is activated charcoal efficacy dependent on?

  • Time after ingestion of toxin

  • How long stays in GI tract

    • Toxin-AC can start to desorb after 30 min

  • Toxin to AC ratio

    • 1:10 ratio optimal

  • Stomach contents

  • Quality of AC product

    • Many products contain AC

    • Be sure to use MEDICAL GRADE AC

2
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What are the other ingredients prepared activated charcoal formulations may have?

  • sorbitol = cathartic

  • kaolin = clay absorbent

  • propylene glycol

  • glycerol = carrier, stabilizer

3
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In clinic, you should be sure to have some activated charcoal on hand without a _______.

cathartic

4
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True or false: it is never too late to give activated charcoal as long as any toxin remains in GI tract

true

5
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How does AC enhance elimination?

decreasing enterohepatic recylcing

6
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What are the pros and cons of giving activated charcoal before inducing emesis?

pros:

  • starts binding toxin right away

  • increases contents in stomach, improves emesis

cons:

  • cannot use vomit or lavage for analysis

  • must repeat after emesis or lavage is complete

7
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What are the benefits of using activated charcoal after emesis or lavage?

  • less toxin to bind up all available sites on AC

  • vomit or lavage fluid can be used for analysis

8
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What clinical pathology is associated with activated charcoal adminstration?

hypernatremia

9
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What are the absorbing agents other than activated charcoal?

• Kaolin

• Pectin

• Bentonite

• Bismuth

• Ion exchange resins (cholestryramine, others)

• Products sold as “mycotoxin binders”

10
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What is the major goal of enhancing elimination?

• To remove as rapidly as possible any toxin that has ALREADY BEEN ABSORBED into the systemic circulation and tissues

• To diminish degree and duration of toxic effects

11
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What are the major methods of enhancing elimination?

  • diuresis (urinary excretion)

  • decrease enterohepatic recycling (biliary excretion) → multiple doses of activated charcoal

12
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What are moxidectin, ivermectin, and lipophilic drugs used for?

IV lipid emulsion treatment to enhance elimination

13
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What is the role of systemic chelators?

enhances elimination of absorbed toxin by altering diffusion gradient (ex. metal chelators used for various metal poisons)

14
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What is an antidote?

an agent that reacts with the poison or its receptor or interferes with its metabolite pathway to decrease the ability of the poison to cause toxicity

15
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How do antidotes treat toxicities?

block receptors used by the toxin or inhibit metabolism of original substance to a toxic metabolite