NEW: Drug Toxicity 4

C1-C4 aliphatic hydrocarbons

Do not present any problems unless they are in a high enough concentration to decrease oxygen levels

C5-C8 aliphatic hydrocarbons

Volatile liquids that are metabolized to neurotoxic substances

What happens when gasoline or kerosene are ingested?

Alcohol-like symptoms lasting hours to days

What happens when gasoline or kerosene are inhaled?

- Sensitizes the heart to epinephrine

- Respiratory failure

- Pneumonitis

What are the key points of carbon tetrachloride toxicity?

- Very lipophilic

- May be inhaled, ingested, or absorbed through skin

- CNS depressant

- Extremely hepatotoxic

- Death due to renal failure

What happens during the first 30-90 minutes of methanol ingestion?

- Sedation

- Ataxia

- Inebriation/disinhibition (large amounts)

What happens 4-8 hours after methanol ingestion?

- Headache

- Vomiting

- Blurred vision leading to blindness

How does methanol lead to death?

- Metabolic acidosis

- Respiratory depression

What is the toxic metabolite of methanol?

Formic acid

What is the toxic metabolite of ethylene glycol?

Glycolic acid

How does ethanol treat methanol toxicity?

- Outcompetes for ADH

- Requires BAC > 0.08

- Prevents formation of toxic metabolite

How is methanol toxicity treated?

- Sodium bicarbonate

- Dialysis

- Ethanol

- Fomepizole

- Folate

How does fomepizole treat methanol toxicity?

- ADH inhibitor

- Single dose of 20 mg/kg

What are the key points of isopropyl alcohol toxicity?

- Alcohol-like inebriation and GI distress

- Much less toxic than methanol

- Metabolized to acetone

- No toxic metabolite

- Supportive treatment until clearance

What are the key points of ethylene glycol toxicity?

- CNS depression

- Metabolic acidosis

- Renal failure

- Treat with fomepizole

Benzene

Carcinogenic industrial solvent

What is toluene found in?

Glue