4 - Household & Industrial Toxicology

b. 1% methylene blue (low dose)

Ratio: need to be large dose

1. The ff drugs are useful in the management of cyanide toxicity, except:

   a. Hydroxocobalamin

   b. 1% methylene blue (low dose)

   c. Sodium thiosulfate

   d. amyl nitrite

a. KOH

2. which of the ff corrosives causes liquefication necrosis?

   a. KOH

   B. CH3COOH

   C. HCl

   d. H2SO4

b. acetone

3. which of the ff poisons is seen in nail polish removers

   a. phenol

   b. acetone

   c. methanol

   d. benzoic acid

c. both are correct

4. Fomepizole is an antidote for

   a. methanol toxicity

   b. ethylene glycol toxicity

   c. both are correct

   d. NOTA

c. formalin

5. Which of the ff poisons is used as embalming fluid

   a. methanol

   b. fomepizole

   c. formalin

   d. disulfiram

Phosphorus

6. Phossy Jaw may occur after a person is exposed to the vapor of

Sodium Bicarbonate

7. It is useful for the treatment of metabolic acidosis

Methanol

Uses: Solvent, Denaturation, Paint Remover

Wood Alcohol

other name for methanol

• Formaldehyde – embalming fluid

• Formic acid – induces metabolic acidosis, can cause blindness

Methanol metabolites:

• Ethanol

• Fomepizole – greater affinity

Methanol tox Antidotes:

Methanal, Formalin

other names for Formaldehyde

Formaldehyde

Uses: Embalming fluid

• NaHCO3 – systemic alkalizer

• Supportive Care

Treatment for Metabolic acidosis

Disulfiram

Antidotes for Formaldehyde toxicity:

Ethylene Glycol

Uses: Coolant

• Glycoaldehyde

• Glycolic acid

• Glyoxylic acid

Ethylene Glycol Metabolites:

Oxalic acid

Ethylene Glycol Toxic Metabolites:

• Ethanol

• Fomepizole – greater affinity

Ethylene Glycol Antidotes:

Isopropyl Alcohol

• Uses: Antiseptic, disinfectant

• Can act as: CNS depressant, Pulmonary depressant

Acetone

Uses: Nail polish remover, Airplane glues

• CNS depression tha leads to coma

• Respiratory depression

S/S of acetone toxicity:

Hydrocarbons

Mostly derived from petroleum distillation: Gasoline & Kerosene

• Lungs = asthma like syndrome & wheezing

• CNS = generalized depression

• Heart = hypotension & arrhythmia

• GIT = nausea/vomiting, abdominal pain

Multi-organ defects of Hydrocarbons toxicity

pneumonitis & aspiration

Vomiting may induce:

• Beta 2 agonist – wheezing

• IV hydration – hypotension

• B1 blockers – arrhythmia

Hydrocarbons toxicity treatment

Base

Liquefication Necrosis

Acid

Coagulation Necrosis

Dilutional Therapy

Treatment for acids & base toxicity

Carbonic Acid

other name for phenol:

Phenol

• Derivative: Lysol (50% Cresol)

• Use: Protein Denaturant

• a)       Dermal exposure: PEG

• b)      Inhalation: 100% oxygen

• c)       GIT exposure: Castor, Mineral Oil

Treatment for Phenol toxicity:

Phosphorus

St. Elmo’s Fire

Red Phosphorus

Non-poisonous (matches)

Yellow Phosphorus

Poisonous (fireworks)

• a.     Luminous Vomitus

• b.     Garlic odor of breath

• c.     Loose teeth à Phossy Jaw (necrosis)

S/S of Phosphorus toxicity:

• a.     Antidote: CuSO4

• b.     Diazepam – seizure

• c.     Calcium – hypocalcemia

Tx for Phosphorus toxicity:

Carbon Tetrachloride

Uses: non-flammable cleaning fluids & fire extinguisher

• a.     Cl3COO – lipid peroxidation

• b.     Phosgene – hepatorenal toxicant

Toxic metabolite of carbon tetrachloride:

Carbon Monoxide

• Colorless odourless air pollutant

• From incompatible combustion of carbon containing fuels

• MOA: bind to haemoglobin à produced carboxyl Hb à hypoxia

• a)       100% oxygen

• b)      Artificial Air (He= 80%; O=20%)

• c)       Hyperbaric Oxygen – use of chamber

Treatment for CO

• 1.     Apple, Peer, Prunus spp – amygdalin

• 2.     Cassava – Mannihoxin, Linamarin

• 3.     Bamboo shoots – Taxiphyllin

Cyanogenic Glycosides sources of Cyanide:

• 1.     Sodium Nitroprusside

• 2.     Laetrile (VB17) – semi-synthetic form of amydalin | ANTI CANCER CLAIM!

Drugs sources of Cyanide:

Cyanide

Blocks cytochrome oxidase, binds to Heme Iron

Hydroxycobalamin

DOC for Cyanide Toxicity

• §  Amyl Nitrite

• §  NaNO2

• §  Na thiosulfate

• §  Dicobalt edetate

• §  Methylene Blue (large dose)

Other treatment for Cyanide Toxicity