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Flashcards in Posions Deck (39)
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1
Q

sources of carbon monoxide

A

endogenous
incomplete conbustion of fossil fuels, old cars
exposure to methylene chloride
some drugs - phenytoin, phenobarb

2
Q

is carbon monoxide a routine analysis

A

no

3
Q

elimination of carbon monoxide

A

unchanged by the lungs

4
Q

mechanism of carbon monoxide poisoning

A

binds to hemoglobin causing tissue hypoxia

5
Q

CO level 30-40% sx

A

sever headache, weakness, dizziness, nv, collapse

6
Q

CO level 40-50% sx

A

retinal hemorrhage

increased respiration

7
Q

over 50% CO sx

A

convulsions
coma
death

8
Q

who is most susceptible to CO poisoning

A
infants
those with lung disease
CV disease
elderly 
anemia
9
Q

treatment of CO poisoning

A

remove person from source of CO

hyperbaric oxygen

10
Q

problems with interpretation in CO poisoning

A

whole blood - has to be whole blood bc binds to RBC
putrefaction - byproducts given off that interfere with analysis bc same UV spectrum
fire victims may have to use liver or kidney tissues bc blood coagulated

11
Q

forms of cyanide

A

hydrogen - cololess gas or blue white liquid

salts - white crystalline powder

12
Q

sources of cyanide

A
normal metabolism
cigarette smoking
insecticides
electroplating industry
dyeing, printing, photgraphy
combustion of N containing compounds - synthetic furniture
cyanogenic glycosides
13
Q

mechanism of cyanide toxicity

A

enzymatic poison attacks the cytochrome system
prevents oxygen utilization at the cellular level
results in metabolic asphyxiation (no oxygen)

14
Q

acute cyanide toxicity sx

A
giddiness
stiff lower jaw
rapid slow breathing
muscle twitching
palpitation
cyanosis
convulsion
coma
death due to resp arrest 
*brain and heart most sensitive
15
Q

chronic cyanide toxicity sx

A
dizzy
weak
congestion of lungs
conjunctivitis
loss of appetite
weight loss
mental deterioration
16
Q

deathly concentrations of cyanide

A

> 270ppm immediately fatal
180 - 10min
135 - 30min
110 - 1 hr

17
Q

treatment of cyanide poisoning

A

body can detoxify on its via rhodanese enzyme

but can be sped up by adding an exogenous source of sulfur

18
Q

agents used in cyanide poisoning

A

amyl nitrite - given at scene
sodium nitrite
sodiom thiosulfate - best one

19
Q

how does sodium nitrite work

A

turns hemoglobin into methemoglobin which combines with iron cyanide to form cyanomethemoglobin so cyanide is tied up not causign damage

20
Q

how does sodium thiosulfate work

A

combines with cyanide to form thiocyanate

21
Q

interpretation of cyanide

A

whole blood

22
Q

problems with postmortem cyanide detection

A

enzymes and bacteria produce cyanide

23
Q

what are inhalants

A

breathable chemical vapors that producs psychoactive effects

volatile solvents, aerosols, anaesthetics, volatile nitrites

24
Q

reason for widespread use of inhalents

A

low cost
ready available
legal

25
Q

methods of inhalant exposure

A

inhalation
oral ingestion
skin contact

26
Q

what is sniffing

A

directly inhaling from container or heated pan or from a piece of clothing soaked with solvent

27
Q

what is huffing

A

holding solvent soaked rag over face and breathing in through mouth

28
Q

what is bagging

A

spraying or pouring the solvent into a plastic bag holding over mouth and nose and inhaling from the bag

29
Q

typical abuser of inhalants

A

young
male
underpriveleged unstable home
poor student with high rate of absenteeism

30
Q

ppl likely exposed to inhalants

A
doctors
nurses
dentist
hair stylist
painter
dry cleaners
31
Q

stimulant phase of sniffing

A
euphoria
excitement
release of inhibitions
floating sensation
delusions of grandeur and invincibility 
lasts 15-30min
32
Q

depressant phase of sniffing

A
drowsy 
slowed reflex
stupor
bizarre thoughts
hallucination
similar to alcohol intoxication 
lasts 1-2hrs
33
Q

indicators of inhalant use

A
pungent chemical odor
excessive nasal secretion
red watery eyes, dilated pupil, rapid involuntary eye movement
double vision
ringing in ears
vivid dreams
hallucination
slow slurred speech 
white powdery ring of dried glue around mouth and nose
paint stains on body or clothing
drooling, sores aroudn mouth
paraphenalia with traces of paint/glue
34
Q

inhalant absorption

A

vapors enter bloodstream directly from lungs

stored in fat tisssues and slowly released back into the blood

35
Q

inhalant distribution

A

rapidly distributed to brain and liver

36
Q

inhalant metabolism

A

some metabolized and excreted by kidneys

other eliminated unchanged via lungs

37
Q

long term effects of sniffing

A
fatigue 
chronic headache
dizzy 
depression
irritable
loss of concentraion
loss of appetite
tremor
liver kidney and brain damage
38
Q

dependence associated with inhalant use

A

psychological dependece
tolerance
no physiological dependence but some develop tremors

39
Q

what is sudden sniffing death

A

follows strenuous exercise or stress after several deep inhalations of sniff
caused b yheart failure resulting from severely irregular heartbeat (arrythmia)
associated with halogenated hydrocarbons