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Toxicology

Kelly Scott Pharmacology and Toxicology Englisch 109 Karten

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  1. 1ToxicologyThe dose marks the poison!!
    The poison causes a harmful effect in the animal
    The route affects toxicity
    Toxicity of poison can be extreme to harmless
    Species respond differently
    Decontaminate!
    Treat the patient not the poison
  2. 2What is a poison?Substance that causes death, illness or injury that can result in death or chronic illness
  3. 3ToxicityProducts tested before put on the market for safety
  4. 4LD50Lethal dose that will kill 50% of animals
    -Some animals can die at a dose lower than the LD50
    Not many antidotes available
  5. 5RatbaitAnticoagulant bait
    LD50 is 0.5mg/kg in cats
  6. 6Exposure and time for animal to reactAcute - within 24 hours
    Subacute - days
    Chronic - months
  7. 7Routes of exposureIf something is eaten eg. selenium it is less toxic than when injected
    Topical, injectables and vapours of some substances/inhalation of gas
  8. 8Animal variationSpecies - cats! (no enzyme)
    Breed
    Sex
    Age: physiology of young animals not as developed as adults, can't eliminate toxins as fast. Old animals have less function in liver and kidneys so more susceptible
  9. 9Assessing the animalWhat is the animal's current condition
    History: what was it exposed to
    Clinical signs
    Advise the client and refer to the vet
    In clinic: clinical exam, give supportive care and decontaminate
  10. 10Things to do in clinicSave vomit, faeces and urine
    Record and label it with careful handling
    Don't assume poisoning
    Call national poison centre for information on the product, not advice
  11. 11Questions to ask when taking historyHow long has animal had clinical signs?
    Clinical signs? Mentation, behaviour, recumbent, respiration
    What did you feed it?
    Do you have a compost bin?
    Do you know what it has access to?
    Snug and snail bait in garden?
    How much was ingested? How much does the animal weigh?
  12. 12Principles of toxicologyLimit exposure
    Limit absorption
    Stabilise the animal: oxygen, fluids, warmth
    Promote elimination: laxatives, fluids
    Identify the poison: stabilise and decontaminate first, then give antidote
  13. 13Limit exposurePrevent access to poisons
    eg. keeping cows off lush pasture and avoid nitrate toxicity
  14. 14DecontaminationEmetics: dogs, cats and pigs (everything else can't vomit)
    Activated charcoal + laxative
    Laxatives:
    -magnesium sulphate (epsom salts)
    -Paraffin oil (NOT concurrently with activated charcoal: will bind charcoal and prevent it absorbing the toxin)
  15. 15Treat the patient not the poisonYou may never find out what the animal was exposed to
    Decontamination and hydration
    Control bleeding and convulsions
    Oxygen
  16. 16Identifying toxinsAsk the client what the animal could have been exposed to
    Have they used anything in their property recently? Slug bat, rat poison etc
  17. 17AntidotesUse if available
    Eg. vitamin K for rat bait
  18. 18Decontamination of dermal exposure-Wash off with copious amounts of tepid water, not hot (vasodilation increased absorption) or cold (hypothermia)
    -Baby shampoo or mild dish soap can be used if needed
    -If contaminant is oil or tar based, use vegetable oil to aid removal
  19. 19Decontamination for oral exposureIf less than 4 hours, give an emetic UNLESS substance is corrosive
    How do you know if something is corrosive? Examine the mouth mucus membranes for erosion, hyper-salivation, licking and pain
    If >4 hours limit GI absorption, use activated charcoal and laxatives if appropriate.
    If corrosive: use milk or water
  20. 20EmeticsApomorphine in dogs
    Xylazine - ok in cats
    Washing soda crystal on tongue at home
    Hydrogen peroxide 3%
    Emetics not useful with cannibis toxicity
  21. 21Emetic contraindicationsSpecies: Don't use in anything except cats, dogs or pigs
    Don't induce vomiting for corrosive toxins
    Petroleum product ingestion - aspiration risk
    Any CNS depression or convulsions: have reduced reflexes and can aspirate
  22. 22Gastric lavageWithin 1-2 hours of ingestion
    Anaesthesia, intubation to prevent aspiration
    Right lateral recumbency with head down
    Warm water and saline flush down oesophagus
    Give activated charcoal
  23. 23Activated charcoal contraindicationsNot effective at binding acids or alkalies
    Alcohol or ethanol
    Petroleum
    Some metals: iron and mercury
  24. 24Common poisonsAnticoagulant rodenticides
    -first gen: warfarin
    -Indanediones: leave tissue residue
    2nd gen: Brodifacoum
  25. 25Rat bait mechanism of actionCompetes with Vitamin K epoxide reductase, preventing recycling of vitamin K to make clotting factors
    Results in haemorrhage
    -Prolonged OSPT
  26. 26Anticoagulant clinical signs3-5 day delay
    Dyspnoea
    Lethargy and weakness
    Coughing
    Pale mucus membranes from bleeding
    Anorexia
    Vomiting
    Melena
    Haematuria
    Lameness
  27. 27Symptomatic and supportive care for anticoagulant toxicityVitamin K1 - give slowly over fluids
    Warmth
    Oxygen
    Fluids
    Clotting factors or blood transfusion:
    PCV <20%, dyspnoea, anaemia
  28. 28Advice to ownersFind out what product and how much eaten
    Decontaminate the animal in clinic
    Use an emetic if <4 hours from ingestion
    * clinical signs take 3-5 days to appear*
    Animals may die suddenly from internal haemorrhage
    2nd gen, products can cause problems for 30+ days, require Vit. K for a month
    Vitamin K1 is the best treatment, K3 not as good for vet use
  29. 29OrganophosphatesCommon agricultural product
  30. 30CarbamatesInsecticides and snail bait
  31. 31Organophosphate mechanism of actionInhibition of acetylcholinesterase at cholinergic receptors
    Affects autonomic nervous system function:
    Often fatal, quickly but can be delayed causing weakness
  32. 32Muscarinic clinical signs of organophosphate toxicitySalivation, lacrimation, urination, defecation ,dyspnoea and emesis
    Will resolve with atropine
  33. 33Nicotinic clinical signs of organophosphate toxicityMuscle tremors
    Not affected by atropine
  34. 34CNS clinical signs from organophosphate toxicityAnxiety
    Hyperactivity
    Seizures
  35. 35Diagnosis of OP toxicityAcetylcholinesterase activity will be decreased, take a blood sample or brain tissue in post mortem
    Give a test dose of 0.02mg/kg atropine: if animal responds with dry mucus membranes it indicates that it is not OP toxicity
    Some animals have a garlic odour
  36. 36OP and carbamate treatmentAtropine sulphate is an antidote for both
    2-PAM for OP toxicity only
    Symptomatic treatment: fluids, oxygen, warmth/cool as needed. Monitor TPR
  37. 37OP and carbamate advice to clientsClinical signs come on quickly (~15 mins)
    Decontaminate the animal in clinic ASAP
    Explain the symptoms and importance of giving antidote rapidly to owner, prognosis is much better if treatment is given within 12 hours
    Don't use tranquilizers (acepromazine)
  38. 38What questions should you ask the owner for rat bait poison?Do you know how much he ate?
    How much did you put out?
    How much does the dog weigh?
    Condition of the dog: breathing, mentation, recumbency
  39. 3915kg dog eats 200g of Talon (0.05g/kg) Did he eat a toxic dose?0.2kg eaten x 0.05g = 10mg
    10mg/15kg = 0.67mg
  40. 40Treatment for rat bait if eaten 1 hour agoInduce emesis
    -Sodium carbonate if at home
    Depending on how much eaten, follow up with activated charcoal
  41. 41CholecalciferolNot an anticoagulant
    Very long half life as it is in the bile which is recycled
    Results in imbalance in calcium homeostasis causing mineralisation of body tissues
  42. 42Clinical signs of cholecalciferol toxicityLethargy, weakness, vomiting, ataxia
    melena and haemetemesis
    Twitching, seizures and depression
    Renal and liver failure in late stages
    Can take 24 hours or more for onset of signs
  43. 43Biochemistry in cholecalciferol toxicityHypercalcaemia
    Hyperphosphataemia
  44. 44Treatment of cholecalciferol toxicityActivated charcoal, repeated doses
    Fluids to maintain kidney function
    Frusemide
    Prednisone/prednisolone
    Pamidronate disodium: treats hypercalcaemia
    or Salmon calcitonin, not together
  45. 45Advice to client for cholecalciferolGive emetic and activated charcoal ASAP
    4 hours post ingestion and clinical signs present, without treatment the animal will die in 2-5 days from renal failure.
    Once the animal has kidney disease, the prognosis is poor
    Requires several weeks of nursing care
  46. 46Sources of lead poisoningPainted surfaces
    Soil and grass contamination
    car batteries
    Roofing caps
    Petrol products and old oil
    Shotgun pellets
  47. 47Susceptibility to lead poisoningAll ages and species are susceptible, but
    toxicity is increased in young animals
    Dogs and cattle most likely to get poisoning
    50-900mg/kg is an acute dose
  48. 48Clinical signs of lead poisoningHysterical barking
    Chomping
    Paralysis
    Blindness
    Abdominal pain
  49. 49Treatment for lead poisiningLarge animals: magnesium sulphate for decontamination. Binds lead and it is passed out. Also has laxative effects
    Small animals: activated charcoal + laxative
    Diazepam to control convulsions
  50. 50Chelation therapy for lead poisoningCalcium EDTA
    Binds lead
  51. 51Advice to clientsLead poisoning is a public health issue - owners should see their GP
    Remove the lead fragments from the animal before giving chelation therapy
    Emetics and charcoal have limited use
    Notify the government if livestock have been poisoned
  52. 52Sources of nitrate toxicityPasture plants, crops and weeds
    weather and fertiliser: rain and overcast weather causes excessive nitrates in plants
    Hungry cattle gorge themselves on lush pasture and get toxicity
    Contaminated water
    Fertilisers
    High nitrite (preservative) in dog roll
  53. 53Mechanism of nitrate toxicityConversion of nitrate to nitrite is toxic
    Nitrite oxidises haemoglobin to methaemoglobin, causes oxygen starvation and death
  54. 54Clinical signs of nitrate toxicityRespiratory distress
    chocolate blood and brown MM
    Salivation and abdominal pain
    Ataxia, tremors and convulsions
    sudden death
  55. 55Diagnosis of nitrate toxicityDiphenylamine test on plants
    Nitrate test strips
    Test aqueous humour from dead animals
    Send plant sample to lab
  56. 56Treatment of nitrate toxicityTriage
    Treat standing animals before recumbent ones
    Don't stress them out
    Move mildly affected animals off pasture
    Provide safe feed
    Give methylene blue - has long WHP
  57. 57PhenolsDisinfectants and clay pigeon fragments
    Corrosive lesions in the mouth and GI tract
    Denatures and ppts proteins can cause necrotic lesions on skin
    Corneal lesions on eyes
  58. 58Advice to clients for phenol toxicityMilk or eggs, not water. Given orally
    Don't use phenol disinfectants in kennels or catteries
  59. 591080 mechanism of actionsodium fluoroacetate
    Builds up citrate by interfering with the Krebb's cycle causing acidosis
  60. 60Clinical signs of 1080 toxicityvocalisation
    Running / excitement
    Tenatic seizures
    Frequent urination and defecation
    Metabolic acidosis
    Hyperthermia
    Hyperglycaemia and decreased ionised blood calcium
  61. 61Treatment for 1080 toxicityDiazepam for seizures
    Sodium bicarbonate fluids for acidosis or
    Acetamide fluid (NOT both)
    Support care - requires anaesthesia to prevent seizures and excitement
  62. 62Advice to clients for 1080 consumptionShort period before onset of clinical signs
    Give emetic if no signs yet
    Bring in to clinic ASAP!!
    Must see the vet immediately if showing clinical signs. Don't make them vomit if giving signs, can aspirate
    Prognosis is poor!
    Animal requires anaesthesia so can do gastric lavage
    Acetamide is a promising antidote
  63. 63Metaldehyde clinical signsslug/snail bait
    Early signs: Anxiety, grimacing, restlessness
    Blindness
    Metabolic acidosis
    Excitation to narcosis
    Tachycardia and tachypnoea
    Nystagmus in cats
    "Shake and bake"
  64. 64Treatment of metaldehyde toxicityMetabolic acidosis due to muscle activity
    -Reduce muscle activity
    Symptomatic and supportive care
    Use anticonvulsants if needed:
    Diazepam, barbituates and methocarbamol
  65. 65Advice to clients for metaldehyde poisoningSerious! bring in ASAP
    Clinical signs onset soon after ingestion
    Can cause liver and renal disease
    Memory loss, diarrhoea and blindness
    NO antidote
    requires decontamination and nursing care
  66. 66Pyrethrin and pyrethroid sourcesInsecticides
  67. 67Clinical signs of pyrethrin toxicityCats are very sensitive to pyrethrin
    Ear twitching,
  68. 68Treatment of pyrethrinsNo antidote!
    Decontaminate
    Rinse off ASAP if topical
    Oral charcoal and laxatives
    Nursing care
    Monitor temperature
    Anti-convulsives: methocarbamol best
    as it prevents muscle twitching
  69. 69Advice to clients for pyrethrin toxicityInsecticides are mostly safe, EXCEPT in cats
    Thoroughly decontaminate and wash off animal
    Symtpmatic care
    control tremors with diazepam or methocarbamol
    NEVER use dog products on cats
  70. 70ParacetamolDepletes glutathione in the liver (needed for detoxification)
    Causes oxidative injury:
    Liver damage in dogs
    RBC damage in cats
  71. 71Clinical signs of paracetamol poisoning in dogsTachypnoea
    Tachycardia
    Abdominal pain
    Vomiting
    Anorexia
    Methaemoglobinaemia
    Facial and paw oedema
  72. 72Paracetamol toxicity in dogsSevere liver damage
    24-36 hours post ingestion
  73. 73Paracetamol clinical signs in catsCyanosis
    vomiting
    Dyspnoea
    Oedema in face and paws
  74. 74Paracetamol toxicity in catsMethaemoglobinaemia
    Heinz body anaemia
    Recumbency, hypothermia and shock
    depression
  75. 75Treatment of paracetamol toxicitySymptomatic and support care
    warmth and oxygen
    Parvolex as a glutathione substrate
    Methylene blue and ascorbic acid for methaemoglobinaemia
  76. 76Advice to clients regarding paracetamolDON'T GIVE IT TO YOUR PETS
  77. 77Macrocyclic lactones: Ivermectins and abamectinEnterohepatic circulation
    Excreted in faeces - don't let dogs eat poop
    Long half lives
    Decontaminate with activated charcoal
    Insecticides and paste wormers for horses
  78. 78Ivermectin and Abamectin toxicity in mammalsEffects GABA in CNS and decreases neuron excitability
    Mutations cause a defect in the BBB so some dogs much more sensitive to low doses (eg. Collies and Collie crosses)
    Normal dogs are sensitive to high doses
  79. 79Clinical signs of Ivermectin and Abamectin toxicityAtaxia, stiff gait, high stepping, depression, reversible blindness
  80. 80Avermectin treatmentSupportive care
    Repeated doses of activated charcoal
  81. 81Avermectin advice to clientsPrevent access to these products (pastes, drenches and pour ons)
    Decontaminate ASAP to prevent a long recovery period
  82. 82Lilium sp. toxicitySerious acute renal disease in cats if they eat the plant or pollen and drink the vase water. Die without treatment
    In the first few hours: salivation, depression and vomiting
  83. 83Lilium toxicityDecontaminate early! emesis and charcoal + laxative. Fluids!! Support renal function
    Poor prognosis for anuric cats, can do peritoneal dialysis
  84. 84Arum lilyProduces burning sensation in the mouth and renal damage due to precipitation of oxalate
  85. 85Arum lily toxicity clinical signsHypocalcaemia: staggering, weakness and tremors
  86. 86Treatment of Arum LilyNo emetics in ruminants!
    Decontaminate with activated charcoal and laxative
  87. 87Bracken fernDepression and weakness from anaemia
    Nervousness and lethargy in horses
    Poor prognosis with the development of anaemia, requires transfusion and treatment
  88. 88ButtercupRanunculum poison
    Causes mouth pain resulting in salivation, gastric ulceration, colic and diarrhoea
    Weakness, staggering and death if eaten lots
    Supply alternative feed
    Symptomatic treatment and decontamination
  89. 89Foxglovecontains digitalis and digoxin
    abdominal discomfort, vomiting and anorexia in small amounts
    Strong, bounding pulse and slow heart rate, tremors and death with large amounts
  90. 90Foxglove decontamination in large animalsActivated charcoal expensive
    Use a purgative or magnesium sulphate then treat symptoms
  91. 91Goat's rueRespiratory distress due to lung damage
    Diuretics and NSAIDs to reduce pulmonary oedema
  92. 92HelmockHas purple blotches on the stem. Stems are hollow
    trouble swallowing, diarrhoea, muscle weakness, tremors, coma and death
    Rapidly toxic, treat ASAP.
    Activated charcoal and laxative
    Sub-lethal doses can be detected in milk
  93. 93KarakaDevelop paralysis due impaired ATP synthesis and cytotoxicity.
    Require good nursing care and decontamination. Remove seeds
  94. 94MacrocarpaCauses third trimester abortion and retained placenta
  95. 95Ngaioleaves have serrated edges and hate small, white flowers
    Causes photosensitivity. Can be confused for facial eczema, but facial eczema is in late spring - summer. Poisoning can occur at any time of year.
  96. 96RagwortCause liver damage and impaired function resulting in giant hepatocytes. Sheep are more resistant than cattle and horses
  97. 97RhododendronGI clinical signs: vomit and regurgitation. Decontaminate! charcoal and laxative
    Depression, muscle weakness, tremors, convulsions and death from respiratory distress
    Dried leaves still poisonous
  98. 98Ryegrass mycotoxin diseasesStaggers - Lolitrem B
    Facial eczema - sporidesmin (pithomyces chartarum)
  99. 99NightshadeGI upset in mild cases
    Restrict access
    Don't feed potatoes to stock
  100. 100TutuCNS excitation compound
    Takes 24-48 hours for clinical signs
    Seizures, tachypnoea, tachycardia, muscle twitches and tremors
    Good nursing care and barbituates to reduce clinical signs
  101. 101YewFluids
  102. 102Questions to ask ownersWhen did clinical signs start?
    Did you see them ingest anything and if so, when? How much?
    Anything around your household that they could have ingested?
    How much do they weigh?
  103. 103Principles of treatmentStabilise the animal:
    Fluids at shock rates, oxygen, warmth diazepam if seizing, propofol and atropine
    Activated charcoal and sorbitol (sorbitol to prevent gut stasis and constipation)
  104. 104AtropineTreatment for organophosphate toxicity (slug & snail bait)
    Organophosphates block acetylcholinesterase at cholinergic receptors
    Acetylcholinesterate will regenerate in some poisons as it doesn't tightly bind, but will overwhelm and age enzymes causing neuropathy and death
  105. 105Emetic useNOT for corrosive toxins: check mouth for irritation
    NOT for animals with clinical signs, seizures or unconsciousness due to aspiration risk
    Not in patients that ingested toxin >4 hours
  106. 106Difference between first and second generation rat poisoningFirst gen requires several doses causing bait shyness. Warfarin and Pindone
    Second gen: Long acting, 30 days ish
    Brodifacoum (Talon)
  107. 107Rodenticide mechanism of actionCompetes with Vitamin K epoxide reductase
    Treatment: Must give vitamin K1
  108. 108SLUDDEOrganophosphate toxicity muscarinic signs
    S
    L
    U
    D
    D
    E
  109. 109Organophosphate toxicity: Intermediate syndromeDelayed onset anorexia
    Depression
    Generalised weakness
    Muscle tremors
    Ventroflexion of the neck

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Pharmacology and Toxicology Karteikarten am Toxicology, erstellt von Kelly Scott am 13/07/2020.
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