Hi-Yield Tox Flashcards

The IUPAC name for Iron(II,III) hexacyanoferrate(II,III) is Prussian Blue. This form of Prussian blue is insoluble and administered orally.

Enhances elimination of cesium (Cs) from the GI tract, which is useful for radioactive fallout.

Prussian blue is also the treatment for thallium (Th) toxicity, via a similar mechanism.

Constipation is also commonly reported, and stools may be blue in color. The medication should be taken with food to enhance biliary secretion of Cs.

Adult dosing is 3 grams PO taken 3 times a day with food.

Although pregnancy category C, pregnant patients should likely still be treated as the benefits likely outweigh the risks.

• -Aerosolized liquids or solids (not actually a gas), 2-chlorobenzalmolonotrile is an example, but there are many other related compounds.
• 
• -Activates TRP receptors and induce substance P release leading to pain and mucosal irritation
• -Complications include ocular irritation, keratitis. Requires very high concentrations to cause life threatening injury.
• -Extraction from environment, decontamination and supportive care?

• Humans can smell at 3 ppm, this causes mild mucus membrane
• As concentration increases, smell strength increases, which is associated with worse lung injury
• -@400 ppm; 30 minutes is fatal, @>1000ppm, instantly fatal.
• Creates HOCl leading to direct injury of the lung tissue
• Supportive, nebulized Bicarb is a safe approach

• -Causes a delayed ARDS type picture and respiratory irritation (typically around ppm>4.8).
• 
• -Causes acylation of cells in the alveoli as well as formation of ROS. It is not readily water soluble so production of HOCl is less likely.
• -Supportive care, high dose steroids, ARDS net protocol, but theoretically antioxidant support with NAC maybe of benefit, ECMO for complete lung failure
• -History: chemical weapon used during World War 1

normal is < 10

• Phenobarbital

• Theophylline

• Carbamazepine

• Dapsone

• Quinine

• Colchicine

• They need MDAC to bind xenobiotic before it is recirculated

Valproic acid (PMID=17711961; theoretical mechanism: empiric evidence, no theory)

Ace-inhibitor overdose (PMID=1928887; theoretical mechanism: inhibition of digestion of endogenous endorphins)

Imidazolines (PMDI=29544366; higher dose, theoretical mechanism: reversal of brain stem Beta-endorphin release)

methyl xanthines (caffeine, theophylline, aminophylline; they increase beta1&2 signaling as a downstream effect of phosphodiesterase activity and adenosine antagonism )

albuterol, clenbuterol (iatrogenic)

glucagon (iatrogenic)

halogenated hydrocarbons (huffers)

• Mohave Rattlesnake (Crotalus scutulatus)

• Diambondback Rattlesnake (Crotalus atrox)

• Eastern Diamonback Rattlesnake (Crotalus adamanteus)

• Cottonmouth/Water moccasin (Agkistrodon piscivorus)

• Ovine papain digested Ab results in cleavage at the hinge site resulting in 2 linear Fab’s per antibody. This is comparison to pepsin cleavage resulting in a v-shaped Fab.