Drug Dependence and Poisoning Quiz

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Questions and Answers

What phenomenon is associated with chronic cocaine use, leading to a sensation of insects crawling under the skin?

  • Helmholtz syndrome
  • Magnan’s symptoms (correct)
  • Cochrane's symptoms
  • Cranston’s illusion

Which of the following withdrawal symptoms is typically associated with cocaine dependence?

  • Severe respiratory depression
  • Intense appetite suppression
  • Neurological pain in arms and legs (correct)
  • Severe gastrointestinal distress

Which treatment is NOT considered appropriate for managing cocaine dependence?

  • Psychological care
  • Use of beta blockers for hypertension
  • Heavy opioid therapy (correct)
  • Symptomatic treatment

What is one reason benzodiazepines have replaced barbiturates in clinical practice?

<p>Wider therapeutic index (D)</p> Signup and view all the answers

What is a potential consequence of chronic benzodiazepine use?

<p>Increased resistance to their effects (D)</p> Signup and view all the answers

Which factor does NOT influence the toxicity of potassium cyanide?

<p>Level of hydration (B)</p> Signup and view all the answers

Which of the following describes an idiosyncratic reaction to a drug?

<p>Exaggerated response due to genetic factors (B)</p> Signup and view all the answers

What is NOT a part of diagnosis in suspected poisoning cases?

<p>Financial assessment (C)</p> Signup and view all the answers

In clinical examination for poisoning, which characteristic is NOT typically assessed?

<p>Emotional state (B)</p> Signup and view all the answers

What is indicated by the term 'toxidromes'?

<p>Unique features of overdose conditions (D)</p> Signup and view all the answers

Which laboratory test is NOT performed in living persons when diagnosing poisoning?

<p>Postmortem examination (C)</p> Signup and view all the answers

What postmortem sign would NOT be indicative of poisoning?

<p>Normal brain tissue (B)</p> Signup and view all the answers

Which of the following is NOT a reason to suspect poisoning based on the patient's history?

<p>Family medical history of renal failure (B)</p> Signup and view all the answers

Which of the following substances is poorly adsorbed by activated charcoal?

<p>Cyanide (B)</p> Signup and view all the answers

What is the primary purpose of gastrointestinal decontamination?

<p>To remove the poison from the gastrointestinal tract (C)</p> Signup and view all the answers

Which of the following is NOT commonly used as a cathartic?

<p>Activated charcoal (B)</p> Signup and view all the answers

Which symptom is NOT associated with chronic mercury toxicity?

<p>Loss of vision (C)</p> Signup and view all the answers

What is the primary indication for whole bowel irrigation?

<p>Removal of poorly absorbed drugs (A)</p> Signup and view all the answers

What treatment is considered curative for chronic mercury toxicity?

<p>D-penicillamine (C)</p> Signup and view all the answers

Which clinical presentation is most likely associated with CNS exposure to mercury?

<p>Depression (D)</p> Signup and view all the answers

Which treatment is explicitly mentioned for managing life-threatening signs associated with drug overdose?

<p>Intravenous phentolamine (A)</p> Signup and view all the answers

What is the definition of forced diuresis?

<p>Enhancing the elimination of poison via urine output (B)</p> Signup and view all the answers

Which method of enhanced elimination requires a specific urine output maintenance?

<p>Forced diuresis (A)</p> Signup and view all the answers

What is a primary prophylactic measure to prevent mercury toxicity in exposed workers?

<p>Proper exhaust ventilation (D)</p> Signup and view all the answers

What is the primary function of administering crystalloids intravenously in acute drug treatment?

<p>To eliminate the drug through urine (C)</p> Signup and view all the answers

What symptom is NOT listed as a potential effect during the drug withdrawal phase?

<p>Severe vomiting (B)</p> Signup and view all the answers

Which of the following antidotes is used to treat dermatitis caused by mercury exposure?

<p>Na hyposulfite (A)</p> Signup and view all the answers

What type of agents are osmotic cathartics like Mannitol classified as?

<p>Diuretics (A)</p> Signup and view all the answers

What is the objective of using dialysis in poison elimination?

<p>To remove toxins from the blood (B)</p> Signup and view all the answers

Which of the following is NOT indicated as a supportive treatment for managing symptoms of drug-induced side effects?

<p>Alcohol consumption (B)</p> Signup and view all the answers

How are organophosphates primarily absorbed into the human body?

<p>Ingestion, inhalation or through the skin (D)</p> Signup and view all the answers

What physical signs may indicate drug use as per the outlined findings?

<p>Needle puncture marks and irregular scars (A)</p> Signup and view all the answers

What is the most significant health risk associated with organophosphate and carbamate insecticides?

<p>3 million human poisoning cases annually (D)</p> Signup and view all the answers

Which symptom is characteristic of mercurialism affecting the gastrointestinal tract?

<p>Gingivitis (B)</p> Signup and view all the answers

Which neurotransmitter is primarily released in excess due to methamphetamine use?

<p>Dopamine (B)</p> Signup and view all the answers

What term is used to describe the extreme weight loss and prominent rib cage associated with chronic methamphetamine use?

<p>Anorexia (B)</p> Signup and view all the answers

What potential consequence of methamphetamine use involves chronic health issues?

<p>Heart rhythm disturbances (A)</p> Signup and view all the answers

What is McEwen’s sign indicative of in a patient?

<p>Constricted pupils that dilate on facial skin stimulation (B)</p> Signup and view all the answers

Which method is NOT used for chemical analysis to detect alcohol?

<p>Skin temperature measurement (D)</p> Signup and view all the answers

During the treatment of ethyl alcohol intoxication, what should be prioritized?

<p>Supportive measures for respiration (B)</p> Signup and view all the answers

What is a common source of methyl alcohol and its reason for human toxicity?

<p>Distillation of wood (A)</p> Signup and view all the answers

What treatment option is primarily indicated for severe ethanol intoxication?

<p>Forced alkaline diuresis (D)</p> Signup and view all the answers

What is the effect of vitamin B6 in the treatment of ethanol intoxication?

<p>It accelerates metabolism of ethanol (D)</p> Signup and view all the answers

Which symptom is NOT treated with sodium bicarbonate in cases of alcohol intoxication?

<p>Hypoglycemia (D)</p> Signup and view all the answers

In the context of methanol, which statement regarding its pharmacokinetics is accurate?

<p>It is rapidly absorbed and distributed mainly to the optic nerve (D)</p> Signup and view all the answers

Flashcards

Cocaine bugs

A common symptom of cocaine overdose where the user feels insects crawling under their skin.

Magnan's symptoms

A term for the symptoms of chronic cocaine use, including feelings of insects crawling under the skin, severe itching, and irritability.

Cocainism

A general term for dependence on cocaine, which can lead to a cluster of symptoms including irritability, neurological pain, and a tendency to violence.

Benzodiazepines (BZs)

A class of medications commonly used to treat anxiety and insomnia, known for being effective but also potentially addictive. Their potential for overdose is relatively low compared to older drugs used for similar purposes.

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Sedative hypnotics

A group of medications, including benzodiazepines, used to treat anxiety and sleep disorders.

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Tachycardia (Meth)

A potentially life-threatening symptom of meth use characterized by an unusually fast heart rate.

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Hyperthermia (Meth)

A symptom of meth use where the body temperature rises significantly, potentially leading to dangerous complications.

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Phentolamine

A drug used to counter the effects of methamphetamine overdose, often given intravenously.

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Crank Bugs

A symptom of meth use often resulting in sores and infections due to excessive scratching.

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Meth Mouth

A condition often associated with methamphetamine use characterized by severe dental decay and tooth loss.

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Dopamine

A neurotransmitter that plays a key role in reward and motivation, its levels are heavily influenced by methamphetamine.

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Bing & Crash

The cycle of intense high followed by a period of exhaustion and negative effects associated with methamphetamine use.

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Dopamine Release

One of the primary ways methamphetamine impacts the brain, leading to cravings and dependence.

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Gastrointestinal Decontamination

A method used to remove poisons from the gastrointestinal tract (GIT) by preventing their absorption. It involves using activated charcoal to bind to the poison and prevent it from entering the bloodstream.

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Substances poorly adsorbed by Activated Charcoal (CHARCOAL)

Substances that are poorly absorbed by activated charcoal, making them unsuitable for gastrointestinal decontamination.

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Cathartics or Purgatives

A type of gastrointestinal decontamination that uses specific medications, primarily magnesium sulfate (Epsom salt), to stimulate bowel movements and eliminate the poison from the GIT.

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Whole Bowel Irrigation

A specialized gastrointestinal decontamination technique involving continuous irrigation of the entire GIT with a non-absorbable isotonic electrolyte solution (usually polyethylene glycol) administered through a nasogastric tube to rapidly cleanse the intestines of the poison.

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Forced Diuresis

The process of enhancing the removal of a poison from the blood by increasing the rate at which the kidneys filter waste products.

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Dialysis

A method used to enhance poison elimination from the blood that involves using artificial means to filter the blood and remove toxins.

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Haemoperfusion

Removal of the poison from the blood by passing the blood through a column containing activated charcoal or other absorbents.

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Plasmapheresis

Removal of the poison from the blood by separating plasma from the blood and replacing it with fresh plasma.

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Achlorhydria and Cyanide Toxicity

Achlorhydria is a condition characterized by the absence of hydrochloric acid (HCl) in the stomach. This can decrease the toxicity of potassium cyanide by reducing its absorption.

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Idiosyncrasy

Idiosyncrasy refers to an abnormal or unexpected response to a drug or substance that is unique to an individual.

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Hypersensitivity (Allergy)

Hypersensitivity, often related to allergies, is an exaggerated response to a drug or substance. It's usually an antigen-antibody reaction.

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Tolerance (Poisoning)

Tolerance in the context of poisoning refers to the body's gradual decrease in responsiveness to a particular poison over time, often due to repeated exposure.

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Toxidromes (Toxic Fingerprints)

Toxidromes are a set of clinical signs and symptoms that are commonly observed in patients who have been exposed to a specific poison or class of poisons.

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Postmortem Changes

Postmortem changes are observable alterations in the body after death. They can provide information about the cause of death, especially in poisoning cases.

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Postmortem Changes: Hypostasis, Edema, Rigor Mortis

These changes, such as the presence of edema, congestion, or putrefaction, might be specific to certain types of poisoning. The rigor mortis is the stiffness that sets in after death.

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Rigor Mortis and Convulsants

Rigor Mortis, the stiffness of death, often occurs earlier in cases involving convulsants such as amphetamines and strychnine.

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Mercury Poisoning

Mercury poisoning is a serious condition caused by prolonged exposure to mercury. It can affect multiple bodily systems, resulting in a variety of symptoms.

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Gray Line on the Gums

A gray line along the gum line is an early and often visible sign of mercury poisoning. It indicates the buildup of mercury in the body.

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Mercurialism

Mercurialism is a chronic condition resulting from prolonged exposure to mercury. It encompasses a variety of symptoms affecting the digestive, nervous, and other systems.

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Chelation Therapy

Chelation therapy involves using specific medications to bind to heavy metals like mercury and help remove them from the body.

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DMSA and DMPS

DMSA and DMPS are oral medications used to treat mercury poisoning by binding to mercury and aiding its excretion.

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Organophosphates

Organophosphates are a type of insecticide that can cause severe poisoning if ingested, inhaled, or absorbed through the skin.

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Carbamates

Carbamates are another group of insecticides that act similarly to Organophosphates by affecting the nervous system.

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Pesticides

Pesticides encompass a broad category of chemicals used to control pests, including insects, rodents, fungi, and weeds.

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McEwen's Sign

A medical sign characterized by a constricted pupil that dilates upon pinching the skin of the face or neck. Commonly observed in patients suffering from alcohol poisoning.

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Respiratory Depression

A condition where breathing is abnormally slow or shallow due to a dysfunction of the respiratory center in the brain. This is a serious complication often seen in alcohol poisoning.

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Central Asphyxia

A type of death that occurs due to the failure of the central nervous system to control breathing, resulting in a lack of oxygen in the body. This is a serious consequence associated with alcohol poisoning.

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Breath Analyzer Test

A rapid test, also known as a breathalyzer, that uses a colorimetric reaction to detect the presence and approximate concentration of alcohol in the breath. It provides a quick estimation of blood alcohol levels.

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Urine Analysis

A urine test used to detect the presence of alcohol in the body. This test provides a more accurate analysis of alcohol consumption compared to the breath analyzer.

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Gastric Lavage

The process of removing alcohol from the stomach by stomach lavage using sodium bicarbonate solution. Strong coffee is left in the stomach at the end to reduce the risk of reabsorption.

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Forced Alkaline Diuresis

A procedure to remove alcohol from the bloodstream by increasing urine production through the administration of sodium bicarbonate. This method enhances the elimination of alcohol.

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Haemodialysis

A medical procedure used to remove waste products and toxins from the blood, including alcohol, using a dialysis machine. This is an effective treatment for severe alcohol poisoning.

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Study Notes

General Toxicology

  • Toxicology is the study of poisons on living organisms.
  • The term is derived from Greek and Latin, where toxicum = poison; toxikom = arrow poison; logia = science or study.
  • Toxicology covers the source, kinetics, action, diagnosis, and prevention/treatment of poisoning.
  • All substances are poisons, only the dose determines the effect.
  • Poisons can be classified by nature (solid, liquid, gaseous), site of action (local, remote), and target organ (GIT, kidneys, liver, CVS, lungs).
  • Factors modifying toxic effects include the state of the toxic agent, the dose, route of administration, cumulation, and chemical interaction (addition, synergism, antagonism).
  • Patient factors influencing toxicity include the GIT's pH, type of food, patient's age & overall health, toxicogenetics (idiosyncrasy), and tolerance.

Diagnosis of Poisoning

  • Diagnosis involves history taking (sudden symptoms in healthy individuals, symptoms in a group eating the same food, presence of poison/related items/suicidal note), clinical examination (vital signs, neurological exam, and assessment of skin/breath), and laboratory investigations (qualitative and quantitative analysis of poison from blood/urine/vomitus/stool/hair/nails/organs in dead individuals or electrolytes, arterial blood gases, ECG/EEG, liver/kidney function).
  • Postmortem investigations may involve checking the stomach (smell of phenol/opium/organophosphates/cyanide, presence of ulcers, seeds/tablets) and skin (eschar presence, color, site of injections).
  • Further postmortem evaluation may include brain edema or congestion and signs of asphyxia (related to barbiturates/opium/CO/HCN).
  • A person in a coma may be evaluated using the AVPU system, which assesses alertness/verbal responses/pain responses/unresponsiveness, or the Reed's scale.

Treatment of Poisoning

  • Treatment principles involve supportive therapy (maintain ABC's, manage potential circulatory failure/hypotension, manage coma, altered mental status with specific interventions like glucose/thiamine/naloxone), GIT decontamination (emesis using certain chemicals/procedures, activated charcoal/WBI), elimination of the poison from the blood through forced diuresis or dialysis/hemo/peritoneal or other methods, as well as administering antidotes targeting specific poisons.
  • Antidotes can be local (physicomechanical) or systemic/physiological (chelators like EDTA/BAL/DMSA/DMPS/penicillamine/deferoxamine).
  • Specific antidote is often critical and can involve different molecules used to counteract different toxicity effects in terms of physical and physiological problems.

Specific Toxins/Drugs (by class)

  • Detailed notes on different classes of toxins and drugs (e.g., alcohol, methanol, paraquat, organophosphates, heavy metals, and others) are included in separate toxin-specific sections.

Additional information

  • Specific considerations or approaches are included for different toxin classes (e.g., treatment, indications, and contraindications for each toxin)
  • Different classifications or categorizations of drugs are included and explained.
  • Information about poisoning is not only restricted to general considerations, but it extends to different specifics of the agents in question.

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