Solvents toxic
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Questions and Answers

Which route is the major route of solvent exposure?

  • Ingestion
  • Absorption through eyes
  • Inhalation (correct)
  • Skin contact

    • What happens to the lipophilicity of solvents with increasing molecular weight?

  • It increases (correct)
  • It becomes unpredictable
  • It decreases
  • It remains constant

    • What are solvents frequently used for in relation to materials?

  • To separate materials into different layers
  • To increase their solubility in water
  • To reduce their volatility
  • To dissolve, dilute, or disperse insoluble materials (correct)

    • Which property of solvents decreases with increasing molecular weight?

    <p>Volatility</p> Signup and view all the answers

    Which class of solvents includes compounds like chlorinated aliphatic hydrocarbons?

    <p>Aliphatic hydrocarbons</p> Signup and view all the answers

    Which class of solvents is characterized by a benzene ring in their structure?

    <p>Aromatic hydrocarbons</p> Signup and view all the answers

    Which class of solvents contains compounds with the functional group -OH?

    <p>Alcohols</p> Signup and view all the answers

    Which class of solvents includes compounds with the functional group C=O?

    <p>Aldehydes</p> Signup and view all the answers

    What is a major determinant of a solvent's inherent toxicity?

    <p>Presence of functional groups</p> Signup and view all the answers

    What property of alcohols contributes to their capacity to induce central nervous system sedation?

    <p>Molecular weight</p> Signup and view all the answers

    Why do nonpolar molecules penetrate the blood-brain barrier more freely?

    <p>Due to their lower molecular weight</p> Signup and view all the answers

    Which factor contributes to making a molecule less polar as its molecular weight increases?

    <p>Number of carbon atoms</p> Signup and view all the answers

    What is the exceptional case where a low molecular weight alcohol is more toxic than higher molecular weight alcohols?

    <p>Methanol</p> Signup and view all the answers

    Which type of alcohol has great clinical interest due to its dihydroxy composition?

    <p>Ethylene glycol</p> Signup and view all the answers

    What is the density of ethanol?

    <p>0.78 g/mL</p> Signup and view all the answers

    How does ethanol distribute throughout the body?

    <p>Uniformly in proportion to the water content of each organ</p> Signup and view all the answers

    What phenomenon may potentially result from ethanol crossing the placenta in a pregnant woman?

    <p>Fetal alcohol syndrome</p> Signup and view all the answers

    What is the ratio of blood ethanol to CNS ethanol after ethanol crosses the blood-brain barrier?

    <p>1:0.9</p> Signup and view all the answers

    Where does the major part of an ethanol load get metabolized?

    <p>Liver</p> Signup and view all the answers

    Which enzyme catalyzes the first step of ethanol metabolism?

    <p>Alcohol dehydrogenase</p> Signup and view all the answers

    What occurs more quickly, the formation of acetaldehyde or its dissipation?

    <p>Dissipation of acetaldehyde</p> Signup and view all the answers

    Why is it beneficial for only small amounts of acetaldehyde to be present in the blood at any one time?

    <p>Because acetaldehyde is more toxic than ethanol</p> Signup and view all the answers

    What is the final product of alcohol metabolism?

    <p>Acetic acid</p> Signup and view all the answers

    Which system is responsible for converting ethanol to acetaldehyde as the first product of ethanol oxidation?

    <p>Catalase</p> Signup and view all the answers

    What is the major substrate for the Krebs cycle?

    <p>Acetyl coenzyme A</p> Signup and view all the answers

    Which enzyme oxidizes ethanol with molecular oxygen and NADPH?

    <p>MEOS enzymes</p> Signup and view all the answers

    What is the unlikely route for catalase to account for more than 10% of ethyl alcohol metabolism?

    <p>Using the Krebs cycle</p> Signup and view all the answers

    What is the final product of the hepatic microsomal ethanol oxidizing system (MEOS)?

    <p>Acetaldehyde</p> Signup and view all the answers

    What is the primary site of action for alcohol in the brain?

    <p>Reticular activating system</p> Signup and view all the answers

    Which part of the brain is less sensitive to alcohol's effects compared to the reticular activating system?

    <p>Medulla</p> Signup and view all the answers

    What are two bad effects of alcohol that can be attributed to the large quantity of NADH resulting from alcohol metabolism?

    <p>Liver damage and low blood sugar</p> Signup and view all the answers

    Which compound is favored in the presence of high quantities of reduced NAD (NADH), as found during alcohol metabolism?

    <p>Fatty acids</p> Signup and view all the answers

    Which process occurs during times of low glucose ingestion, such as long after eating, due to high quantities of NADH from alcohol metabolism?

    <p>Gluconeogenesis</p> Signup and view all the answers

    What is the normal range for blood sugar levels?

    <p>70 to 110 mg/dL</p> Signup and view all the answers

    At what blood sugar level is coma usually present?

    <p>20 mg/dL</p> Signup and view all the answers

    What results in severe depression of blood sugar in chronic drinkers dependent on alcohol for most of their calories?

    <p>Low liver glycogen and impaired gluconeogenesis</p> Signup and view all the answers

    What happens when liver glycogen is low and gluconeogenesis is impaired in chronic drinkers dependent on alcohol for most of their calories?

    <p>Blood sugar is severely depressed</p> Signup and view all the answers

    At what concentration of ethanol in the blood might a person experience emotional instability, impaired perception, and memory?

    <p>0.09–0.25 g/dL</p> Signup and view all the answers

    Which concentration range of ethanol in the blood is associated with coma, anesthesia, severely depressed reflexes, and possible respiratory and circulatory collapse?

    <p>0.03–0.12 g/dL</p> Signup and view all the answers

    What effect is typically associated with a concentration of 0.01–0.05 g/dL of ethanol in the blood?

    <p>No obvious impairment, small reduction in reflex action</p> Signup and view all the answers

    Which concentration range of ethanol in the blood is characterized by dizziness, diplopia, decreased muscular coordination, and slurred speech?

    <p>0.18–0.30 g/dL</p> Signup and view all the answers

    What is the common effect of ethanol concentration in the blood range of 0.03–0.12 g/dL?

    <p>Euphoria, decrease in judgment and control, and start of sensory impairment</p> Signup and view all the answers

    What are the signs and symptoms associated with an ethanol concentration in the blood of 0.35–0.50 g/dL?

    <p>Coma, anesthesia, severely depressed reflexes, respiratory and circulatory collapse possible, death possible</p> Signup and view all the answers

    At what concentration of ethanol in the blood might a person experience emotional instability, impaired perception, and memory?

    <p>0.09–0.25 g/dL</p> Signup and view all the answers

    What is the effect associated with an ethanol concentration in the blood of 0.09–0.25 g/dL?

    <p>Emotional instability, impaired perception and memory, reduced visual ability, impaired balance</p> Signup and view all the answers

    Which organ system is most severely affected by alcohol?

    <p>Central nervous system</p> Signup and view all the answers

    What condition arises from impaired hepatic circulation due to cirrhosis?

    <p>Esophageal varices</p> Signup and view all the answers

    Which liver condition is reversible ?

    <p>Fatty liver</p> Signup and view all the answers

    What kind of psychoses may behavioral disturbances resemble in severe cases of alcoholism ?

    <p>Paranoid and schizophrenic psychoses</p> Signup and view all the answers

    What is a marketed inhibitor of aldehyde dehydrogenase used in the treatment of chronic alcoholism?

    <p>Antabuse (Disulfiram)</p> Signup and view all the answers

    What is the effect of taking Antabuse (Disulfiram) for someone who consumes alcohol?

    <p>Increased acetaldehyde concentration in blood</p> Signup and view all the answers

    What is the primary reason why patients taking Antabuse (Disulfiram) are inclined not to drink alcohol?

    <p>Acetaldehyde toxicity after drinking</p> Signup and view all the answers

    What is a common symptomatic therapy used for ethanol toxicity?

    <p>Glucose</p> Signup and view all the answers

    What is the approximate lethal dose of methanol?

    <p>1 g/kg</p> Signup and view all the answers

    What is the volume of distribution of methanol?

    <p>0.7 L/kg</p> Signup and view all the answers

    In what products is methanol found?

    <p>Windshield washer fluid, paint thinner, and formaldehyde</p> Signup and view all the answers

    How does the toxicity of methanol compare to that of ethanol?

    <p>Methanol is approximately 4 times as toxic as ethanol</p> Signup and view all the answers

    What are the specific products of methanol metabolism?

    <p>Methanal and acetic acid</p> Signup and view all the answers

    Why does formic acid accumulate in severe methanol overdose?

    <p>Because of the slow hepatic conversion of methanol</p> Signup and view all the answers

    What route makes a larger percent contribution to methanol excretion than that observed for ethanol?

    <p>A+D</p> Signup and view all the answers

    Why do ethanol and methanol not metabolize at the same rate when present together?

    <p>Ethanol metabolism is faster</p> Signup and view all the answers

    In the conversion of formate to CO2, which enzyme is responsible for the first step of producing 10-formyl-THF?

    <p>Formyl-THF synthetase</p> Signup and view all the answers

    What is the final product when 10-formyl-THF is oxidized to CO2 in the conversion process?

    <p>CO2</p> Signup and view all the answers

    Which enzyme is responsible for oxidizing 10-formyl-THF to CO2 in the formate to CO2 conversion process?

    <p>Formyl-THF dehydrogenase (FTHF-DH)</p> Signup and view all the answers

    Which compound is converted to 10-formyl-THF by formyl-THF synthetase in the conversion process?

    <p>Formic acid</p> Signup and view all the answers

    What is the characteristic visual disturbance associated with acute methanol poisoning?

    <p>Complete blindness and diplopia</p> Signup and view all the answers

    At what concentration of ethanol in the blood might a person experience emotional instability, impaired perception, and memory?

    <p>0.06–0.09 g/dL</p> Signup and view all the answers

    What is the primary site of action for alcohol in the brain?

    <p>Reticular activating system</p> Signup and view all the answers

    What is the major substrate for the Krebs cycle?

    <p>Pyruvate</p> Signup and view all the answers

    What is a potential retinal symptom of ethanol poisoning?

    <p>Blurred vision</p> Signup and view all the answers

    Which condition may result from ethanol poisoning progressing to hypotension and cardiogenic shock?

    <p>Renal damage</p> Signup and view all the answers

    What is a potential respiratory symptom of ethanol poisoning ?

    <p>Tachypnoea</p> Signup and view all the answers

    Which symptom is associated with ethanol poisoning at an approximate concentration of 0.35–0.50 g/dL in the blood?

    <p>Coma and convulsions</p> Signup and view all the answers

    Which compound has been shown to accumulate in humans following methanol treatment and acts as a direct ocular toxin?

    <p>Formic acid</p> Signup and view all the answers

    What is the cause of metabolic acidosis due to its inherent acidic nature in the context of methanol treatment?

    <p>Formic acid</p> Signup and view all the answers

    Which compound inhibits cytochrome oxidase and thereby reduces cellular respiration of methanol treatment?

    <p>Formic acid</p> Signup and view all the answers

    What does the accumulation of lactic acid lead to in the context of methanol treatment?

    <p>Exacerbation of evolving acidosis</p> Signup and view all the answers

    What is suggested to be necessary for the initiation of retinal toxicity by formic acid?

    <p>The entry of methanol into the vitreous humor and its intraretinal metabolism</p> Signup and view all the answers

    Which enzyme is mentioned to be able to nonspecifically oxidize methanol ?

    <p>Retinol dehydrogenase</p> Signup and view all the answers

    What is believed to be a function of ocular toxicity ?

    <p>Metabolism in retinal or optic nerve tissues generating toxic metabolites locally</p> Signup and view all the answers

    What contributes to the extensive entry of methanol into the vitreous humor?

    <p>The extremely aqueous nature of the vitreous humor</p> Signup and view all the answers

    What is the main concern of therapy for methanol poisoning ?

    <p>Infusing sodium bicarbonate to reverse acidosis</p> Signup and view all the answers

    Why is ethanol considered a semi-specific antidote for methanol poisoning ?

    <p>It neutralizes the toxic metabolites of methanol</p> Signup and view all the answers

    What is the recommended range for blood ethanol level when infusing ethanol as an antidote for methanol poisoning?

    <p>100-150 mg/dL</p> Signup and view all the answers

    Why can't one provide ethanol as an antidote for methanol poisoning in an unlimited manner?

    <p>Due to the risk of CNS toxicity</p> Signup and view all the answers

    What is the main concern of therapy for a methanol-poisoned patient?

    <p>Reversing the acidosis</p> Signup and view all the answers

    Which compound is mentioned as a semi-specific antidote for methanol poisoning?

    <p>Ethanol</p> Signup and view all the answers

    Why is ethanol given as an antidote for methanol poisoning?

    <p>To tie up the enzymes converting methanol to toxic metabolites</p> Signup and view all the answers

    What should be done unless a contraindication exists in a methanol-poisoned patient?

    <p>Forcing the patient to vomit</p> Signup and view all the answers

    What is the mechanism of action of Antizol (fomepizole)?

    <p>It acts as a competitive inhibitor of alcohol dehydrogenase</p> Signup and view all the answers

    Which compound is Antizol (fomepizole) indicated as an antidote for?

    <p>Methanol poisoning</p> Signup and view all the answers

    What is the effect of ethanol and Antizol (fomepizole) on alcohol dehydrogenase?

    <p>Ethanol and Antizol both inhibit alcohol dehydrogenase</p> Signup and view all the answers

    What is the primary function of Antizol (fomepizole) of methanol and ethylene glycol poisoning?

    <p>To block the metabolism of methanol and ethylene glycol to their toxic metabolites</p> Signup and view all the answers

    What is the primary function of Antizol (fomepizole) of methanol and ethylene glycol poisoning?

    <p>Inhibits the metabolism of methanol and ethylene glycol to their toxic metabolites</p> Signup and view all the answers

    What compound has been shown to accumulate in humans following methanol treatment and acts as a direct ocular toxin?

    <p>Formic acid</p> Signup and view all the answers

    What is a potential retinal symptom of ethanol poisoning ?

    <p>Blurred vision</p> Signup and view all the answers

    At what concentration of ethanol in the blood might a person experience emotional instability, impaired perception, and memory?

    <p>$0.09-0.25 g/dL$</p> Signup and view all the answers

    What is an advantage of Antizol® compared to ethanol in the context of methanol and ethylene glycol poisoning?

    <p>It does not require monitoring of serum Antizol</p> Signup and view all the answers

    What is a significant difference between 4-methylpyrazole and ethanol in the context of methanol and ethanol combination?

    <p>4-methylpyrazole is a CNS depressant, reducing the danger of extreme CNS depression</p> Signup and view all the answers

    Why is hemodialysis unnecessary in some cases of Antizol® treatment?

    <p>Because Antizol® acts as a not CNS depressant</p> Signup and view all the answers

    What aspect makes 4-methylpyrazole a preferable therapeutic option compared to ethanol of methanol and ethylene glycol poisoning?

    <p>It is a CNS depressant, reducing the danger of extreme CNS depression</p> Signup and view all the answers

    When should Antizol treatment be initiated?

    <p>On suspicion of ethylene glycol or methanol poisoning</p> Signup and view all the answers

    Under what condition should hemodialysis be considered during Antizol treatment?

    <p>When serum concentration is &gt;25 mg/dL</p> Signup and view all the answers

    How should Antizol be administered?

    <p>Dilute dose in 100 ml saline, infuse over 30 minutes</p> Signup and view all the answers

    At what frequency should Antizol be dosed until ethylene glycol or methanol concentration level is zero?

    <p>Q12H</p> Signup and view all the answers

    When should Antizol treatment be initiated?

    <p>On suspicion of ethylene glycol or methanol poisoning</p> Signup and view all the answers

    What is the indication for initiating hemodialysis?

    <p>Blood methanol level greater than 25mg/dL</p> Signup and view all the answers

    How is Antizol administered as per the given information?

    <p>Dilute dose in 100 ml saline, infuse over 30 minutes</p> Signup and view all the answers

    What is the function of calcium leucovorin of methanol poisoning?

    <p>Enhance the folate dependent degradation of formic acid</p> Signup and view all the answers

    What serum concentration level indicates the need to consider hemodialysis?

    <p>&gt;25 mg/dL</p> Signup and view all the answers

    How often should Antizol be dosed until the ethylene glycol or methanol concentration level is zero?

    <p>Q12H</p> Signup and view all the answers

    What is the final product of the metabolism of isopropanol?

    <p>Acetone</p> Signup and view all the answers

    Which alcohol is found in many consumer products primarily as a cosmetic base and also used as a disinfectant?

    <p>Isopropanol</p> Signup and view all the answers

    What property of isopropanol allows it to cause depression by entering the CNS?

    <p>Slight polarity compared to ethanol</p> Signup and view all the answers

    What happens as isopropanol is cleared from the blood by metabolism?

    <p>The concentration of acetone in blood rises</p> Signup and view all the answers

    What are the symptoms associated with isopropanol overdose?

    <p>Hypotension, mild acidosis, hypoglycemia, and signs of alcoholic stupor</p> Signup and view all the answers

    What is the main concern of therapy for isopropanol poisoning?

    <p>Managing hypotension and electrolyte imbalances</p> Signup and view all the answers

    What therapy should be considered if hypoglycemia is present in the case of isopropanol overdose?

    <p>Infusing glucose with constant monitoring of blood sugar</p> Signup and view all the answers

    When should hemodialysis be considered for isopropanol overdose?

    <p>If laboratory findings confirm an electrolyte or acid-base imbalance</p> Signup and view all the answers

    What is the primary route of exposure to ethylene glycol?

    <p>Dermal and accidental ingestion</p> Signup and view all the answers

    What are the major metabolites responsible for symptoms of serious ethylene glycol poisoning?

    <p>Glycolic and oxalic acids</p> Signup and view all the answers

    What characteristic makes ethylene glycol of low volatility?

    <p>Viscosity</p> Signup and view all the answers

    What is the lethal dose of ethylene glycol?

    <p>1.4 – 1.6 ml/kg</p> Signup and view all the answers

    In the metabolism of ethylene glycol, what happens when the first carbon is fully oxidized?

    <p>The second carbon undergoes a two-step oxidation</p> Signup and view all the answers

    What is the enzyme central to the oxidative pathway of ethylene glycol metabolism?

    <p>Alcohol dehydrogenase</p> Signup and view all the answers

    Which intermediate in the path of ethylene glycol metabolism can be converted to formic acid or oxalic acid?

    <p>Glyoxylic acid</p> Signup and view all the answers

    What is the primary reason for the diverse range of symptoms associated with ethylene glycol overdose?

    <p>The variety of metabolites and the duration of the metabolic process</p> Signup and view all the answers

    What contributes to making a molecule less polar as its molecular weight increases?

    <p>Increased surface area</p> Signup and view all the answers

    What is the major substrate for the Krebs cycle?

    <p>Acetyl-CoA</p> Signup and view all the answers

    Why does formic acid accumulate in severe methanol overdose?

    <p>It is produced as a result of methanol metabolism</p> Signup and view all the answers

    What is the characteristic visual disturbance associated with acute ethylene glycol poisoning?

    <p>Scotoma</p> Signup and view all the answers

    During which stage of ethylene glycol poisoning is the renal toxicity with calcium oxalate crystals observed?

    <p>Stage 3 (24 hours- 3 days)</p> Signup and view all the answers

    What is the potential consequence of untreated metabolic acidosis during stages 2 and 3 of ethylene glycol poisoning?

    <p>Progressively severe metabolic acidosis</p> Signup and view all the answers

    During which stage of ethylene glycol poisoning may the duration and degree of inebriation vary depending upon the dose?

    <p>Stage 1 (30 minutes-12 hours)</p> Signup and view all the answers

    What is the characteristic of stage 2 (12 hours-24 hours) of ethylene glycol poisoning?

    <p>Tachycardia and tachypnea, progressing to cardiac failure and pulmonary edema</p> Signup and view all the answers

    What is the first clinical stage of ethylene glycol poisoning?

    <p>Central Nervous System symptoms</p> Signup and view all the answers

    What is the primary effect of ethanol on the Central Nervous System?

    <p>Depression</p> Signup and view all the answers

    What potential consequence can occur during stages 2 and 3 of ethylene glycol poisoning?

    <p>Metabolic acidosis</p> Signup and view all the answers

    What is the final metabolic product of aldehyde metabolism?

    <p>Oxalic acid</p> Signup and view all the answers

    What is the major cause of metabolic (lactic) acidosis in ethylene glycol overdose?

    <p>Inhibition of cytochrome oxidase</p> Signup and view all the answers

    What does a high anion gap indicate in the context of ethylene glycol poisoning?

    <p>Elevated additional anions present in the blood</p> Signup and view all the answers

    What causes hypocalcemia in aldehyde metabolism?

    <p>Calcium oxalate crystals</p> Signup and view all the answers

    What is the primary effect of formic acid in ethylene glycol overdose?

    <p>Inhibition of cytochrome oxidase</p> Signup and view all the answers

    What is the significance of measuring the anion gap in confirming ethylene glycol poisoning?

    <p>Useful in confirming poisonings of this type</p> Signup and view all the answers

    What is the primary purpose of hemodialysis in the treatment of ethylene glycol poisoning?

    <p>To enhance elimination of unmetabolized toxin and metabolites</p> Signup and view all the answers

    Why may infusions of calcium be necessary in ethylene glycol poisoning?

    <p>Hypocalcemia may be life-threatening</p> Signup and view all the answers

    What is one of the primary objectives of treating ethylene glycol poisoning?

    <p>Correcting metabolic acidosis</p> Signup and view all the answers

    What type of calcium oxalate crystals are more specific for ethylene glycol poisoning?

    <p>Calcium oxalate dihydrate</p> Signup and view all the answers

    Which antidotal therapy is used in the same way as for methanol in ethylene glycol poisoning?

    <p>Ethanol</p> Signup and view all the answers

    What is the characteristic visual symptom associated with acute methanol poisoning?

    <p>Yellow halos around lights</p> Signup and view all the answers

    Which enzyme oxidizes ethanol with molecular oxygen and NADPH?

    <p>Cytochrome P450</p> Signup and view all the answers

    What is the purpose of using either ethanol or 4-methyl pyrazole in the context of methanol poisoning?

    <p>To prevent the conversion of methanol to formic acid</p> Signup and view all the answers

    What contributes to the extensive entry of methanol into the vitreous humor?

    <p>Highly polar nature</p> Signup and view all the answers

    What is a characteristic visual symptom associated with acute methanol poisoning?

    <p>Blurred vision with halos around lights</p> Signup and view all the answers

    What happens as isopropanol is cleared from the blood by metabolism?

    <p>It is converted to acetic acid</p> Signup and view all the answers

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