Study Set Content:
Study of the modeling and mathematical description of the time course of disposition (absorption, distribution, biotransformation, and excretion) of xenobiotics in the whole organism.
Toxicokinetics
Chemicals are said to move throughout the body as if there were one or more compartments that may have no apparent physiologic or anatomical reality. It is either one-compartment or two-compartment model.
Classic Toxicokinetics
Attempts to portray the body as an elaborate system or discrete tissue or organ compartments that are interconnected via the circulatory system.
Physiologic Toxicokinetics
The following general steps represent important components of the initial clinical encounter with a poisoned patient:
1. Stabilization of the patient 2. Clinical Evaluation 3. Prevention of further toxin absorption 4. Enhancement of toxin elimination 5. Administration of antidote 6. Supportive care and clinical follow-up
The first priority in the treatment of the poisoned patient is stabilization. Initial assessment of airway, respiration, and circulation is crucial.
CLINICAL STABILIZATION
The primary goal of taking a () in poisoned patients is to determine, if possible, the substance ingested or the substance to which the patient has been exposed as we as the extent and time of exposure.
medical history
A thorough () is required to assess the patient’s condition, determine the patient’s mental status, and, if altered, determine possible additional causes such as trauma or central nervous system infection
physical examination
Whenever possible, the patient’s physical examination parameters are categorized into broad classes re erred to as (), constellations of clinical signs that, taken together, are likely associated with exposure from certain classes of
toxic syndromes (toxidromes)
Categorization of the patient’s presentation into toxic syndromes allows for the initiation of () treatment based on the most likely category of toxin responsible, even if the exact nature of the toxin is unknown.
rational
Blood pressure
Sympathomimetic, Anticholinergic, Cholinergic, Opioid
Increase, Slight Increase or NC, Slight decrease or NC, Decrease
Pulse
Sympathomimetic, Anticholinergic, Cholinergic, Opioid
Increase, Increase, Decrease, Decrease
Temp.
Sympathomimetic, Anticholinergic, Cholinergic, Opioid
Slight Increase, Increase, NC, Decrease
Pupils
Sympathomimetic, Anticholinergic, Cholinergic, Opioid
Mydriasis, Mydriasis, Miosis, Miosis
Lungs
Sympathomimetic, Anticholinergic, Cholinergic, Opioid
NC, NC, Increased bronchial sound, NC or rules
Abdomen
Sympathomimetic, Anticholinergic, Cholinergic, Opioid
NC, Decreased bowel sounds, Increased bowel sounds, Decreased bowel sounds
Neurologic
Sympathomimetic, Anticholinergic, Cholinergic, Opioid
hyperalert, increased reflexes, Altered mental status, Altered mental status, Decreased level of consciousness
Bitter almonds potential poison
Cyanide
Eggs
Hydrogen sulfide, mercaptans
Garlic
As, organophosphates, DMSO, Thalium
Mothballs
Napthalene, camphor
