The dose that will be effective in 50% of test animals
What is the therapeutic index?
The ratio between LD50 and ED50. It tells you how safe the drug is.
How safe is a drug if it has an a) high or b) low TI?
a) relatively safe
b) less safe
What are the five basic routes of intoxication?
If you are not sure how to treat a poisoned animal, where can you get help?
VPIS - veterinary poisons information service
What are some of the most common enquires to the VPIS?
How is a poisoned animal treated?
Breathing, heart rate and temperature stabilised
Information is gathered from the owner
Continued absorption of the poison is prevented
Elimination of the absorbed poison is attempted
An antidote may be given
Symptomatic and supportive care is given
How can you prevent continued absorption of a poison?
How can you stimulate gastric evacuation in an animal? (What areas do you stimulate?)
You can stimulate the vomiting centre in the brain. Also the Medullary chemoreceptor trigger zone (MCTZ).
You can also stimulate the vagal and sympathetic afferents int he GI tract to trigger emesis
What are some household/emergency remedies to induce emesis?
Salt solution, mustard, washing soda, sticking a finger down the back of the animals throat
What is the drug commonly used to trigger emesis in cats?
What is the drug commonly given to dogs to induce emesis?
When would you not want to induce emesis in an animal?
If the animal is:
loss of gag reflex
species unable to vomit
ingestion of corrosives/volatile petroleum products
recent abdominal surgery
What is gastric lavage?
Washing out the stomach contents
Give an example of an adsorbent
What is activated charcoal?
Charcoal that has been treated with oxygen to open up pores; these pores can bind to the toxins.
How do adsorbents work?
There is no chemical reaction between a toxin and adsorbent. Once the toxin is 'stuck' to the adsorbent they can move through the GI tract to be eliminated from the body
What are cathartics?
Substances that help to increase the motility of the GI tract (to help things move through faster)
Give examples of cathartics
Sodium or magnesium salts
Sorbitol (which is often used in activated charcoal formulations as activated charcoal itself causes constipation whilst sorbitol draws water into the GI tract)
What are chelating agents?
Agents that bind metal ions only. The bound ions are chemically inert and so this prevents poisoning
Give an example of a chelating agent
How do anticoagulant rodenticides act as a poison?
They are vitamin K antagonists (reversible) and so interfere with the production of clotting factors. This leads to haemorrhages.
What are the clinical signs of anticoagulant rodenticide poisoning?
Depression and anorexia (even before bleeding)
In acute ingestion of very high doses - vascular collapse
Repeated intake - haemorrhage (either internal or external) and the symptoms of this e.g. weakness
What is the treatment for anticoagulant poisoning?
An oral dose of vitamin K1 will act as an antidote, this overcomes the antagonism of the drug
What are the clinical signs of chocolate poisoning?
What type of chocolate is most poisonous?
Dark > milk > white
What is the treatment for chocolate poisoning?
There is no antidote for chocolate poisoning, so you must stabilise the animal and provide supportive care
Why are cats and dogs susceptible to paracetamol poisoning?
Paracetamol is normally removed by conjugation. However, dogs have an inability to conjugate things to sulphate and cats have an inability to conjugate things to glucuronide (missing the enzymes). This means in cats and dogs paracetamol is made into a toxic intermediary.
What are the symptoms of paracetamol poisoning?
Liver damage - haemolysis, jaundice
What is the treatment for paracetamol poisoning?
You can give N-acetylcysteine (a glutathione precursor) to increase glutathione levels in the body. This helps as when the toxic intermediary reacts with glutathione it makes mercapturic acid which is not toxic and can be eliminated in the urine.
You can also give a sodium sulphate to act as an alternative substrate for the reaction.
What is the main source of ethylene glycol poisoning?
Why is ethylene glycol poisonous?
The metabolites are toxic
What are the clinical signs of ethylene glycol poisoning?
Early clinical signs (1-2hrs):
weakness, vomiting, incoordination
Delayed signs (24-96hrs):
thirst, inhibition of urine production, blood in urine, convulsions, death
What is the treatment for ethylene glycol poisoning?
Ethanol acts as an alternative substrate - give 20% ethanol IV slowly over a long period of time