Toxicity of CCl4, CO, Beta-blockers

Rañola, Monica AnnRecibe, Chelsea Leigh

Reyes, JanineRivera, Rein Casey

Rocha, JestoniSabater, Kristine

Silva, KateSimora, Mary Erzebeth

BSP-4K

CCl4, CO, Beta-blockers

Add your procedure here

Tetrachloromethane, carbon tet, carbona, tetrasol, carbon chloride

Clear, colorless, nonflammable, heavy liquid that evaporates easily, producing a sweet odor and very stable chlorinated hydrocarbon

One of the most potent hepatotoxins

Can synthesize new productsAdd your procedure here

Carbon Tetrachloride (CCl4)

Intermediate in chemical manufacturing

Therapeutic use (former):Principal anthelmintic use is in the treatment of fascioliasis (for veterinary purposes)

Add your procedure here

Carbon Tetrachloride (CCl4)- USES

ROUTES OF ADMINISTRATION:InhalationIngestion (per-oral)Skin absorption

Add your procedure here

Carbon Tetrachloride (CCl4)

Toxic Doses more than 0.1 µg/kg/day from inhalation exposure and 0.01 µg/kg/day from ingesting drinking water

Add your procedure here

Carbon Tetrachloride (CCl4)

TOXICOKINETICSInhalation of its vapor can depress central nervous system

activity and cause degeneration of the liver and kidneysAnaerobic metabolism: CO, chloroform, hexachloromethaneAerobic metabolism: Trichloromethanol- phosgene (COCl2)

Carbon Tetrachloride (CCl4)

SIGNS AND SYMPTOMSAcute inhalation and

Oral exposure (rapid CNS depression)HeadacheWeaknessLethargyN&V

Acute exposure to higher levels and chronic inhalation or oral exposureLiver damage (hepatitis)Kidney damage

Clinical Presentation- CCl4

Classification 10 min

30 min 1 h 4 h 8 h End Point (Reference)

AEGL-1 (Nondisabling)

N.R.a N.R. N.R. N.R. N.R. —

AEGL-2b

(Disabling)420 ppm (480 mg/m3)

150 ppm (170 mg/m3)

83 ppm (95 mg/m3)

33 ppm (38 mg/m3)

27 ppm (31 mg/m3)

Cardiac effects in humans with coronary artery disease (Allred et al. 1989a, 1991)

AEGL-3c

(Lethal)1700 ppm (1900 mg/m3)

600 ppm (690 mg/m3)

330 ppm (380 mg/m3)

150 ppm (170 mg/m3)

130 ppm (150 mg/m3)

Lethal poisoning was associated with a COHb ≥40% in most lethal poisoning cases reported by Nelson (2006a); no severe or life-threatening effects in healthy humans at a COHb of 34-56% (Haldane 1895; Henderson et al. 1921; Chiodi et al. 1941)

Lab/ Diagnostic testsDirect Biologic IndicatorsGas chromatography in

blood and adipose tissueIndirect Biologic IndicatorsLiver and kidney function

test, chest x-ray, ECG

Clinical Presentation- CCl4

AntidotesAcetylcysteinHyperbaric oxygen (pressurized O2)

Add your procedure here

Carbon Tetrachloride (CCl4)- MANAGEMENT

Poisonous, colorless, odorless, non-irritating, tasteless gas

Incomplete combustion of organic matter which is carbon containing materials

Carbon Monoxide (CO)

Industry usesFuels and fuels additivesIntermediatesProcessing aids

Consumer usesBuilding/construction materials

not covered elsewhereFabric, textile, and leather

products not covered elsewhereFuels and related products

Carbon Monoxide (CO)- USES

ROUTES OF ADMINISTRATION:Inhalation

Toxic dose:100ppm or at levels

around 10%.

Carbon Monoxide (CO)

TOXICOKINETICSCarbon monoxide combines

with hemoglobin to form “carboxyhemoglobin”IrreversibleNo oxygen carrying capacity

Asphyxiation Promotes hypoxiaOxygen deprivation

Inhibition of cellular respiration

hypoxiaAdd your procedure here

Carbon Monoxide (CO)

Lab/ Diagnostic TestsDepressed S-T

segment of ECGdecreased pulse

and respiratory

SIGNS AND SYMPTOMSInhalation

CNS damageheadachedizzinessratesunconsciousnessdeathCherry-red skin Manifestation of toxicity

during post poisoning analysis

Clinical Presentation- CO

Antidoteshyperbaric oxygen therapy

(pressurized O2)Goal: adjust attachment of

CO + Hg within 23minsThe half-life of

carboxyhemoglobin is 6hrs at room air, 1.5hrs with 100% oxygen, and 23mins at 3 atmospheres of pressure.

Add your procedure here

Carbon Monoxide (CO)- MANAGEMENT

For cardiovascular condition (Metoprolol and Propanolol)

Add your procedure here

Beta-blockers

Therapeutic UsesAnti-arrhythmia agentsAntihypertensive

agentsSympatholyitcs

Add your procedure here

Beta-blockers -USES

ROUTES OF ADMINISTRATION:Ingestion (per-oral)

TOXIC DOSE: more than 60mg/day

Add your procedure here

Beta-blockers

TOXICOKINETICSCritical signs of overdose can

appear 20mins post ingestion but are commonly observed within 1-2 hours

Half life is 2-12 hoursIntermediate toxicity results

in a moderate drop in BP (systolic BP >80) or bradycardia (heart rate <60 bpm)

Add your procedure here

Beta-blockers

Lab/ Diagnostic Testssystolic BP < 80 mm

Hg, heart rate < 60 bpm

prolongation of the QRS complex

SIGNS AND SYMPTOMSCardiovascular

(Bradycardia, Arrhythmias, AV block, Hypotension CHF)

CNS (sedation)Bronchoconstrictionhypoglycemia

Clinical Presentation- Beta blockers

AntidotesGlucagon

to counteract hypoglycemiaincrease blood glucose level

IsoproterenolActivates beta receptors

(nonselective beta agonist)EpinephrineNew phosphodiesterase

inhibitorsAdd your procedure here

Beta Blockers- MANAGEMENT