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Raola, Monica Ann

Recibe, Chelsea Leigh


Reyes, Janine
Rivera, Rein Casey
Rocha, Jestoni
Sabater, Kristine
Silva, Kate
Simora, Mary Erzebeth

CCl4, CO, Beta-blockers


BSP-4K

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Carbon Tetrachloride (CCl4)


Tetrachloromethane,

carbon tet,
carbona, tetrasol, carbon chloride

Clear,

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

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One

of the most potent hepatotoxins

Can

synthesize new products

Carbon Tetrachloride (CCl4)- USES


Intermediate

in chemical
manufacturing

Therapeutic

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

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Carbon Tetrachloride (CCl4)

ROUTES OF
ADMINISTRATION:
Inhalation
Ingestion

(per-oral)
Skin absorption

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Carbon Tetrachloride (CCl4)

Toxic Doses
more than 0.1
g/kg/day from
inhalation exposure
and 0.01 g/kg/day
from ingesting
drinking water
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Carbon Tetrachloride (CCl4)


TOXICOKINETICS

Inhalation of its vapor can depress central nervous system


activity and cause degeneration of the liver and kidneys
Anaerobic metabolism: CO, chloroform, hexachloromethane
Aerobic metabolism: Trichloromethanol- phosgene (COCl 2)

Clinical Presentation- CCl4


SIGNS

AND
SYMPTOMS

Classification 10
min
AEGL-1
N.R.a
(Nondisablin
g)
AEGL-2b
420
(Disabling) ppm
(480
mg/
m3)

Acute inhalation and


Oral exposure (rapid CNS
depression)
Headache
Weakness
AEGL-3
(Lethal)
Lethargy
N&V

Acute exposure to
higher levels and chronic
inhalation or oral exposure

30 min

1h

4h

8h

N.R.

N.R.

N.R.

N.R.

150 ppm
(170
mg/m3)

83
33 ppm
ppm
(38
(95
mg/m3)
mg/m3)

27
Cardiac effects in humans
ppm with coronary artery disease
(31 (Allred et al. 1989a, 1991)
mg/
m 3)

330
150 ppm
ppm
(170
(380
mg/m3)
mg/m3)

130
ppm
(150
mg/
m 3)

1700 600 ppm


ppm (690
(190 mg/m3)
0
mg/
m3)

End Point (Reference)

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)

Clinical Presentation- CCl4


Lab/

Diagnostic tests

Direct

Biologic Indicators

Gas

chromatography in
blood and adipose tissue

Indirect
Liver

Biologic Indicators

and kidney function


test, chest x-ray, ECG

Carbon Tetrachloride (CCl4)MANAGEMENT

Antidotes
Acetylcystein
Hyperbaric

oxygen
(pressurized O2)

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Carbon Monoxide (CO)


Poisonous,

colorless,
odorless, non-irritating,
tasteless gas

Incomplete

combustion of
organic matter which is
carbon containing
materials

Carbon Monoxide (CO)- USES


Industry

uses

Fuels and fuels additives


Intermediates
Processing aids
Consumer

uses

Building/construction materials
not covered elsewhere
Fabric, textile, and leather
products not covered elsewhere
Fuels and related products

Carbon Monoxide (CO)


ROUTES

OF
ADMINISTRATION:
Inhalation
dose:
100ppm or at levels

Toxic

around 10%.

Carbon Monoxide (CO)


TOXICOKINETICS
Carbon

monoxide combines
with hemoglobin to form
carboxyhemoglobin
Irreversible
No oxygen carrying capacity

Asphyxiation

Promotes hypoxia
Oxygen deprivation
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Inhibition

of cellular
respiration

Clinical Presentation- CO
SIGNS

AND SYMPTOMS

Inhalation
CNS damage
headache
dizziness
rates
unconsciousness
death
Cherry-red skin
Manifestation of toxicity
during post poisoning
analysis

Lab/

Diagnostic
Tests
Depressed S-T
segment of ECG
decreased pulse
and respiratory

Carbon Monoxide (CO)- MANAGEMENT


Antidotes
hyperbaric

oxygen therapy
(pressurized O2)
Goal: adjust attachment of
CO + Hg within 23mins

The
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half-life of
carboxyhemoglobin is 6hrs at
room air, 1.5hrs with 100%
oxygen, and 23mins at 3

Beta-blockers
For

cardiovascular
condition (Metoprolol
and Propanolol)

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Beta-blockers -USES
Therapeutic

Uses

Anti-arrhythmia agents
Antihypertensive
agents
Sympatholyitcs

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Beta-blockers
ROUTES

OF
ADMINISTRATION:
Ingestion (per-oral)

TOXIC
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DOSE:

more than 60mg/day

Beta-blockers
TOXICOKINETICS
Critical

signs of overdose can


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

Half

life is 2-12 hours

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

Clinical Presentation- Beta blockers


SIGNS

AND SYMPTOMS

Lab/

Diagnostic Tests

Cardiovascular
systolic BP < 80 mm
(Bradycardia, Arrhythmias,
Hg,
AV block, Hypotension
heart rate < 60 bpm
CHF)

prolongation of the
CNS (sedation)
QRS complex
Bronchoconstriction
hypoglycemia

Beta Blockers- MANAGEMENT


Antidotes
Glucagon

to counteract hypoglycemia
increase blood glucose level
Isoproterenol

Activates beta receptors


(nonselective beta agonist)
Epinephrine
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New

phosphodiesterase inhibitors

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