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    Arba P. Ramadani: Toxicology

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    Fitri Andriani Ibrahim
    This case is likely due to food poisoning from improperly stored and handled crepes eaten at a university festival food stall. Storing cooked food at room temperature allows for bacterial growth, which caused gastrointestinal symptoms in most people who ate the crepes. A few severe cases required hospitalization. Improper food safety practices led to this outbreak.

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    Arba P. Ramadani: Toxicology

    Uploaded by

    Fitri Andriani Ibrahim
    13 views26 pages
    This case is likely due to food poisoning from improperly stored and handled crepes eaten at a university festival food stall. Storing cooked food at room temperature allows for bacterial growth, which caused gastrointestinal symptoms in most people who ate the crepes. A few severe cases required hospitalization. Improper food safety practices led to this outbreak.

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    11&12. toxicology

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    This case is likely due to food poisoning from improperly stored and handled crepes eaten at a university festival food stall. Storing cooked food at room temperature allows for bacterial growth, which caused gastrointestinal symptoms in most people who ate the crepes. A few severe cases required hospitalization. Improper food safety practices led to this outbreak.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    13 views26 pages

    Arba P. Ramadani: Toxicology

    Uploaded by

    Fitri Andriani Ibrahim
    This case is likely due to food poisoning from improperly stored and handled crepes eaten at a university festival food stall. Storing cooked food at room temperature allows for bacterial growth, which caused gastrointestinal symptoms in most people who ate the crepes. A few severe cases required hospitalization. Improper food safety practices led to this outbreak.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 26

    toxicology

    Arba P. Ramadani
    TOXICOLOGY

    study of the level of which a


    substance able to cause
    The science deal with
    damage and unable to cause
    toxic substances damage of biological system
     safety
    substance (chemical) may cause
    ●

    damage on biological system


    though may cause disorders or
    health problems ●
    Quantity
    ●
    How to enter the body
    LD50
    Toxic substance ●
    How frequent&the lenght
    of exposure
    LD50

    is the parameter of toxicity


    (dose that cause death of 50% animal –
    subject)
    do not indicate any thing if there is no data or
    information about the way of entering the
    substance into the body
     LD50 orally, perinhalation etc
    Biochemistry Pathology
    Physiology Pharmacology
    Chemistry Anatomy
    Physics Public health

    TOXICOLOGY
    Clinical toxicology War toxicology

    Forensic toxicology Environmental toxicology

    11
    PARACELCUS (1493-1541)

    All substance are poisons, there is none that is not poison


    The right dose differentiates a poison from a remedy

    INDICATION
    Toxic agents
    LD50 (mg orally,rat)
     Extremely toxic 1 or less
     Highly toxic 1 - 50
     Moderately toxic 50 - 100
     Low toxic 500 – 5.000
     Practically non toxic 5.000 – 15.000
     Relatively harmless > 15.000
    TOXICOKINETIC

    TOXICODYNAMICS
    TOXIC RESPONSE - EFFECTS
     All or none response
     the death of an individu

     Graded response
     increase of body temperature
     decrease of blood pressure
     damagee of the liver
    TOXIC ACTIONS
     Common target tissue  lung, liver, brain,
    kidney
     Non selective action  corrosive compound,
    at exposure site
     Selective action  rodenticide warfarin,
    absorbed & distributed
     Immediate & delayed actions 
    organophosphate insecticide , carsinogen
    asbestos
    TOXIC EFFECTS
    Physiological / biochemical disturbances

    Structural changes

    REVERSIBLE

    IRREVERSIBLE
    PHYSIOLOGICAL DISTURBANCES
     Atropine  muscarinic blockage
     Theophyline  PDE-inhibition, CNS
    Stimulation  convulsion
     Diklorvos  AChE inhibition
    BIOCHEMICAL DISTURBANCES
     Insulin  hypoglycemia
     OAD  hypoglycemia
     Cyanide  cytochrome oxydase
     Methanol  formaldehyde
    STRUCTURAL CHANGES
     NABQI, ethanol  liver necrosis
     Nitrogen oxide, sulfur oxide  bronchiolysis
     Silicate, asbestos  lung fibrosis
     Mercury  nephrotoxicity
    SPECIAL TOXICITY
     Teratogenicity
     Mutagenicity
     Carsinogenesis
     etc
    GENERAL THERAPHY OF INTOXICATION
     Immediate stabilization  ABC
     History
     Antidote
     Inhibit further absorption
    emesis, gastric lavage, adsorbent, laxant
     Increase the elimination
    force diuresis, dialysis, hemoperfusion trapping,
    alkalinization, acidification
    Antidote
     Antagonize  atropine >< anticholinesterase
     Accelerate detoxification  N-acetylcystein
    (subtitute glutathione)
     Provide alternative target  sodium nitrite
     Reduce metabolic activation  fomepizole
     Chelator  dimercaprol, succimer, edetate
    calcium disodium
    CASE

     Afebrile, HR 80x/min, BP 120/80 mm Hg, RR 12x/min


     Pulse oximetry 98% O2 saturation
     Hoarse voice, bilateral ptosis, a weak gag reflex, and bilateral
    proximal upper extremity weakness, no lower extremity
    weakness
     Sensation is intact in all extremities
     Mental status is normal
    additional information

     He can not remember everything he ate during the last 72


    hours, but recalls eating lunch at a coffee shop near his office.
    He and his wife hosted a barbeque one evening at which they
    served grilled chicken, vegetables, and home-made ice cream.
    The night before onset of his symptoms, they ate at their
    favorite Italian restaurant where they shared a calamari
    appetizer, had salad prepared by the waiter at the table, and
    shared an entree of Fettuccine Fra Diablo. The patient’s wife
    had the house Dijon on her salad, but the patient had garlic-
    infused olive oil. They finished the meal with a cappuccino and
    tiramisu.
    CASE
    June, 7th 2008
    74 people exhibited vomiting(90%), nausea(89%),
    diarrhea (73%), abdominal pain (69%), fever
    (24%) and 4 people with severe symptom were
    admitted to hospital after ate crepes on food stall
    of Nagoya University Festival.
    Investigation result showed that the creepes was
    cooked 1 day before festival (although it was
    prohibited by healthy authority) &stored at room
    temperature,also bad on food handling.

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