Problem Statement.
A man was found having nausea, vomiting and abdominal pain, sweating, confusion and agitation follow. His next of kin told the triage that he accidentally swallow a rodent poison, which he thought it is some kind of candy placed on the kitchen table. The lab results were positive for fluoroacetate toxic.
As a pathology researcher, you have to explain the whole situation (biochemically) to a bunch of industrial trainees in your pathology lab.
As a pathology researcher, you have to explain the whole situation (biochemically) to a bunch of industrial trainees in your pathology lab.
About.
- Sodium fluoroacetate @ 1080 poisons.
- Derivatives of acetic acids.
- Found in plants (Australia, South America & Africa) as a defense mechanism towards pest.
- Use as metabolite poisons.
- How fluoroacetate spread : - inhalation, skin & ingestion.
- Physicals properties: odorless, colourless, dissolve easily in water.
Taste: like sodium salt
Kreb Cycle.
IS THE PROCESS REVERSIBLE
- Krebs cycle needs sufficient amount of oxygen to proceed
- Fluoroacetate causes patients to have symptoms such as hard to breathe, which will cause less intake of oxygen
- Krebs cycle will be inhibited
- Due to ATP depletion, It will also inhibit high-energy consuming reactions such as gluconeogenesis.
- Gluconeogenesis is the reverse process of Glycolysis.
- Therefore, the process cannot be reversible when fluoroacetate is taken.
- Glutamate will less produced, [Ammonia] increase, urine increase.
- Results in accumulation of citrate in the blood, depriving cell of energy.
- ATP can’t produce , inhibit high energy consuming.
- Fluoroacetate poisoning caused significant decrease in ionized calcium and severe metabolic acidosis with increased levels of lactate and pyruvate.
Treatment:
- Symptomatic treatment : Is any medical therapy of a disease that only affects its symptoms, not its cause.
- Vomiting : Remove any toxin (FA) that ingested by the patient.
- Saline cathartic : Increase fluidity of intestinal contents by osmotic forces and indirectly increases motor activity (liquid feces).
- Known as salt, epsom salt, used to produce evacuation of the bowel.
- Monoacetin : Monoacetin prolonged average survival time to 166 min Metabolic acidosis was aggravated in monoacetin-treated animals.
- IM (intramuscular therapy). Within muscle. Injections here usually have faster rates of absorption of medication.
- Artificial respiration: Methods that causes air to flow in and out of a person's lungs when natural breathing is inadequate or ceases, as in respiratory paralysis, drowning, electric shock, choking, gas or smoke inhalation, or poisoning.