An afternoon at the hospital, two men, Alf and Ole, come in with symptoms that look like a poisoning of some kind. Blood samples are immediately taken, and also collected for 8 hours. The laboratory identifies a chemical entity from a pesticide responsible for the symptoms. The chemical is extensively metabolized by CYP3A4. The plasma concentration of the chemical is given in table 1.
|Time [hrs]||Concentration [ng/ml]|
The two men live together, and during the examination, they inform the doctor that they have eaten the same amount of bananas that day, as a part of a special diet. The two men weigh about 70kg and spend much time together:
In the literature, we find that the compound’s NOAEL (from rats) is 0.1mg/kg/day and the volume of distribution is 25 litres.
Describe elaborately the toxic effects on humans of organophosphate and carbamate insecticides, including effect mechanisms, acute effects and the phenomena “aging” and “dying back” neuropathies. What is the difference between organophosphates that have a sulphur atom bound with a double bond to the central phosphor atom and those who have an oxygen atom instead of the sulphur atom in the same position? What is the difference between the organophosphates and the carbamate insecticides? Describe shortly general principles for treatment of poisoning with these substances.
Which type of allergy may be caused by nickel? List also other substances that may cause the same type of allergy. Describe the immunologic mechanisms for this reaction, that is, what happens in the sensitization phase, what happens in the effector phase, down regulation of the reaction and in which organ does the major part of the reaction takes place.
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