REVIEW ON POISON & TOXICOLOGY Toxicology - is that branch of science which treats of poisons, their origin, physical and

chemical properties, physiological action treatment of their noxious effect, and methods of detection. Toxicology - "toxic" means poison; "ology" mean Science Definition of poison - !rom the medical point of "iew#$ % substance which when introduced into the body and is absorbed through the blood stream and acting chemically, is capable of introducing noxious effect or destroy life. &lassification of poison a# %ccording to 'ingdom ( animal - ex. &haracteristic ) "egetable - ex. Strychnine * mineral - ex. +ydrochloric acid b# %ccording to chemical properties. ( ,norganic poisons. a -olatile and non-"olatile - ex. .romine, chlorine, iodine, sulfuric a"id. b /ineral acids - ex. +ydrochloric acid c /ineral al'alies - ex. Sodium hydroxides ) 0rganic poisons a "olatile - ex. %lcohol, chloroform b al'alcids - ex. Strychnine c animal poisons - ex. Sna'e "enom d bacterial - ex. 1tomaine e organic aid - ex, salisilic acid f alucosides - ex. Digitalis c# %ccording to physiological action ( ) * 5 6 7 8 &orrosi"e - highly irritant poisons which cause local destruction of tissues and characteri2ed by nausea, "omiting and great local distress. 3x. strong acid and al'alies ,rritants - produces irritation of inflammation of the mucus membrane and characteri2ed by "omiting, pain in the abdomen, and purging. 3x. arsenic, canthaddes 4arcotics - poison which produce stuper, complete insensibility, or loss of feeling. 3x. opium, demerd, cocaine 4eurotics - one which act chiefly on the ner"ous system producing delirium, con"ulsion, and coma, with disordered circulation and respiration as the outstanding symptoms. 3x. alcohol, opium, &0, strychnine Tetanics - substance which act directly upon the spinal cord producing such spasmodic and continuos contraction of muscles as a result of stiffness or immobility of the parts to which they are attached. Depressant or sedati"es - agents which retard or depress the physiological action of the organ. 3x. nicotine, cocaine %sthenics or exhausti"es - agents which produce exhaustion mar'ed loss of "ital or muscular power. 3x. hydrocyanic acid

d# %ccording to pharmacological action ( ) * Substances characteri2ed by local action - 3x. "olatile oils, s'in irritants Substances characteri2ed by their action after absorption - 3x. %l'aloids +ea"y metals and metalloids - 3x. 1, %s, and +g

e# %ccording to methods of isolation ( -olatile poison and those isolated by distillation with or without current of system. 3x. alcohol, phenol, chloroform ) 4on-"olatile poisons - those that are isolated by extraction with organic sol"ents.

3x. al'aloids, organic acids /etallic poisons - 3x. %s, +g

%ction 0f 1oisons %. 9ocal - &hanges or disturbance produced on the part with which the poison comes in contact. .. :emote - the changes or disturbance produced in distant part away from the site of application. &. &ombined - the effect of the poison is not only locali2ed at the site but also affect remote organs. &onditions /odifying The %ction 0f 1oisons %. those (. ). *. 5. 6. 7. 8. ;. .. Those (. ). *. 5. 6. 7. 8. attributed to the indi"idual %ge and sex +ealth +abit - the repeated ta'ing of small dose drugs it builds up immunity. ,diosyncrasy - a term applied to indi"iduals who exhibit unusual reaction to a certain substance. Disease !ood 3xhaustion Sleep which are attributed to the poison physical state dilution solubility of poison mode of administration chemical combination mechanical combination dose - the <uantity of a poison to be administered at one time

1osology - a branch of science which treat of the form and <uantity of medicine to be administered within a certain period. =,4D 0! D0S3 (. ). *. 5. Safe dose - one that does not cause harmful effect Toxic dose or poisonous dose - on that is harmful both to healthy and sic' person. 9ethal dose - one that 'ills /inimum dose - is the smallest amount that will produce the therapeutic affect without causing harm. 6. /aximum dose - is the largest amount that will cause no harm but at the same time produce the desired therapeutic effect 34T:%4&3 0! 10,S04 1oison /ay 3nter ,nto The .ody Trough ( ) * 5 6 7 /outh and are absorbed into the circulation after passing through the stomach and intestinal wall 4ose and enter the blood from the upper respiratory passages or lungs 3yes rectum, "agina, urethra, bladder and ureter by action. +ypodermic in>ection ,ntra"enous in>ection 39,/,4%T,04 0! 10,S04S 10,S04 /%? .3 39,/,4%T3D .?$

( ) * 5 6 7 8

3mesis :espiration !eces @rine /il' Sa"ila Sweat

D,%A40S,S 0! 10,S04,4A .3!0:3 D3%T+ D,%A40S,S 0! 10,S04,4A .3!0:3 D3%T+ ,S -3:? D,!!,&@9T .3&%@S3$ (. 9arge number of poisons and the factors modifying their actions. ). Some of the symptoms obser"ed in cases of poisoning are also see in certain diseases. D,ST,4A@,S+,4A 10,S04,4A !:0/ D,S3%S3S ( ) * 5 symptoms of poisoning come suddenly upon a person whose pre"iously has been in good health, while disease is usually proceeded by a number of hour, days or e"en wee's of local or general indisposition. ,n cases of poisoning, the symptoms commonly ma'e their appearance after ta'ing of food, drin's or medicine. ,f se"eral persons ta'e the same food and drin's, they should all show similar symptoms. Diseases are generally much slower in their progress and are preceded by cumstances as exposure, recogni2ed symptoms and general or local indisposition of longer duration.

A343:%9 T:3%T/34T 0! 10,S04,4A ( ) * 5 6 :emo"al of the position from the stomach. %dministration of antidotes. 3limination of poisons by exertion. Stimulation and other symptomatic treatment. Special treatment.

%ntidotes - are agent which neutrali2e a poison or otherwise counteract or oppose it or its effect. =,4DS 0! %4T,D0T3S ( ) * /echanical antidote - an agent that remo"es the poison without changing it or coats the surface of the organ so that absorption is pre"ented. &hemical antidotes - substances that ma'e the poison harmless by chemically alerting it. The antidote renders the poison insoluble or alert. 1hysiological antidote - sometimes called %4T%A04,ST, an agent that acts upon the system so as so to counteract the effect of poison. ,t merely mas' the symptoms produced.

=,4D 0! &+3/,&%9 %4T,D0T3 a stomach tube or pump b emetics - agent which produce "omiting &lasses of emetics (. 9ocal emetics ). Aeneral emetics c d e &athartics - agent which produce intestinal e"acuation Demulcents - substances which soo the and protect the part with which they are applied. 1recipitants - these are substances which pre"ent absorption of poisons by precipitating them and rendering them soluble.

Investigation of fatal cases - in the in"estigation of fatal poisoning cases, it is not necessary that an in"estigator should be an expert on poisons, since he will be assisted in this in"estigation by a medico legal officer and a toxicologist but it is important and will be of great help to him to 'now the following$ ( symptoms of "arious 'inds of poisoning ) the lethal dose of a poison * the length of time that may elapse after the poison has been ta'en, before death occurs. 5 Bhere the poison was obtained 6 The chemical formula of the poison 7 0ther names of it is 'nown in the mar'et 8 @ses of poison ; %ntidotes for the poison. 3-,D34&3 0! 10,S04,4A ,4 T+3 9,-,4A .0D? The e"idence of poisoning will depend upon whether the poisoning is acute or chronic. ,n acute poisoning the symptoms appear suddenly while the indi"idual is in good health. The person is usually affected with a group of symptoms of a definite characteristics out of consonance with his pre"ious state of health. ,n chronic poisoning, the onset of the symptoms is more gradual and insidious due to small <uantity of poison which has been administered on such occasion since the intention of the poisoner is 'ill his "ictim slowly in order to a"ert suspicion. 3-,D34&3 0! 10,S04,4A ,4 T+3 D3%T+ ,n all cases of poisoning whether homicidal or suicidal, fatal or not, the presence of 1oison must be pro"ed and proofs of poisoning in the dead may be obtained form$ ( ) post-mortem examination or autopsy - an examination of a death body especially to determine the cause of death. 3"idence from chemical analysis of the organs ta'en from the body.

10ST /0:T3/ %113%:%4&3 10,S04S ,4D,&%T3D ( 9essions of the mouth. ) blac'ening and se"ere corrosion - sulfuric acid * brownish-yellowish stain - strong mineral acid, oxalic acid, carboxylic acid lysol 5 corrosion and softening of the tissue of the mouth and throat. - al'alies 6 Se"ere corrosion without blac'ening. - hydrochloric acid 7 Se"ere corrosion and yellow stain nitric acid 8 9ips swollen, bronchopneumonia if death is delayed - ammonia ; /ucous membrane whitened - oxalic acid C .lue and blac'line on gums - 1b, .i, +g, %g (D ?ellow stains about the lips, soluble in 4+* - iodine (( :eddening of mucuous membrane of mouth, eye and glands. - formalin 93SS,04S 0! T+3 A%ST:0-,4T3ST,4%9 T:%&T ( corrosion - strong acid ) soapiness - caustic al'alies * dar' brown gelatinous mass in the stomach - oxalic acid 5 stomach grayish white - acetic acid 6 stomach yellow or reddish yellow - picric acid, potassium dichromate 0ther 9essions %nd &hanges bright red, spots on s'in - hydrocyanic acid, cyanides, &0 tissue abnormally red - potassium, sodium nitrite, &0 odors mar'ed on opening the body - opium and some of its deri"ati"es in some cases 5 pupils contracted - belladonna, scopolamine 6 dry gangrene of extremities - ergot ,nterpretation of toxicological analysis POST MORTEM EXAMINATION confirmed the strong possibility of poisoning but toxicological ( ) *

analysis failed to show the pressure of the poison. The negati"e result of the toxicological examination must be interpreted to explain the discrepancy between the clinical and postmortem findings and that of the toxicological analysis. :3%S04S !0: 43A%T,-3 :3S@9TS 0! T+3 T0E,&090A,&%9 3E%/,4%T,04 a b c some poison maybe rapidly altered in the body to a form which is not detectable by the methods of an alysis employed. Some poisons with or without pre"ious chemical change maybe rapidly exerted but not in the tissues and may only be detectable in the urine but not in the body tissues and organs. Sometimes symptoms of poisoning may appear which maybe fatal, following the administration of e"en small and ordinarily harmless <uantity of a substance classes as a poison.

,n e"ery case of poisoning the expert is often confronted with forensic <uestions which he should explain in order to help the in"estigator in assessing the e"idence. !0:34S,& F@3ST,04S !0: T+3 T0E,&090A,ST T0 3E19%,4$ (. Bas the death or illness of the sub>ect caused by the poisonG ). Bhat poison produced the illness or deathG *. Bhen and how was the poison administeredG 5. &ould the substance administered caused illness or deathG 6. Bas the substance found by the toxicologist in the body the poison which caused deathG 7. ,s the substance gi"en in minute <uantity a poisonG 8. Bas the poison ta'en in sufficient <uantity to produce deathG ;. Bay a poisoning ha"e occurred and the poison either be or become undetectableG C. /ay the poison extracted from the body ha"e an origin other than that of poisoningG (D. /ay the poisoning be stimulatedG 9%B &04T:099,4A T+3 S%93 ST0:%A3 0! 10,S04$ (. Sec. 866 - 1ro"isions relati"e to dispensing of "iolet poisnons ). Sec. 867 - 1ro"isions relati"e to dispersing of less "iolet poison *. Sec. 868 - :eceptacle for poisonous poisons. T+:33 *# ST%A3S ,4 &+90:0!0:/ 10,S04,4A .? ,4+%9%T,04 (. stage of excitement ). stage of surgical anesthesia *. stage of paralysis S?/1T0/S 0! &+90:0!0:/ 10,S04,4A Three ( ) * *# stages in chloroform poisoning by inhalation Stage of excitement - characteri2ed by a feeling of warmth, first in the face, then the entire body and followed by a tingling sensation of the s'in. Stage of surgical anaesthesia - characteri2ed by a relaxation of the muscles and the patient lies perfectly still with regular but slow and shallow respiration and is entirely insensible to pain. Stage of paralysis - characteri2ed by a fall blood pressure and the failure of the respiration and the heart. The s'in becomes cyanotic, the pupils are widely dilated, and death due to failure of respiration. -o0o-