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General Toxicology
FATAL PERIOD
Qualitative Analysis
Means name of the poison which is used
Toxicology
POISON
OR
Medicine Poison
1 Used for cure of a disease Used to harm a person or
or prevention of a disease To cause injury to a person
2 Therapeutic dose is taken Toxic or lethal dose is taken
or given
3 Legal differences is intention with which a
substance is taken or given to someone
Classification of Poisons
1. Symptomatic classification
2. Ancient classification
3. Historical classification
Symptomatic Classification of Poisons
1. Corrosive Poisons:
Are poisons which when come in contact with
tissues cause extensive inflammation, deep
ulceration and bleeding.
2. Irritant Poisons:
Are substances which when come in contact with
the tissues cause slight inflammation, shallow
ulceration and may cause slight bleeding.
Differences
Corrosive Irritant
4. Cardiac Poisons:
Poisons acting on heart
5. Asphyxiant Poisons:
Causing asphyxia, disturbance of normal process
of respiration
6. Miscellaneous Poisons
1. Corrosives These are Strong acids and strong alkalis
i. Mineral acids H2SO4, HCl, HNO3 e.g.
ii. Organic acids e.g. oxalic acid, acetic acid, carbolic acid and
salicylic acid
iii. Vegetable acids e.g. Hydrocyanic acid
iv. Conc. Solution of Alkalies e.g. caustic soda (NaOH), caustic
potash (KoH), ammonia, Carbonate of Na & K i.e.
Sodium Carbonate &
Potassium carbonate
2. Irritant
i. Inorganic irritants e.g. metallic & non metallic
irritants
ii. Organic irritants vegetable and animal poisons
iii. Mechanical irritants e.g. powdered glass, dried
sponge
Metallic irritants e.g. arsenic, antimony, mercury,
lead, copper, manganese, barium etc.
Non Metallic irritants e.g. phosphorus, chlorine,
bromine, iodine
Organic irritants:
Vegetable irritants e.g. caster oil seeds, croton oil
seeds, abrus precatorus, ergot, capsicum, marking
nut, madar
Cerebral neurotics:
i. Somniferous e.g. opium alkaloids like morphine,
heroin (diacetyl morphine)
ii. Inebriant e.g. Alcohol, anaesthetics, hypnotics
iii. Deleriants e.g. Dhatura, Blladona, Hyoscyamus,
Canabis indica (bhung, charus, gunja, mari juana,
hashish)
Spinal cord Poisons
e.g.(1) Nux vomica which stimulates the
spinal cord
(2) Gelsimium which depresses the spinal
cord
Peripheral neurotics
e.g. Curare, conium (poison given to Sucrat)
4. Cardiac Poisons
5. Asphyxiant Poisons
a. Analgesics
b. Abortificiant
c. Anti histamines
d. Other drugs
Poison
LD 50
Is a dose that represents the concentration of
contents required to produce death in 50% of animals
that are exposed to it
ED 50
Is a dose of substance that is therapeutically effective
in 50% of subjects receiving it
Therapeutic Index:
It is LD50/ED50
Toxicity Rating
1. Nontoxic: Dose more than 15gm/kg body wt
2. Slightly Toxic: Dose more than 5 15gm/kg body wt
3. Moderately Toxic: Dose more than 500mg 5gm/kg
body wt
4. Very Toxic: Dose more than 50mg 500mgkg body
wt (one tea spoon full to 1 ounce)
5. Extremely Toxic: Dose more than 5 50 mg/kg body
wt (7 drops to one tea spoon full)
6. Super Toxic: Dose less than 5 mg/kg body wt (less
than 7 drops)
Ancient Classification of Poisons
1. Human Poisons
2. Animal Poisons
Human Poisons
Homicidal poisons e.g. Arsenic
Suicidal poisons e.g. Tranquilizers, Hypnotics
Accidental poisons e.g. administrated without any
intentions e.g. Kerosene oil is taken instead of water
Stupefying poisons e.g. Dhatura poison, it is also
called road poison
Used to cause dullness of the senses
Persons behave like a tamed animal
Exhibitional poisons e.g.
Poisons are taken to express the interior feelings
Suicidal Poison
Stupefying Poison
Causes dullness of senses
Victum offers no resistance
Examples are Dhatura , Canabis indica.
Exhibitional Poisons
Occupational Classification:
1. Agricultural poisons e.g. insecticides, pesticides,
DDT, organo phosphorus compounds, parathion
Actions of Poisons:
1. a) Local:
Poisons comes in contact with tissues e.g. H2SO4
deep ulceration, bleeding and inflammation
1. b) General:
Actions occurs when the poisons are absorbed
Toxicology
2. a) Immediate Action:
Occurs immediately e.g. burning sensation in
phosphorus poisoning.
2. b) delayed action:
Occurs after some time i.e. half hour to fifteen
minutes for example in phosphorus poisoning
Toxicology
3. a) specific actions:
Where a specific organ or a specific system is
involved e.g. Arsanic affects the liver (Hepato toxic)
Hg= Para mainly affects kidney (Nephrotoxic)
CO specifically affects brain
3. b) Non specific actions:
Neuro genic shock after intake of H2SO4 (Due
severe pain)
Toxicology
Lethal dose:
Minimum amount of a drug which is sufficient to
kill a healthy person.
LD 50 = Average fatal dose
Dose required to kill 50% of experimental animals
d. Synergian = Potentiation
2+2>4 alcohol & Barbiturates
If two or more poisons are mixed their total effect is
much much more than of their individual effect
FORM OF POISONS:
i. Physical State
chemical communication
Toxicology
a. Inhalation
b. I/V
Toxicology
Body Conditions:
i. Age:
Children can not tolerate the adults dose, both
extreme of ages are susceptible to toxic effect of
drugs
ii. Health:
Healthy may tolerate well than weak or diseased
person
Toxicology
iii. Sleep
Rate of metabolism is decreased during sleep so
effects of poisons will be less during sleep than
during awake state
iv. Intoxication:
When person is under effect of alcohol, effects will
be decreased due to intoxication and sleeping
tendency of body
Toxicology
Safety Index
Diagnosis of Poisons:
b. In the dead
Toxicology
iii. Examination
b. Systemic examination
vi. Miscellaneous
X-Ray
Biopsy e.g. small piece of an organ e.g. liver
Ultrasound hepatomeglay e.g. in alcoholic
intake initially & then it shrinks in cirrhosis
ECG for cardiac poison, oleander, tobacco etc
Toxicology
3. Chemical analysis:
The most important point. Your findings should be
in consistence with the lab findings
4. Experiment on animal
5. Miscellaneous
Legal Duties of Doctor in Poisoning
Cases
1. TREATMENT
Consent:
should be taken prior to the start of treatment as
treatment without consent in assualt
Age:
person should be above twelve years for medial treatment.
compos mentis : mentally fit condition (sane)
not intoxicated
(under the effect of alcohol)
consent should be taken from the pateint
if below twelve years then take consent of parent/guardian.
Legal Duties of Doctor in Poisoning
Cases
Treatment of poisons:
1. Avoid further intake by removal from source of
poison
2. Removal of unabsorbed poison by a) gastric levage
b) by inducing vomiting
3. Removal of absorbed poison
4. Use of antidotes
a) chemical antidotes
b) universal antidotes
c) specific antidotes
Toxicology
Chealating Agents:
these are specific antidotes against heavy metals
they form stable compounds which are non toxic
Types
BAL (british antilewisite)
CDTA: (calcium diethyl tetra acetate)
EDTA: ( ethylene diamine tetra acetate)
PENCILL AMINE:
all these four are effective against heavy metals
Toxicology
BAL:
This substance was developed against a war gas used in world
war two and its name was lewisite gas it is very much effective
against heavy metals
it is effective for arsenic and mercury poisoning
Dose: 3mg/kg body weight
Side effects
anorexia
restlessness
body aches
nausea
vomiting
convusions
comma and death
Toxicology
EDTA:
therapeutic uses: effective against arsenic lead
mercury
side effects:
Hypotension, neuro toxicity, hypokalaemia,
Pencillamine:
Therapeutic uses: mercury, lead, & in copper
poisoning
side effects:
Allergy anapylactic shock, nausea, vomiting, fever,
aplastic anaemia, optic neuritis, nephrotic syndrome
etc.
Toxicology