inebriants

2. CHARACTERIZED BY
■ Excitement
■ Narcosis
■ Classical Inebriant
Alcohol

3. ■ALCOHOL (ETHYL ALCOHOL)

4. APPEARANCE
■ Transparent, colorless, volatile, spirit-like odor and burning taste.
■ Examples
Rum
Whiskey
Gin
Wines
Beers

5. METABOLISM
■ Rapidly absorbed from GI tract
■ which depends on
1 . Concentration of alcohol
2. Presence or absence of food
in the stomach
3. Condition of the Stomach Wall
4. Rate of Drinking
5. Weight of person
6. Development of tolerance
■ 90% of absorbed alcohol is
oxidized in liver and 10% is
excreted by kidneys and lungs.

7. ETHYL ALCOHOL POISOING(ACUTE)
■ Depresses the CNS (from cortex to medulla)
■ Depresses the higher centers that controls the judgement
and behavior ( Stage of excitement)
■ Depresses the motor centers (Stage of incoordination)
■ Depresses the Vital centers in medulla (Stage of narcosis)

9. STAGE OF EXCITEMENT
■Laughs, converses well
■May disclose secrets
■Talk in vulgar language

10. ■ Incoordination of thoughts, speech and action.
■ Impaired Judgement, confusion, slurred speech and
staggering
■ Morose, euphoric or irritable
■ Nausea, Vomiting
■ Pupils are dilated
STAGE OF INCOORDINATION

11. ■ Deep sleep and responds well to stimuli.
■ Rapid, temperature, subnormal, breathing, stertorous
■ Pupils contracted
■ MAC EWAN’S SIGN :
Pinching the neck or face pupils dilate or reach to their
original size
STAGE OF NARCOSIS

12. FATAL DOSE
■ Concentration of 0.35% (350mg)
FATAL PERIOD
12 to 24 hours

13. TREATMENT
■ Gastric Lavage(5 %solution of sodium bicarbonate)
■ Saline purges and IV hypertonic glucose solution
■ Hemodialysis/ Peritoneal dialysis

14. POSTMORTEM APPEARNCES
■ Furred tongue
■ Bruises all over the body
■ Blood is fluid and dark
■ Brain is edematous
■ Oedema of larynx
■ Fatty liver
■ Stomach has gastritis

15. Liability to fatal complications such as
head injuries, serious bleeding from
trivial injuries , suffocation, drowning
and exposure
Medicolegal Importance

16. ■CHRONIC POISONING

17. CHARACTERIZED BY
■ Gradual physical, moral and mental
detoriation
■ Lack of personal hygiene
■ Loss of appetite
■ Chronic gastroenteritis
■ Wasting
■ Peripheral neuropathies
■ Impotence and sterility
■ Fatty changes in liver and heart

18. ■ State of excitement with hallucinosis
■ Lasts 3 to 4 days
■ Results from
Unusual bout of drinking
Sudden withdrawal of alcohol
Acute infection
Shock from injury
Exposure to cold
Treatment :
Chlorpromazine 100mg QID
IV hypertonic glucose to relieve cerebral oedema
DELIRIUM TREMENS

19. KORSAKOFF’S PSYCHOSIS
■ Syndrome characterized by hallucinations, disorientation, multiple neuritis
■ Acute hallucinations
Auditory with systematized delusions of persecution lasting from weeks to
months.
Treatment
Antabuse Disulfiram
Temposil (Calcium carbamide citrated)

21. POSTMORTEM APPEARANCE
■ Degenerative changes in the liver, kidneys and brain, atrophic
gastritis
■ Cirrhosis of liver
■ Cardiomyopathy