1. INSECTICLDAL: These are
a. Organo-phosphorus compounds:
They are derived form phosphoric acid are
form two series of compounds.
(i). Alkyl compounds:
• Tetraethyl pyrophosphates (TEPP)
• Hexaethyl tetra phosphate (HTP)
• Octomethyl pyrophos-phoramide (OMPA)
• systox , dimefox, sulfotep, & Malathion .
3. b. Halogenated Hydrocarbons : A good
number of preparation of chlorinated
hydrocarbon available in the market in the
form of :- Aldrin, Dieldrin, Endrin, D.D.T.
Gammexane, Heptachlor.
c. Miscellaneous preparations: Salts of
murcury and arsenic, Fluorides cyanides,
etc.
4. Organophosphorus Compound (OPC)
or organic poly phosphates.
• OPC are deadly toxic to human
beings as they are most effective as
insecticidal agents, hence these
preparation are mostly popular on
one side and also takes many lives
every year. Though mostly in rural
areas but also to a considerable
extent in urban areas.
5. Absorption, Fate and Excretion
• It is absorbed by inhalation, through the
skin, mucus membranes of the GIT.
parathion is absorbed in the body fat and
slowly released in the circulation,
prolonging the duration of toxic effects.
6. • It is metabolized to paraoxone which is the
active toxic agent of the preparation and
then to para-nitrophenol to be excreted
through urine. They are mixed with a
solvent, usually aromax, which is
responsible for kerosene like smell in the
body cavities, stomach contents, vomits,
froth etc.
7. MODE OF ACTION OF OPC
• Acethyl choline(ach) is a chemical transmitter
plays the vital role to propagate cholinergic
nerve impulse across the synapses of the
peripheral and central nervous system. Traces
of actylcholine are produced at the myoneural
junction, which is hydrolysed to choline and
acetic acid by cholin-esterases, which are
present in plasma and on the membranes or
within the cytoplasm of many cells.
8. • OPC are powerful inhibitors of carboxylic
esterase enzymes, including
cholinesterase.
• OPC inhibits the enzymes cholinesterase
in all parts of the body, due to which
acetylcholine is accumulate at the
parasympathetic, sympathetic and
somatic sites and transfer nerve impulses
across synapses. This provides a
syndrome of over activity of acetylcholine
due to unhydrolysed ach.
9. • Symptoms appears in both sympathetic
and parasympathetic nervous system.
• Symptoms are similar to those resulting
from over dosage of acctylcholine,
pilocarpine and physostigmine.
• They have three distinct toxic actions.
• ( i). A MUSCARINIC LIKE EFFECT which
potentiates post ganglionic
parasympathetic activity and affects
pupils, bronchial muscles salivary and
sweat glands, urinary bladder (contracted)
cardiac sinus node (blocked).
10. • (ii). NICOTINE LIKE STIMULATION followed
by paralysis of pre-ganglionic and somatic
motor nerves causing twitching of the eyelids,
tongue and fascial muscles followed by
neuromuscular block and paralysis .
• (iii). CENTRAL NERVOUS SYSTEM
STIMUZATION : followed by depression
causing headache, giddiness, restlessness,
apprehension, tremors, ataxia, insomnia, coma
& death.
12. • FATAL PERLOD: Within 24 hours in
untreated cases and within 10 day in those
treated cases when treatment is not
successful.
• S/S:- Signs and symptoms appear when
the cholinesterarase level drops to 30% of
its normal activity.
13. • (i). Muscarinic Manifestations:-
• These symptoms can be easily remembered by
the acronym.
• SLUDGE
• S- Salivation
• L- lacrymation
• U- Urination
• D- Defaecation
• G- Gastro-intestinal distress
• E- Emesis
18. • Cause of Death: Death is caused by
paralysis of the respiratory muscles,
respiratory, arrest due to failure of
respiratory centre or intense broncho-
constriction.
19. • Diagnosis:-
• Diagnosis depends on history, signs and
symptoms.
• Treatment:-
• 1. Avoiding the risk of further exposure:
• a. Removal of the patient from the place
of exposure.
• b. Removal of the clothing's :-
Contaminated clothes should be removed
to prevent further absorption.
20. • c. If the skin is contaminated then washing
of the skin or bathing will be necessary.
• 2. The airway should be immediately
controlled with oxygen, and aspiration of
secretion, tracheostomy may be required.
• 3. When cyanosis is present maximal
oxygenation should be achieved before
giving atropine, Artificial respiration if
necessary.
21. • 4. When poison ingested the stomach should
be washed with 1:5000 potassium
permanganate solution.
• 5. Atropin sulphate I/V in 2 mg to 4 mg /hr
doses till atropinization i, e, dilatation of pupils.
• (0. 05 mg/ kg is given as a test dose if there is
no effect this dose may doubled every 5 to 10
minutes until muscarinic symptoms are
relieved.)
22. • 6. Antidotes: Oximes are considered proper
antidotes of opc poisons.
• Different preparation of oximes are:- Diacctyl
Mono Oxime (DAM). Pralidoxime.
• The adult dose is 1 to 2 gm I/V either as a 5%
solution given over 5 min or 150 ml of saline
and infused over half an hour. This can be
repeated in one hour if muscle weakness and
fasciculations are not relieved.
• The dose should be repeated at 6 to 12 hrs
interval for 24 to 48 hours to ensure distribution
to all affected sites.
23. • Pralidoxime & atropine work
synergistically and should be used
together.
• 7. If convulsions – Benzodiazepines.
• 8. Pulmonary oedema and
bronchospasm should be treated with
oxygen, intubation, atropine and positive
pressure ventilation.
• 9. Antibiotics to prevent pulmonary
infections.
24. POSTMORTEM APPEARANCE
• Externally: 1. Cyanosis.
2. Deep postmortem.
3. Congested face .
4. Frothy discharge often
blood stained from nose and mouth.
5. Kerosene like smell due to
diluents of poison .
25. INTERNALLY
• 1. The mucosa of the intestine is
congested
• 2. The stomach contents gives Kerosene
like smell.
• 3. Petechial haemorrhagic spots may be
present at the subplural level and sub-
mucosal level of the others viscera.
• 4. Gross congestion and oedema of lungs.
• 5. Congestions of other organs.
• 6. Oedema of brain.
26. • 7. Blood stained froth in the respiratory
tract. Cholinesterase level of cells and
plasma is low.
• M/L ASPECTS:
27. CHLORINATED
HYDROCARBONS
• D.D.T. (DICHLORO- DIPHENYL- TRICHLORO
ETHANE) ALDRIN,DIELDRIN, ENDRIN,
HEXACHLORO-CYCLOHEXANE
(GAMMEXANE, LINDANE,) CHLORDANE.
• USES: These chlorinated hydrocarbons are
used in home, in Gardens and in agricultural
fields as insecticidal agents. They are insoluble
in water.
28. • DDT:
DDT is a white crystalline powder with a
faint aromatic odor, almost insoluble in
water but moderately soluble in vegetable
oils, kerosene, and various organic
solvents. It is important both as an
insecticide and as parasiticide. In low
concentrations, it is lethal to mosquitoes,
house flies, lice and to many other insects
and arthropods.
29. • ACTION:- It acts chiefly on the cerebellum
and motor cortex of the CNS. It also
sensitises the myocardium to adrenaline.
• DDT and its metabolites accumulate and
persist in body fat for long period of time.
• MODE OF INSECTICIDAL USE:- Being
insoluble in water they are used either as
dust or emulsion or mixed with solvent like
kerosene.
30. • ABSORPTION, FATE & EXCRETION:- For
the insects chlorinated hydrocarbons are
contact poisons and absorbed through the
exoskeleton of the insects. In human being,
except Dieldrin, chlorinated hydrocarbons in
dry powder form are poorly absorbed through
the M.M. of GIT.
31. • In the body these are mainly deposited in
the body fat and also to a small extent in
liver kidneys and brain.
• These are destroyed mainly in liver. Some
Metabolic products are excreted in stool,
urine and milk.
32. • Fatal Dose:-
• Aldrin, Dieldrin, Endrin → 2.5gms
• CHLORDANE → 5-7 gms.
• DDT & LINDANE → 15 – 30 gms.
• Fatal period:- With Optimum dose death occurs
within some hours.
33. • S/s: With DDT & Gammexane nausea,
Vomiting and diarrhoea occurs possibly
due to the action of their solvents, It
causes, headache, dizziness and
weakness. With higher doses it cause
cerebral disturbance like restlessness,
irritability, dizziness, palpitation, tremor,
twitching of muscles and convulsion occur.
In children death may occur within a few
hours due to respiratory failure.
34. • After the immediate danger is over, risk of
hepatitis, irritation of the gut with vomiting (often
mixed with blood) melena, bile in urine and
tachycardia may persist. Aldrin, dieldrin ,
endrin, chlordane are more active conversant.
→ If convulsion or unconsciousness occur
without preceding symptoms, then the
prognosis is grave.
35. • Rx,
• 1. Removal of the ingested poison by emesis or
gastric lavage and magsulph purgation.
• 2. When the poisoning is through surface
contact removal of clothing's & washing of the
skin.
• 3. If convulsion – pentobartone sodium, 180 mg
½ or para-aldehyde 4-6 ml 1/m is given.
•
36. • 4. If convulsion repeats, then controlled
respiration is recommended with the help
of anesthetist.
• PM findings :
• (1). Externally: Cyanosis & others sign of
asphyxial death. kerosene like smell near
the mouth. Discharge of blood stained
from the nose and mouth.
37. • 2. Internally:
• The stomach content smells of like that of
kerosene, Irritation of stomach m. mems.
Lungs congested and edematous subplural
hge spot.
• There is froth in the lumen of be respiratory
tract. Organs are congested.
• There may be fatty deg. of liver, kidneys.