deliriant poisons class,effects on body

1. DELIRIANT POISONS
 Dhatura
 Atropa belladonna
 Hyoscyamus niger
 Cannabis indica
 Cocaine

2. DHATURA
(THORN APPLE)
 Two Types
 Dhatura Alba (Safed Dhatura) White
Flowered
 Dhatura Niger (Kala Dhatura) Black or Purple
Flowers

3. Characteristics
 Flowers: Bell shaped
 Fruits: Spherical, having sharp
spines
 Seeds: Brown kidney shaped resembling
chilli seeds
450 to 500 seeds in a fruit
100 seeds weight about 1 gram
 Seeds & fruit most noxious

8. Active Principle
 Contains Alkaloids:
 Laevo-hyoscyamine
 Hyoscine or scopolamine
 Traces of atropine

9.  Absorption
 Distribution
 Metabolism
 Crushed seeds Absorption of alkaloids
from small intestine blood body
tissues partial oxidation
 Analyst may not detect them due to their
oxidation
Same for all alkaloids

10. Mode of Action
 Stimulate the higher centers of brain
 Followed by the motor areas
 Depression and paralysis – vital center of
medulla
 Respiration – stimulated then depressed

11. Signs & Symptoms
 Symptoms described as:
 “ Dry as a bone, red as a beet, blind as a bat,
hot as a hare and mad as a wet hen”

12.  Alkaloids : Immediately
 Seeds: Within half an hour
 Decoction: Within few minutes
(concentrated water extract)
 Powered seeds given in food

13.  Earliest symptom: Bitter taste in mouth
 Inhibition of salivation: Dryness of mouth
and throat (dry as a bone)
 Difficulty in talking
 Dysphagia
 Unquenchable thirst
 Dilatation of cutaneous blood vessels
 Face is flushed (red as a beet)

14.  Pupils:
 Dilated
 Insensitive to light
 Power of accommodation near vision
paralyzed
(Blind as a bat)

15.  Inhibition of sweat secretion & stimulation of
heat regulating center:
 Body temp. raised
 Skin dry and hot (hot as a hare)
 Vomiting
 Giddiness, unsteady gait (drunken individual)
 Initially restless and confused
 Later delirious, mutters indistinct words (mad
as a wet hen)

16.  Visual and auditory hallucinations:
 Grasps at imaginary objects
 Picks at his clothings
 Tries to pull imaginary threads from tips of
fingers
 Scarlatiniform rash
 Delirium passes off in an hour
 Drowsiness Stupor or coma
 Death…..Respiratory paralysis
 Secondary delirium: After recovery

17. 9 Ds
1. Dryness of the mouth and throat
2. Difficulty in talking
3. Dysphagia
4. Dilatation of cutaneous blood vessels
5. Dilatation of pupils
6. Dry hot skin
7. Drunken gait
8. Delirium
9. Drowsiness

18. FATAL DOSE & FATAL PERIOD
 Seeds: 100 to 125
 Alkaloids: 60 mg (Adult)
4 mg (Children)
 Death occurs within 24 hours

19. TREATMENT
 Stomach wash:
 Weak solution of potassuim permangmate
OR
 4 to 5% tannic acid
 Physiological anti dote
 Physostigmine: 1 to 4 mg every 1 to 2
hours
OR
 Neostigmine: 2.5mg i.v. every three hours

20.  Purgatives
 Symptomatic
 Recovery: 1 to 2 days (in non fatal cases)
Effect on pupils last to disappear

21. POSTMORTM APPEARANCES
 Asphyxia
 Seeds found in stomach
 Congestion of GIT
 Seeds resist putrefaction

22.  Poisons resisting putrefaction
1. Phosphorus
2. Arsenic
3. Antimony
4. Hyoscine
5. Strychinne
6. Nicotine

23. MEDICOLEGAL ASPECTS
 Stupefying Poison: Robbery
Kidnapping
Rape
 Road Poison: Powered seeds mixed
with food, tea or drinks or pan & given to
travelers

24.  Small dose due to smoking or ingestion causes
loss of reasoning ability
 By mixing Dhatura with tobacco in cigarettes
 Children kidnapped by giving candy mixed
with Dhatura. They comply with the
instructions of the poisoner to follow him

25.  Accidental Cases: Children & Adults
 Eat raw fruits or seeds mistaking them for
edible fruits or capsicum seeds
 Quacks for treatment of various ailments
 Aphrodisiac
 Added to country liquor

26. Chilli Seed
Chilli Seed Dhatura Seeds
Dhatura Seeds
Small & thin
Small & thin Large and thick
Large and thick
Pale yellow
Pale yellow Brown or black
Brown or black
Smooth & round
Smooth & round Kidney shaped, finely
Kidney shaped, finely
pitted
pitted
Pungent smell
Pungent smell Odourless
Odourless
Pungent taste
Pungent taste Bitter taste
Bitter taste
On section embryo
On section embryo
curved inward like
curved inward like
figure of 6
figure of 6
On section embryo
On section embryo
curved outward
curved outward

31. Cannabis

32. CANNABIS INDICA (hemp)
 It is a CNS stimulant
 Cultivation is restricted by Law
 All parts of the plant are poisonous

33. Cannabis
Origins & History of use
 Psychoactive properties were first recorded
about 2800 BC in China and 2000 BC in India
 Early uses included rheumatic pains,
constipation, malaria, ‘absentmindedness’,
menstral cramps, and for its anxiolytic and
euphoric properties

34. ACTIVE PRINCIPLE
 Fat soluble oleoresin- cannabinol
 Stored in fat cells of body and acts like
time release capsule
 The effect of a single dose lasts for 7 days

35. Common Names
 Indian hemp or cannabis sativa in India
 Dagga in South & Central Africa
 Hashish in Egypt
 Marihuana: Mexican term meaning
pleasurable feeling

36. Routes of Absorption
 GIT
 Respiratory tract

37. Forms of hemp
 Common forms of hemp
 BHANG
 MAJOON
 GANJA
 CHARAS
 MARIJUANA

38. BHANG
 Least potent form
 Also called siddhi, patti, sabji
 Prepared from dried leaves & fruit shoots
 Used as an infusion in the form of a
beverage
 Suspension (Sardai) also mixed in ice cream,
sweets, pakauras

39.  Mildest and contains 15% of active
principle
 Produces a feeling of happiness
 Person sings and dances
 Effect lasts for about 3 hours & followed
by sleep

40. MAJOON
 Sweet prepared with bhang
 Produces grandiose delusion in addition
to all effects of drug

41. GANJA
 Consists of flowering tops of the female
plant
 It is mixed with tobacco and smoked in
pipe
 Contains active principle in conc. of 25%
 Smoker feels lazy & indulges in day
dreaming
 Used by sadhus and fakirs

42. MARIHUANA OR MARIJUANA
 Common names are pot, grass tea, Mary Jane
 Similar to Ganja
 Eaten alone or as part of confection or drunk
in beer
 Smoked in pipe or rolled in cigarette called
reefers or weed
 Their use leads to consumption of more
dangerous drugs & in particular to heroin
addiction

43. Cannabis
Origins & History of use
 Marijuana (the name for the dried and
crushed flowers) comes from the spanish
maraguanaquo (meaning an inebriant plant)
 Cannabis became an illegal substance in
North America in the 1920’s
 Revival in marijuana interest occurred in the
60’s

44. Cannabis
Origins & History of use
 Claims for medicinal and psychiatric uses
expanded in the 1800’s and 1900’s as for all
drugs
 Hash (the name for the resin) comes from the
arabic word hashsha shim (meaning hash
eaters- it also spawned the word assasin)

45. CHARAS OR HASHISH
 Resin exuding from leaves and stems
 Dark green or brown color
 Smoked with tobacco in a pipe ‘hookah’
 Active principle is in con of 25- 40%
 It is the most powerful of all cannabis
preparations

46.  Main effects are:-
Aphrodisiac, hypnotic and analgesic
Psychological dependence
Fatal Dose Charas 2gm/ kg body wt
Ganga 8.0gms/ kg body wt
Bhang 10 gm/ kilo body wt
Fatal Period Death is rare, but may occur in
12hrs in case of acute
poisoning.

47. Sign & Symptoms
 With Small Doses
 Euphoria
 Feeling of well being, talkative
 appetite
 With Moderate Doses
 Impaired immediate memory function
 Disturbed thought patterns
 Lapses of attention

48.  With High Doses
 Loss of perception of time and space
 Visual hallucinations
 Changes in body image
 Depersonalization
 Marked sensory distortion

49. HASHISH INSANITY (Chronic
Poisoning)
(Often attributed to chronic use)
 Patient suffers from hallucinations and
delusions of a persecuting nature
 Irresistible desire to destroy willfully life and
property of which he has no recollection
after wards
 Likely to commit sexual jealousy crimes
 Chronic use reduces serum testosterone
and sperm count

50.  Loss of appetite
 Weakness
 Wasting
 Tremors
 Sleepy facial expression
 Vacant look
 Red eyes
 Impotence
 Moral & mental deterioration
 May suffer from hallucinations & delusions of
persecution

51. RUN AMOK
 It is a psychotic disturbance caused by the
continued use or even first time use of
cannabis
 It is characterized by a frenzied desire of the
person to commit murders
 He first kills a person against whom he may
have real or imaginary enmity and then kills
anyone who comes in his way until the
homicidal tendency lasts.
 Then he may commit suicide or surrender
himself.

52. TOLERANCE & PSYCHOLOGICAL
DEPENDENCE
 Develops when the drug is consumed
over a prolonged period of time

53. TREATMENT
 Stomach wash with warm water
 100ml of 50% glucose
 2mg naloxone
 5-10mg diazepam if aggressive
 Hypodermic injection of strychnine
 Strong tea or coffee by mouth
 If necessary saline purgatives

54. POST- MORTEM APPEARANCES
 Not characteristic
 Usual appearance of asphyxia

55. Medicolegal Aspects
 Accidental ingestion or inhalation
 Overindulgence
 Majun and charas used by road poisoners
 To strengthen the nerves before committing
a crime or a bold act
 Aphrodisiac
 Used by fakirs and poojaris to get into a
religious mood