datura poisoning

1. Datura
poisoning
(Deliriant Poision)
By Dr. Muhammad Zeeshan
Dept. of Forensic Medicine ,
BMC, Bannu

2. Datura
poisoning
(Deliriant Poision)
By Dr. Muhammad Zeeshan Marwat
Dept. of Forensic Medicine ,
BMC, Bannu

3. Key points
 Introduction
 Mechanism of action
 Signs and symptoms (toxicity)
 Fetal and Lethal doses
 Diagnosis
 Treatment
 Postmortem Appearance
 Medicolegal Aspects
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4. Introduction
 Datura is a genus of nine species of poisonous
Vespertine flowering plants belonging to the
family Solanaceae of kingdom Plantae.
 The leaves are alternate, with a lobed or
toothed margin.
 The flowers are erect or spreading trumpet-
shaped ,colors vary from white to yellow, pink,
and pale purple.
 The fruit is a spiny capsule giving the name
thorn apple to the plant,splitting open when
ripe to release the numerous seeds. An
average size fruit contains 450-500 seeds and
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5. Datura poisoning 5

6. Datura poisoning 6

7. Introduction (cont’d)
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 Synonyms: devil's trumpets ,moonflower,
jimson weed, devil's weed, hell's bells
and thorn-apple.
 Traditionally used for skin disorder, ear
pain, cough ,asthma, arthritis,
antispasmodics and as adjunctive with
some drugs i.e cannabis to boost its
effects.
 There are two varieties of datura i.e
1. Datura alba (safad datura)
2. Datura nigra (kala datura)

8. Active Principles
 All parts of the plants are toxic but fruits
and seeds are more, and datura has a
long history of use for causing delirious
states and death.
Active Principle:
Laevohyoscyamine
Hyoscine or scopolamine
Traces of atropine
The all act mainly on CNS each having its
own individual action.
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9. Mechanism of action
 Alkaloids of datura interact with and
inhibit all muscarinic receptor in the
body which lead to blockage of action
of neurotransmitter Ach at muscarinic
receptor and hence block
parasympathetic system.
 High dose may also block nicotinic
receptor at autonomic ganglia and
NMJ.
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10. Signs and Symptoms
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 The alkaloids of datura stimulate higher
centers of brain and then motor centers.
 They inhibits secretion of sweat and saliva,
dilate the cutaneous blood vessels, dilate the
pupil and stimulate heat regulating centre.
 CNS effects: The initial stimulation is followed
by depression and paralysis of vital centres in
medulla. The mind is affected first and he is
subjected to auditory and visual hallucination.
He appears to grasp an imaginary objects ,
picks at clothes and tries to pulls imaginary
threads from tips of fingers.

11. Signs and Symptoms (cont’d)
 Signs and symptoms can be
described as
1. Dry as bone (decrease salivation,dry
throat and mouth)
2. blind as bat ( pupils are dilated and
non reactive to light)
3. hot as hare (skin is hot and dry)
4. mad as hatter ( altered mental
status)
5. red as beet (cutaneous vasodilation
and flushed face) Datura poisoning 11

12. Datura poisoning 12

13. Signs and Symptoms (cont’d)
 Important symptoms can be summerized
as 9Ds
1) Dryness of mouth, 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
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14. Fatal Doses and Fetal Period
Fatal Dose:
 100 to 125 seeds.
 The lethal dose for alkaloid is about 60mg
for adult and 4 mg for children.
Fatal Period:
 death usually occur within 24 hours
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15. Diagnosis
• History
• Circumstantial evidance
• Physical examination
• Investigation i.e toxicology screen,
ECG abnormalities
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16. Treatment
 Decontamination i.e stomach wash with
KMnO4 or tannic acid AND purgatives
 Physiological antidote i.e physostigmine (1-
4mg and is repeated at intervals of 1-2
hours if necessary ) OR Neostigmine
(2.5mg I.v every 3 hours) .
Moistening of tongue and change in size of pupils guides
towards good prognosis.
 In non fatal case recovery takes a day or
two , the effect on pupil being last to
disappear
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17. Postmortem Appearances
 Findings are those of Asphyxia
 Datura seeds may be found in
stomach
 Congestion of GI
 Datura seeds resist putrefaction
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18. Medicolegal Importance
 For Crime ie robbery, kidnapping and
rape.Children can easily be kidnapped
by giving them candy or toffee mixed
with datura.
 Accidental cases occur when children
and adults eats the raw fruit or seeds
mistaking them for edible fruits or
capsucum seeds.
 Homicide
 Sucide
 Abortificant Datura poisoning 18

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