This document summarizes information about opium and its effects. It discusses that opium is derived from poppy plants and contains alkaloids like morphine and codeine. It can be administered orally, intravenously, by inhalation, or through other orifices. Its effects include an initial excitement stage, followed by a stupor stage and then deep narcosis. It acts on opioid receptors in the central nervous system. Prolonged use can lead to morphine dependence and withdrawal symptoms. Naloxone is used as an antidote for opiate overdoses.

1. SOMNIFEROUS POISONS
Characterized by two set of symptoms
1. Excitement
2. Narcosis

2. OPIUM CAPSULE

3. OPIUM{AFIM}

4. OPIUM PAPAVER SOMNIFERUM
Opium is the dried juice of papaver somniferum
ripe and dry poppy capsule – trace of opium
– used as sedative.
Poppy seeds (Khas Khas) harmless.

5. PROPERTIES
 Smells like raw flesh.
 Taste bitter when fresh plastic & moist
internally
on keeping becomes hard, brittle & dark
brown.
Active Principle
Two groups of alkaloids
1. Phenanthrene group
2. Isoquinoline group

6. ALKALIODS OF OPIUM
 Phenanthrene group
1. Morphine 9-14 %
2. Codeine 2- 4 %
3. Thebaine 0.5 %
used in analgesic, euphoriants, anti tussives
anti diarrheal.
 Isoquinoline group
1. Papaverine 1 %
2. Narcotine 6 %

7. raw opium extract
morphine codeine thebaine
Percadanheroin (1898)

8.  Opium
• Fluid obtained from the poppy plant
• Opiate
• a substance derived from opium
• Opioid
• substance with morphine-like actions, but not derived directly from
the poppy plants

9. ROUTES OF ADMINISTRATION
1. Oral
2. Parental ( IV or hypodermic)
3. Inhalation ( smoked )
4. Tropical
5. Through orifices

14. ABSORPTION & EXCRETION
Absorbed through GIT
excreted in stomach, intestine, bile & milk
eliminated mainly as morphine in urine &
faeces
it is excreted in the stomach & small intestine
even after parental use.

15. MODE OF ACTION
Acts as agonists on different opiate receptors
sites
in CNS .
There are 3 sub species of opiate receptors
e.g Kappa,(OP2) Sigma Delta(OP1)
It acts by depression of cortex
Respiration and cough centers are stimulated
Vagal reflex and vomiting is stimulated

16. SIGN AND SYMPTOMS
1. STAGE OF EXCITEMENT
( may be absent if a large dose is taken )
 Euphoric feeling of well being
 Restlessness and hallucination
 Increased pulse rate
 Flushing of face
 In children convulsions may occur

17. 2. STAGE OF STUPOR
 Headache Nausea Vomiting
 Uncontrollable desire to sleep
 Pupils contracted
 Cyanosis
 Itching sensation
 Pulse respiration normal

18. 3. STAGE OF NARCOSIS
 Patient is in deep coma
 Muscles relaxed and reflexes lost
 Secretions are suspended except of skin
 Blood pressure falls pulse is week and slow
 Cheyne – stroke breathing (R. rate 2-4/m)
 Lower jaw drops
 Pin point pupils
 Bladder distended

19. UNUSUAL SYPTOMS
 Vomiting
 diarrohea
 Convulsions
 Increased Temperature
 Dilated Pupils

20. DIFFERENTIAL DIAGNOSIS
 Apoplexy (Pontine hemorrhage)
 Metabolic condition
a. uraemic coma
 Barbiturate poisoning
 Alcoholic coma
 Hysterical coma
 Epileptic coma
 Carbolic acid poisoning

21. FATAL DOSE
Crude Opium 1-2 grams
Morphine 200-400 mg
Tincture 8-16 ml
In children 1-3 drops
FATAL PERIOD
6-12 hours in extreme case 45 minutes

22. TREATMENT
 Gastric lavage
First with warm water then with potassium
permagnate or tannic acid
Magnesium sulphate 15 grams as enema
Oxygen in halation
ANTITODE
Naloxone hydrochloride is antidote for opiate
poisoning .01 - .02mg /kg / body weight i.v

23.  Nalorphine hydrochloride 10 mg i.v
(total of 40 mg can be given)
rest of the treatment is symptomatic
Post Mortem Appearance
External
Specific smell
Deep cyanosis
Pin point Pupils
Froth
Well marked lividity

24. Internal
Smell of opium (musty)
Marked venous congestion
Blood is dark & fluid.
Stomach congested may contain
black
particles of opium.
Bladder full of urine

25. MEDICO LEGAL ASPECTS
 Suicidal
 Accidental
 Homicidal (rare) but used for
infanticide
 Cattle poisoning
 Drug addiction

26. MANY PRODUCTS, MARKETED FOR ADULTS AND
CHILDREN, WERE SOLD FOR PAIN AND COUGH
RELIEF. THEY ALL CONTAINED OPIUM.

27. PROLONGED USE OF OPIUM{MORPHINISM}
 In young adults
 Can tolerate up to 3 _6 gm per day
 Effects are
 Multiple scar mark
 Dry skin mouth tongue and hair
 Nausea vomiting
 Depression hallucination
 Dementia
 anorexia

28. WITHDRAWAL SYMPTOMS
 1st few hours fear and anxiety
 8_16 hrs restlessness
 14 hrs sweating and running nose and eyes
 24 hrs dialted pupil and shivering
 36 hours sever twitching of muscle, painful cramps in
legs and abdomen,vomiting,diarrhoea,insomnia
 3_4 days symptoms subsides