The document discusses opioid poisoning from substances derived from the opium poppy plant like morphine and codeine. It notes that opioids work by stimulating receptors in the central nervous system, causing sedation and respiratory depression which can lead to respiratory failure and death. Symptoms of acute opioid poisoning range from euphoria to vomiting and lethargy while chronic use can cause depression, weight loss, and social withdrawal. Treatment focuses on maintaining breathing and circulation along with the antidote naloxone to reverse effects while also providing supportive care and counseling.

1. Opoids Poisoning
SarojYadav

2. Introduction
 Opium is Latex obtained from Papaver somniferium
 Also called Poppy
 It is a alkaloid( Morphine, Codeine, Narcotine, & Papaverine)
 Used as analgesic , cough suppressant
 Derivative heroin, apomorphine, oxymorphine
 Other synthetic derivative are pethidine and
pentazocine,methadone

3. Mechanism of toxicity.
 generally, opioids share the ability to stimulate a number of
specific opiate receptors in the CNS, causing sedation and
respiratory depression.
 Death results from respiratory failure, usually as a result of
apnea or pulmonary aspiration of gastric contents.

4. Pharmacokinetics.
 peak effects occur within 2–3 hours, but absorption may be
slowed by their pharmacologic effects on gastrointestinal
motility.
 Most drugs have large volumes of distribution (3–5 L/kg).

5. Toxicity
 Acute Poisoning »When dose exceeds therapeutic
dose
Symptoms include:
 Euphoria
 Hallucination
 Tachycardia
 Vomiting
 Lethargy
 Constricted pupil
 Constipation

6. Severe toxic
Symptoms include:
 Hypotension
 Relaxation of muscle
 Hypothermia
 Respiratory depression
 Pin point pupil (may dilate in terminal stage)

7. Diagnosis
 Marquis’s Test:
Mix 3ml of sulphuric acid with 3 drops of formalin and add
this to suspected tissue or fluid .
A purplish colour develops which gradually turns blue

8. Treatment
 Maintain ABC
 If needed use endotracheal incubation
 Stomach levage
 Naloxone as an antidote
 Administer naloxone, 0.4–2 mg IV. As little as 0.2–0.4 mg is
usually effective
 for heroin overdose. Repeat doses every 2–3 minutes if there
is no response, up to a total dose of 10–20 mg if an opioid
overdose is strongly suspected.

9.  IV Dextrose 50% with vitaminB1
 Nalfemen as superior antidote
 Nalmefene may be given in doses of 0.1–2 mg IV, with
repeated doses up to 10–20 mg if an opioid overdose is
strongly suspected.
 Supportive treatment for hypotension and pulmonary edema

10. Chronic Poisoning
Symptoms include:
 Depression
 Amnesia
 Withdrawal from family, friends and social activities
 Pinpoint pupils
 Anorexia
 Weight loss
 Chronic constipation

11. Treatment
 Drug usually stopped
 A less potent drug given
 Antispasmodic can be given
 Tranquilizer for bed time sedation
 Psychiatric counselling