Unit 2( chapter 2)

POISONS

CONTENTS
* DEFINITION OF POISON
* FORMS OF POISON
* CLASSIFICATION OF POISON BASED ON MODE OF
ACTION ,BASED ON CHEMICAL NATURE AND GENERAL TYPE OF
CLASSIFICATION BASED ON THE MAIN SYMPTOMS PRODUCED.
*ACCIDENTAL,SUICIDAL AND HOMICIDAL POISONING
* NOTES OF ANTIDOTES.

Definition of poison

*Poison is defined as any substance which when administered by any

route can cause disease, deformity or death.

*According to law statutes, any substance, irrespective of its quality or

quantity, when given with intention to endanger, injure or kill a person is
called poison.

FORMS OF POISONS:
This means the state of existence of a poison, i.e. gas, liquid or solid state.
For gas, inhalation is the best route for rapid onset of action. For liquids, onset
of action is more rapid than solids when administered orally. Among solids, fine
powder acts faster than coarse powder.
Physical state: Gases and vapors act more rapidly than liquid. Liquid poisons
act more rapidly than solid ones, of which fine powders act more quickly than
coarse ones.

Chemical combination: Action of poison depends upon the solubility or

insolubility resulting from chemical combination, e.g. AgNO3 and HCl are both
strong poisons, but when combined, an insoluble salt of AgCl is formed which
is harmless.

Mechanical combination: Action of poison is altered when combined

mechanically with inert substances. Corrosives when sufficiently diluted with
water act as irritants.

Classification of Poisons

Classification of poisons can be done according to

A) Mode of action
B) Chemical nature
Both classifications have their own importance in forensic investigation.
Mode of action
helps in determining the type of poison and on the other hand chemical
nature of poison
helps in analysing it.

Mode of action

Poisons act usually by three ways: locally, remotely and both locally and
remotely.
•Locally acting: These act only at the site of application such as skin/mucosa,
e.g. corrosive poisons.

• Remotely acting: These act only after being absorbed into the circulatory
system, e.g. narcotic poisons, cardiac poisons, etc.

• Both locally and remotely acting: These act by local and remote actions,
synergistically, e.g. carbolic acid, etc.

Chemical nature:
The poisons are also classified on the basis of their nature in to the
following types:
GASEOUS POISONS

These types of poison are in gaseous state and if inhaled hamper the
competence of blood as a carrier of oxygen and may damage the tissues of the
air passages and lungs .Some of the examples are carbon monoxide, carbon
dioxide, hydrogen sulphide, sulphur oxide, chlorine, nitrous oxide, tear gas etc.
Volatile Inorganic Poisons:
Acute poisoning with volatile substances usually follows the slow inhalation of
vapors in order to become intoxicated. Cyanide, phosphine, arsine, phosgene,
chloride, etc. are few Volatile Inorganic Poisons.

Volatile Organic Poisons: These are organic chemicals that have a high
vapor pressure at ordinary room temperature. The high vapor pressure which
results from a low boiling point, causes large numbers of molecules to
sublimate from the liquid or solid form of the compound and enter the
surrounding air. Examples of Volatile Organic Poisons are ethanol, ethanol,
formaldehyde, and acetaldehyde
.
Non-Volatile Inorganic (anions) Poisons: Examples are halides,
dichromate, chlorates, azides , nitrites ,sulphate, phosphide , cyanide etc.

Non-Volatile Inorganic (cations) Poisons: Examples are mercury,

arsenic, barium, thallium, lead, antimony, bismuth etc.

Non-Volatile Organic Neutral Poisons (pesticides): Examples of

Non-Volatile Organic Neutral Poisons are organophosphates, organochlorates,
carbmates, pyrethroides.

Non-Volatile Organic Acidic Compound (acidic drugs). Drugs/

Poisons, which are acidic in nature, are called Acidic Drugs. These drugs
readily reacts with bases to form salts. Few of the examples are barbiturates,
sulpha, phenolic compounds (Phenol, Cresols etc.), salicylates.

Non-Volatile Organic Alkaline Compounds (basic drugs): If the

drugs contain a nitrogen atom with a lone pair of electrons available for reaction
with protons they will behave as bases only
Examples alkaloids, benzodizepine.

Plant Poisons: The active constituents of plants that exert toxic effects are
organic compounds and non-volatile in nature. Examples: - Dhatura, aconite,
oleander, nux vomica etc.

Miscellaneous Poisons: These poisons may be organic or inorganic,

volatile or nonvolatile and or animal, plant origin or toxins produced thereof
*Mechanical poisons
*Food poisoning
 *Animal or insect poison

General Classification of Poisons:

According to the main symptoms produced, poisons are basically

classified into four groups, namely: corrosives, irritants, systemic
poisons and other poisons.
MANNER OF POISONING

Homicidal poisoning
Administration of poisonous substances by a poison to kill
another
Essential quality of a homicidal poison
* It should be cheap
*Easily available,no residual part left
*Odourless,Highly toxic
 *Signs and symptoms resemble natural diseases
*No antidotes available
*Show no postmortem changes.
They must act rapidly even in small quantity.
Eg: Arsenic,Aconite,Abrus precatorius,Nux vomica

SUICIDAL POISONING
Intake of some poisonous substances by individual himself for
self-killing
IDEAL SUICIDAL POISON
*Easily available
*Should have no bad taste
*Cause no pain or less pain
*Must be cheap,highly toxic
*Tasteless or pleasant smell
*Capable of being taken with food or drink
Eg: Opium,Carbolic acid,Organophosphates

ACCIDENTAL POISONING
Take place due to the storage of poisonous and non poisonous
substance at the same place.
Noticeable accidental poisons include Aspirin,Snake bite,Carbon
monoxide poisoning and carbon dioxide poisoning etc.

It include,
*Food poisoning
*Latrogenic poisoning
*Synergistic poisoning
*Agrochemical poisoning
*Drug poisoning

ANTIDOTES AND ITS CLASSIFICATION

Antidotes are the doses of any substance, which counteract or neutralize the
effects of poisons without causing appreciable harm to the body. Antidotes are
specific to the poisons administered. If the administration of the antidote is
quick enough and in sufficient quantities, it can help save the life of a human or
an animal that has been poisoned. Many of the poisons and venoms spread
swiftly through the body via bloodstream, so an early medical attention is
indispensable for the effectiveness of an antidote.
For example an activate charcoal is used as an effective antidote for a wide
range of poisoning cases.

Here are some of the common modes of action in which the antidote functions:

1) By the formation of inert complex. e.g; chelating agents for heavy metals,
dicobalt edentate for cyanide.
2) Accelerated detoxification, e.g; thiosulphate is used as an antidote for
cyanide.
3) Reduced toxic conversion, e.guse of ethanol for methanol poisoning.
4) Blockage of receptor site, e.g naloxone for opiates; atropine for
organophosphates at muscarinic receptor sites
5) Bypass toxic effect, e.g 100% oxygen in cyanide poisoning
Classification of Antidotes

Antidotes are classified on the basis of their mode of action and are
grouped into following
four categories:

1) Mechanical or Physical Antidote

2) Chemical antidote
3) Pharmacological or physiological antidote
4) Universal antidote

Mechanical or Physical Antidotes

These are the substances that neutralize the poison and they also help stop the
absorption of poison in the body. They are further sub-grouped as following
based on their functions;
a) Activated charcoal: Activated charcoal is fine black, odourless powder. It is
manufactured by the destructive distillation of various organic materials mainly
wood pulp and then treated at high temperatures with a variety of activating
agents such as steam, carbon dioxide etc. Activating Agents help increase the
absorptive capacity. It has a property of small particle size and the surface area
is very large. Slurry is prepared by mixing it with water and can be used for
treatment. Activated Charcoal acts by delaying the absorption of poison from
the stomach. Activated charcoal is particularly beneficial in adsorbing the
alkaloidal poisons, such as strychnine and to a lesser degree, mineral
poisons. In multiple doses it significantly increases the total body clearance of
Opium, Cyanide and Phenobarbital. Phenol, Salicylates, Kerosene and
Paracetamol are moderately absorbed. The limitation of activated charcoal is
that it is not very useful in dealing with the cases of corrosives, heavy metals,
hydrocarbons and alcohol poisoning.
Dose: It is given in a dose of 30-60grams in children and 60-100grams in adults
in five times the quantity of water. The correct dose of activated charcoal is
about 5 to 10 times the amount of drug ingested.

b) Demulcents: Demulcents are capable of forming a protective coating on the

gastric mucous membrane thus preventing the damage caused by the poisons.
Demulcents include fatty products like egg, milk, albumin, oil etc. But fat and
oils should not be used for oil-soluble poisons such as kerosene, phosphorus,
organophosphorous compounds, DDT, phenol, turpentine, aniline, acetone etc.
They act in the same manner both in corrosive and irritant poisoning.

c) Bulky food: The mechanism of action of bulky food on poison is similar to

mechanical antidotes. They allow imprisoning of the particles on its
surface.Eg.banana acts as a mechanical antidotes to glass by imprisoning its
particles and thus preventing its action

Chemical Antidotes

The chemical antidotes inhibits the action of poison by forming harmless or

insoluble compounds or by oxidizing poison when brought into contact with
them. For eg. Potassium permanganate has oxidizing properties. It is used as
solution in a ratio of 1:5000 for opium and its
derivatives,strychnine,phosphorous,hydrocyanic acid, cyanides, barbituric acid
and its derivatives atropine and other alkalis.It loses its pink color in stomach
when it reacts with the poison.Some other examples are as follows:

➢ Tannin(strong tea) produces insoluble compounds with most alkaloids,

glucosides and metals.
➢ Common salt decomposes silver nitrate by direct chemical action, forming
the insoluble silver chloride.
➢ A solution of tincture iodine or lugol’s iodine (15 drops) to half a glass of
warm water precipitates most alkaloids, lead,mercury,silver,quinine and
strychnine.
➢ Alkalis neutralize acids by direct chemical action.
➢ Acid neutralizes alkalis by direct chemical action. Only those substances that
are harmless by themselves should be given e.g;vinegar,lemon juice, canned
fruit juice. Neutralization of acids with alkali and vice versa should be avoided
because exothermic reaction of neutralization can cause additional injury.

Physiological and Pharmacological Antidotes

These agents acts on the principle of antagonism. Most of the known antidotes
are only partial antagonist in their action. They act on tissues of the body and
produce symptoms exactly opposite to those caused by the poison. They are not
dangerous but their use is limited. The two real physiological antidotes are
atropine and physostigmine. They act on nerve endings and produce opposite
effect on heart rate. Other examples are cyanide and amyl nitirate, barbiturates
and picrotoxin or amphetamine.

Universal Antidote

If the nature of administrated poison is not known and it is suspected that two or
more poisons have been taken. In those cases the universal antidotes are
administered. They are simply the mixture of easily available substances.
Usually it is a combination of Physical and Chemical Antidotes. They are not
very effective, even if they after give soon after the administration of the
poison.