Chapter 8 Toxicology Poisons and Alcohol All substances

Chapter 8 Toxicology: Poisons and Alcohol “All substances are poisons. There is none which is not. The right dose differentiates a poison and remedy. ” —Paracelsus (1495 -1541). Swiss physician and chemist

A history of poison… N dates from before 4500 BC to the present day. Poisons have been used for many purposes most commonly as weapons, anti-venoms, and medicines. Poison has allowed much progress in branches of medicine, toxicology, and technology, among other sciences.

` N Nazi war leader Herman Goering even used it to kill himself the night before he was supposed to be hanged during the Nuremberg Trials. Adolf Hitler had also taken a pill of cyanide shortly before the fall of Berlin along with his wife, Eva Braun

N Example: Strychnos toxifera, a plant used for the making of dart and arrow poisons: N Strychnine

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N The Colorado River Toad or Bufo alvarius, also known as the Sonoran Desert Toad, is a psychoactive toad found in the Southwestern U. S and northern Mexico. . Chapter 8 Kendall/Hunt Publishing Company 7

N The toad's primary defense system is glands that produce a poison that is potent enough to kill a full grown dog. These parotoid glands also produce the 5 -Me. O-DMT and bufotenin for which the toad is known; both of these chemicals belong to the family of hallucinogenic tryptamines. The presence of these substances in the skin and poison of the toad produces psychoactive effects when smoked. Chapter 8 Kendall/Hunt Publishing Company 8

N Bufotenine is a Schedule I controlled substance in the U. S. While possession of the toad is not a crime in itself (in Arizona, U. S. A. , one may legally bag up to ten toads with a fishing license), it could constitute a criminal violation if it can be shown that one is in possession of this toad with the intent to milk and smoke its venom. In Nov. 07, a man in Kansas City was arrested and charged with possession of a controlled substance when police discovered B. alvarius toad poison in his possession. Chapter 8 Kendall/Hunt Publishing Company 9

N Dog Eats Poison Toad

N Pesticides in crop dusting planes spread toxins in our air and on our food in order to kill crop destroying pests

In this Unit You will learn: N A measurable approach to N § § § Chapter 8 toxicology. The danger of using alcohol. The connection of blood alcohol levels to the law, incapacity, and test results. Poison vocabulary Design and conduct scientific investigations. Use technology and mathematics to improve investigations and communications. Identify questions and concepts that guide scientific investigations. Communicate and defend a 14 scientific argument.

Biological Definition of Poison N Substances that can cause disturbances to organisms by chemical reaction or other activity on the molecular scale, when a sufficient quantity is absorbed by an organism. Legally and in hazardous chemical labeling, poisons are especially toxic substances; less toxic substances are labeled "harmful", "irritant", or not labeled at all. Chapter 8 Kendall/Hunt Publishing Company 15

Medical Definition of Poisons N (particularly veterinary) and in zoology, a poison is often distinguished from a toxin and a venom. Toxins are poisons produced via some biological function in nature, and venoms are biologic toxins that are injected by a bite or sting to cause their effect, while other poisons are generally defined as substances which are absorbed through epithelial linings such as the skin or gut. Chapter 8 Kendall/Hunt Publishing Company 16

N Cattle poisoned overnight by ingesting a toxin in a poisonous weed Chapter 8

Toxicology: The study of the adverse effects of chemicals or physical agents on living organisms. Types: NEnvironmental—air, water, soil NConsumer—foods, cosmetics, drugs NMedical, clinical, forensic Chapter 8 18

Forensic Toxicology N Postmortem—medical examiner or coroner N Criminal—motor vehicle accidents (MVA) N Workplace—drug testing N Sports—human and animal N Environment—industrial, catastrophic, terrorism Chapter 8 Kendall/Hunt Publishing Company Kendall/Hunt Company 19

Toxicology Toxic substances may: N Be a cause of death N Contribute to death N Cause impairment N Explain behavior Chapter 8 20

A history of Poisoners: N N Olympias—a famous Greek poisoner Locusta—personal poisoner of Emperor Nero Lucretia Borgia—father was Pope Alexander VI Madame Giulia Toffana—committed over 600 successful poisonings, including two Popes. N Hieronyma Spara—formed a society to teach women how to murder their husbands N Madame de Brinvilliers and Catherine Deshayes— French poisoners. AND many others through modern times. Chapter 8 21

The Severity of the Problem “If all those buried in our cemeteries who were poisoned could raise their hands, we would probably be shocked by the numbers. ” —John Harris Trestrail, “Criminal Poisoning” Chapter 8 Kendall/Hunt Publishing Company 22

People of Historical Significance Mathieu Orfila: A. K. A. the father of forensic toxicology, published in 1814 “Traite des Poisons” describing the first systematic approach to the study of the chemistry and physiological nature of poisons. Chapter 8 Kendall/Hunt Publishing Company Kendall/Hunt Company 23

His Role in Forensic Toxicology N If there is reason to believe that a murder or attempted murder may have been committed using poison, a forensic toxicologist is often brought in to examine pieces of evidence such as corpses and food items for poison content. In Orfila's time the primary type of poison in use was arsenic, but there were no reliable ways of testing for its presence. Orfila created new techniques and refined existing techniques in his first treatise, Traité des poisons, greatly enhancing their accuracy. Chapter 8 Kendall/Hunt Publishing Company 24

N In 1840, Marie La. Farge was tried for the murder of her husband using arsenic. Mysteriously, although arsenic was available to the killer and was found in the food, none could be found in the body. Orfila was asked by the court to investigate. He discovered that the test used, the Marsh Test, had been performed incorrectly, and that there was in fact arsenic in the body, allowing La. Farge to be found guilty. Chapter 8 Kendall/Hunt Publishing Company 25

Aspects of Toxicity N Dosage N The chemical or physical form of the substance N The mode of entry into the body N Body weight and physiological conditions of the victim, including age and sex N The time period of exposure N The presence of other chemicals in the body or in the dose Chapter 8 Kendall/Hunt Publishing Company Kendall/Hunt Company 26

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Lethal Dose N LD 50—refers to the dose of a substance that kills half the test population, usually within four hours N Expressed in milligrams N of substance per kilogram of body weight Chapter 8 Kendall/Hunt Publishing Company 28

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Toxicity Classes LD 50 (rat, oral) Correlation to Ingestion by 150 lb Adult Human Toxicity <1 mg/kg a taste to a drop extremely 1 -50 mg/kg to a teaspoon highly 50 -500 mg/kg to an ounce moderately 500 -5000 mg/kg to a pint slightly 5 -15 g/kg to a quart practically non-toxic Over 15 g/kg more than 1 quart relatively harmless Chapter 8 Kendall/Hunt Publishing Company Kendall/Hunt Company 31

Federal Regulatory Agencies N Food and Drug Administration (FDA) N Environmental Protection Agency (EPA) N Consumer Product Safety Commission N Department of Transportation (DOT) N Occupational Safety and Health Administration (OSHA) Chapter 8 Kendall/Hunt Publishing Company Kendall/Hunt Company 32

Symptoms Poison Types Poison Symptom/Evidence N Caustic Poison (lye) N Carbon Monoxide N N N N Sulfuric acid Hydrochloric acid Nitric acid Phosphorous Cyanide Arsenic, Mercury Methyl (wood) or Isopropyl (rubbing) alcohol Chapter 8 Characteristic burns around the lips and mouth of the victim Red or pink patches on the chest and thighs, unusually bright red lividity Black vomit Greenish-brown vomit Yellow vomit Coffee brown vomit. Onion or garlic odor Burnt almond odor Pronounced diarrhea Nausea and vomiting, unconsciousness, possibly blindness Kendall/Hunt Publishing Company Kendall/Hunt Company 33

Critical Information on Poisons N N N N N Form Common color Characteristic odor Solubility Taste Common sources Lethal dose Mechanism Possible methods of administration Time interval of onset of symptoms. Chapter 8 N Symptoms resulting from an acute exposure N Symptoms resulting from chronic exposure N Disease states mimicked by poisoning N Notes relating to the victim N Specimens from victim N Analytical detection methods N Known toxic levels N Notes pertinent to analysis of poison N List of cases in which poison was used —John Trestrail from “Criminal Poisoning” Kendall/Hunt Publishing Company Kendall/Hunt Company 34

To Prove a Case N N N N Prove a crime was committed Motive Intent Access to poison Access to victim Death was caused by poison Death was homicidal Chapter 8 Kendall/Hunt Publishing Company Kendall/Hunt Company 35

Forensic Autopsy Look for: N Irritated tissues N Characteristic odors N Mees lines—single transverse white bands on nails. Order toxicological screens N Postmortem concentrations should be done at the scene for comparison N No realistic calculation of dose can be made from a single measurement Chapter 8 Kendall/Hunt Publishing Company Kendall/Hunt Company 36

Human Specimens for Analysis N Blood N Urine N Vitreous Humor of Eyes N Liver tissue N Brain tissue N Kidney tissue N Hair/nails N Bile N Gastric contents Chapter 8 Kendall/Hunt Publishing Company Kendall/Hunt Company 37

Alcohol—Ethyl Alcohol (C 2 H 5 OH) N Most abused drug in America N About 40% of all traffic deaths are alcohol-related N Toxic—affecting the central nervous system, especially N N N the brain Colorless liquid, generally diluted in water Acts as a depressant Alcohol appears in blood within minutes of consumption; 30 -90 minutes for full absorption Detoxification—about 90% in the liver About 5% is excreted unchanged in breath, perspiration and urine Chapter 8 Kendall/Hunt Publishing Company Kendall/Hunt Company 38

N DUI: driving under the influence N DWI: driving while intoxicated N OUI: operating under the influence N OWI: operating while intoxicated N MIP: minor in possession N DUI or DWI? N AZ DUI Chapter 8

N Man Eats Underwear to Beat Breathalyzer An 18 -year-old man tried to eat his underwear while sitting in the back of a police car in the hope that it would absorb the alcohol before he took a Breathalyzer test. —abstracted from The Advocate This didn’t work. He had a BAC of 0. 08. Chapter 8

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N EVERY 15 MINUTES: paramedic Norm Desautels covers the body of Darrell Reed as Justin Eaglin and Rita Gonzalez mourn his death from a drunk driving accident as student at Tracy High took part in the "Every 15 Minutes" event. The program simulates a drunk driving accident with a fatality and arrest. Leading up to the accident one student is removed from class every 15 minutes as an example of the lives lost from DUI Chapter 8 accidents. Photo by Glenn Moore

Rate of Absorption Depends on: N amount of alcohol consumed N the alcohol content of the beverage N time taken to consume it N quantity and type of food present in the stomach N physiology of the consumer Chapter 8 Kendall/Hunt Publishing Company Kendall/Hunt Company 44

BAC Blood Alcohol Content N Expressed as percent weight per volume of blood N Legal limits in all states is 0. 08% N Parameters influencing BAC: § § Chapter 8 Body weight Alcoholic content Number of beverages consumed Time between consumption Kendall/Hunt Publishing Company Kendall/Hunt Company 45

BAC N Burn off rate of 0. 015% per hour but can vary: § Male BAC male = 0. 071 x (oz) x (% alcohol) body weight § Female BAC female = 0. 085 x (oz) x (% alcohol) body weight Chapter 8 Kendall/Hunt Publishing Company Kendall/Hunt Company 46

Alcoholic proof N a measure of how much alcohol (i. e. , ethanol) is contained in an alcoholic beverage. The measure is commonly used in the United States, where it is defined as twice the percentage of alcohol by volume. N At 60°F (15. 5°C). 100 -proof whiskey contains 50% alcohol by volume; 86 -proof whiskey contains 43% alcohol. N Sailors and Rum Chapter 8

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BAC male = 0. 071 x (oz) x (% alcohol) body weight What would be the approximate BAC of a 185 pound man who has consumed three shots (1. 5 oz each) of Jack Daniels (80 proof = 40% alcohol) within an hour? Should he drive? What about after an hour? BAC male = 0. 071 x ( ( _______ oz) x ( ) % ) = X Burn off rate of 0. 015% per hour but can vary Chapter 8

BAC female = 0. 085 x (oz) x (% alcohol) body weight What would be the approximate BAC of a 185 -pound female (yes, she is a giant - 6’ 5” tall) who has consumed three shots (1. 5 oz each) of Jack Daniels (80 proof = 40% alcohol) within an hour? BAC female = 0. 085 x ( ( oz) x ( ) % ) After an hour: _______ X 0. 015% = Chapter 8

Henry’s Law N When a volatile chemical is dissolved in a liquid and is brought to equilibrium with air, there is a fixed ratio between the concentration of the volatile compound in the air and its concentration in the liquid; this ratio is constant for a given temperature. THEREFORE, the concentration of alcohol in breath is proportional to that in the blood. N This ratio of alcohol in the blood to alcohol in the alveolar air is approximately 2100 to 1. In other words 1 ml of blood will contain nearly the same amount of alcohol as 2100 ml of breath. Chapter 8 Kendall/Hunt Publishing Company Kendall/Hunt Company 51

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Field Tests N Preliminary test: determines the degree of suspect’s physical impairment and whether or not another test is justified. N Psychophysical tests— 3 Basic Tests § Horizontal gaze nystagmus (HGN): follow a pen or small flashlight, tracking left to right with one’s eyes. In general, wavering at 45 degrees indicates 0. 10 BAC. § Nine Step walk and turn (WAT): comprehend and execute two or more simple instructions at one time. § One-leg stand (OLS): maintain balance, comprehend and execute two or more simple instructions at one time. Chapter 8 Kendall/Hunt Publishing Company Kendall/Hunt Company 55

The Breathalyzer N More practical in the field N Collects and measures alcohol content of alveolar breath N Breath sample mixes with 3 ml of 0. 025 % K 2 Cr 2 O 7 in sulfuric acid and water 2 K 2 Cr 2 O 7 + 3 C 2 H 5 OH + 8 H 2 SO 4 2 Cr 2(SO 4)3 + 2 K 2 SO 4 + 3 CH 3 COOH + 11 H 2 O N Potassium dichromate is yellow, as concentration decreases its light absorption diminishes so the breathalyzer indirectly measures alcohol concentration by measuring light absorption of potassium dichromate before and after the reaction with alcohol Chapter 8 Kendall/Hunt Publishing Company Kendall/Hunt Company 56

N The Alcolock car breathalyzer Chapter 8

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Generalizations N During absorption, the concentration of alcohol in arterial blood will be higher than in venous blood. N Breath tests reflect alcohol concentration in the pulmonary artery. N The breathalyzer also can react with acetone (as found with diabetics), acetaldehyde, methanol, isopropyl alcohol, and paraldehyde, but these are toxic and their presence means the person is in serious medical condition. N Breathalyzers now use an infrared light absorption device with a digital read-out. Prints out a card for a permanent record. Chapter 8 Kendall/Hunt Publishing Company Kendall/Hunt Company 60

People in the News John Trestrail is a practicing toxicologist who has consulted on many criminal poisoning cases. He is the founder of the Center for the Study of Criminal Poisoning in Grand Rapids, Michigan which has established an international database to receive and analyze reports of homicidal poisonings from around the world. He is also the director of De. Vos Children’s Hospital Regional Poison Center. In addition, he wrote the book, Criminal Poisoning, used as a reference by law enforcement, forensic scientists and lawyers. Chapter 8 Kendall/Hunt Publishing Company Kendall/Hunt Company 61

More Information Read more about Forensic Toxicology from Court TV’s Crime Library at: http: //www. crimelibrary. com/criminal_mind/forensic s/toxicology/2. html Chapter 8 Kendall/Hunt Publishing Company Kendall/Hunt Company 62