Deliriant poisons DATURA Datura sanskrit cheat Is a

Deliriant poisons

• DATURA • Datura sanskrit cheat • Is a genus of vespertine flowering plants belonging to the family solanacae • Grows on waste land all over India. • SPECIES- Datura. Metel and D. stramonium are imp. D. Metel has two varities D. alba and D. niger • Plant- leafy herb with a woody stalk that grows upto 5 feet tall. Flowers- bell shaped, have five petals; fruits: spherical, have sharp spines gives the plant the name thornapple

Difference between seeds of chilly and datura Chilly Datura size Small Large Shape Rounded Kidney shape surface smooth pitted Odour Pungent Odourless Taste Pungent Bitter Cut section Embryo curves inwards towards the hilum Embryo curves outwards

• - contain upto 500 yellowseeds. look much like chilly seeds and must be differentiated. • ACTIVE PRINCIPLES AND MOA • Scopolamine, atropine, hyoscyamine • These alkaloids competitively inhibit the muscuranic effect of Ach • SIGNS AND SYMPTOMS • Contact with leaves or flowers- Dermatitis in sensitive persons • 15 D ‘S: Decreased muscle coordination, delirium, delusions, dermatitis, dialated pupils, dreadful hallucinations, drowsiness, drunken gait, dry hot skin, dry membranes, dryness of mouth and throat, dysphagia, dysuria, death due to respiratory failure , dysarthria

• • Signs Pulse- 120 -150/min Vol- arrhythmia BP – raised R/R- increased Temp- increased Muscle tone and reflexes- increased with positive Babinski’s sign

• • • FATAL DOSE- Atropine-120 mg Scopolamine-30 mg Datura seeds- 50 -100 FATAL PERIOD 24 HOURS MANAGEMENT Shift pt to a quiet and dark environment Monitor and correct Respiratory assistance Decontamination- emetics, gastric lavage- datura seeds may be recovered from stomach after even 36 hours

• Purgatives- to continue for 3 -4 days to remove seeds • Activated charcoal • IV Fluids, antidotes: Physostigmine- antidote of choice dose- adult- 2 mg iv slowlyrepeated if required in 20 -60 mins • Symptomatic- agitation- diazepam iv • PM APPEARANCES • Stomach and intestines- walls- inflammed, fragments of seeds and plant may be found. Seeds resist putrefaction for a long time. • Lungs- edematous

• ML Importance • Suicidal poisoning: common in rural areas • Dhatura seeds are generally used by robbers to stupefy travellers and rarely used as abortifacients. • Accidental poisoning: occurs among children and adults by eating raw dhatura fruits as edible fruits and eating their seeds as chilly seeds

• Cannabis Indica/ canabis sativa- Indian hemp • It’s cultivation is restricted and controlled by government • The female plant is taller , is darker and has more cluster of leaves than the male plant • It produces a sticky and amorphous gum: cannainone, which contains cannabinol • ACTIVE PRINCIPLE: Tetrahydrocannabinol

• Forms : • Bhang /siddhi/ patti • It is prepared by rubbing dried leaves and bark of the female plant with sugar and black pepper. It is taken in the form of a bolus or pill or mixed with water. It is mildest form of cannabis • It produces intoxication of most cheerful kind causing a person to sing and dance and to eat food with great relish. This usually lasts for 3 hours followed by sleep. • MAJUN(MAJOON): A sweet made from bhang, after treating it with sugar, flour, milk and butter. Used as appetizer and aphrodisiac

• Ganja : It has a rusty green colour , gum extract of the leaves of the female plant. It is first rubbbed on the palm with water til iit becomes sticky, then mixed with tobacco and then smoked mainly by sadhu, fakirs and laborours • Marijuana(marihuana): dried flowering tops, crushed and smoked in a pipe o as a cigarette. • Charas: a dark green or brown colour concentrated gum extract of leaves and stem of a plant. It is smoked

• CHARACTERISTIC FEATURES • ACUTE POISONING • Occurs in , not accustomed to the use of cannabis, symptoms occur in half an hour to it’s ingestion, occurs in two stages: • Stage of inebriation, includes excitement, visual hallucination, euphoria, uncontrolled laughter, talkativeness, marked increase in appetite, craving for sleep, and purposeless muscular movements, ataxia, dryness of mouth

• Stage of narcosis: frightful hallucination, delirious, homicidal tendencies or fear of death. • CHRONIC POISONING • Due to excessive consumption of cannabis for a prolonged period. • Characterized by: loss of appetite, generalized weakness, emaciation, loss of concentration • Muscular incoordination and lack of sexual power • Gynaecomastia in males • Mouth and lungs cancer • Moral and mental deterioration, toxic psychosis

• Hallucination of a painful naturel, violence, the wilful destruction of property and murder • FATAL DOSE: 1000 -2000 mg • FATAL PERIOD- 12 hours • TREATMENT • Stomach wash • Saline purgative • Oxygen administration • Artificial respiration • Symptomatic therapy

PM APPEARANCE Insignificant ML Aspects Accidental poisoning: common by bhang. Cannabis is a drug of abuse, particularly among sadhus • SUICIDAL POISONING: Rare • HOMICIDAL POISONING : Not uncommon. Charas and majun are used to stupify travellers and steady nerves before commiting a crime. • •

• Continuous use can turn a person amok, a psychic disturbance, characterized by depression , followed by desire to kill, till homicidal tendencies lasts. Then he either commits suicide, or calmly surrender.

Cocaine(snow) • A colourless, odourless, crystalline substance having a bitter taste. • CLINICAL FEATURES • Acute poisoning • Cocaine first stimulates and then depresses CNS. This produces • Euphoria , restlessness, talkativeness and the reflexes are increased. • Fever with rigors • Dryness of mouth and throat, dysphagia • Feeling of tingling sensation in the mouth, hands and feet

• Cramps in stomach, irregular and thready pulse, shallow , gasping respiration • Finally, convulsions and coma. Death occurs usually from respiratory failure. • Fatal dose: oral: 1. 25 gm • S/C injection 40 mg • Fatal period : few minutes to a few hours

• Chronic poisoning (cocainism) • Occurs in addicts , usually seen in upper classes of society to improve image. It causes: • Pale face , sunken eyes, insomnia, digestive disturbances • Dilated pupils, wasting, emaciation, tremors and impotence • Hallucination , melancholia, and mania with delusion of worries. • Magnan’s symptoms: formication leading to itching sensation

• Tongue and teeth: jet black( Due to chemical reaction with lime and saliva with cocaine) • TREATMENT • Symptomatic therapy • Diazepam for convulsions • Alpha and beta blocker for hypertension • PM APPEARANCES • Internal organs including brain shows marked hyperemia • Evidences of nasal erosions and ulceration in snuffers

• MEDICOLOEGAL ASPECTS • Accidental poisoning occurs by the internl use of subcutaneous injections and from uretheral , vesical and rectal injections • Homicidal and suicidal poisoning : unknown