1 / 28

SOMNIFEROUS POISONS (OPIOIDS)

Excitement. Narcosis. SOMNIFEROUS POISONS (OPIOIDS). Known as somniferous poisons or narcotics Reduce pain Induce sleep Important poisons i . OPIUM. ii. HEROIN (Brown sugar) Synthetic derivatives of opium ( Diacetyl morphine) Strong analgesic Narcotics Cause severe addiction

james-patton
Download Presentation

SOMNIFEROUS POISONS (OPIOIDS)

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Excitement Narcosis SOMNIFEROUS POISONS (OPIOIDS) Known as somniferous poisons or narcotics • Reduce pain • Induce sleep Important poisons i. OPIUM

  2. ii. HEROIN (Brown sugar) • Synthetic derivatives of opium (Diacetyl morphine) • Strong analgesic • Narcotics • Cause severe addiction iii. PETHIDINE(Meperidine) • Analgesia • Euphoria • Very high addiction • Difficult to treatment

  3. OPIUM & MORPHINE OPIUM (AFIM):- Dried juice obtained by incision of unripe capsule of white poppy (Papaversomniferum) • There are two groups of alkaloids • Phenanthrene • Isoquinoline

  4. Phenathrene Group • Morphine about 10% • Codeine about 0.5% • Thebaine about 0.3% • Dionin • Heroin (Diacetyl Morphine) • Isoquinoline Group • Papaverine about 1% • Narcotine about 6% (They are mild analgesic but no narcotic effect)

  5. Ripe and dry capsule of poppy contain very little opium. • Poppy seeds (khaskhas) are creamish in colour and contain no opium. • Used as food and oil for cooking. • Alkaloids of opium used in medicine are • Morphine • Codeine • Apomorphine: Used as emetics They act as narcotic and sedative

  6. SIGNS & SYMPTOMS Acute poisoning , mainly acts on CNS in three stages • Excitement • Stupor • Narcosis

  7. STAGE OF EXCITEMENT: • Sense of well being • Laughter • Hallucination • Increase in H.Rate • Convulsions may occur in children

  8. STAGE OF STUPOR • Headache • Giddiness • Diminished sensibility • Strong tendency to sleep • Awake only by painful stimuli. • Pupils are contracted • Lips & face are cyanosed • Pulse normal • Respiration normal

  9. STAGE OF NARCOSIS: • Deep coma • Muscles relaxed • Reflexes abolished. • Pupils contracted • No reaction to light • BP is low • Skin is cold • Profuse perspiration • Temperature is low less than 35oC

  10. IN FATAL------ • Cyanosis • Fine froth for month. • Breathing is sighing & irregular (2-4/m) • Pulse is imperceptible. • Pupils dilate terminally • No reaction to light. • Coma deep & respiratory paralysis.

  11. DIAGNOSITC POINT: • Breath smells of opium(raw flesh) • Pin point pupils with no reaction to light. • Moist perspiring skin ----------- • Low temp < 35oC • Cyanosis, froth at month & nose.

  12. D/D: • CVA (elderly hypertensive,pontinehmg) • Metabolic conditions • Uraemic coma • Diabetic coma • Alcohol poisoning • Organophosphorous poisoning • Carbolic acid poisoning • Epileptic ,hysterical coma and in barbiturate poisoning

  13. TREATMENT Emetics – ineffective – due to depression of vomiting centre.

  14. Stomach wash • with tepid water, initially & then • with KMNO4 : 1: 5000 strength till the washed water returns with original pink colour • Some KMNO4 should be left in stomach to oxidize alkaloids that is secreted in stomach after absorption • In the absence of KMNO4, wash stomach with.

  15. Tea or tannic acid • Mixture of powder Charcoal & water. IMPORTANT: • Gastric lavage should be done if the drug is taken by Hypo dermic or S / C injection as alkaloid is resecreted into stomach after absorption.

  16. SPECIFIC: • Nalorphine(Specific antidote to opium) • 5 – 10 mg after every 15 minutes till • Pupils begin to dilate • Response becomes normal • Patient is aroused • Maximum dose 40 mg

  17. Naloxone (pure antagonist): • 0.4 – 0.8mg I/m or I/V to be repeated every 10 to 15 minutes • Maximum dose 10 mg • Antibiotic in case of prolonged coma. • Artificial respiration • Keep the body warm • Symptomatic treatment

  18. MEDICOLEGAL ASPECTS • Mostly suicidal easily availability & painless. • Homicidal rare due to bad smell and taste, mostly used in infanticide . • Accidental poisoning due to over dosage. (death on the needle)

  19. OPIUM ADDICTION Chronic poisoning morphinism morphinomania Chronic poisoning is characterized by • Physical • Mental • Moral degeneration

  20. SIGNS OF PHYSICAL DEGENERATION • Emaciation • Infections • Anorexia • Constipation • Impotence • Sterility, etc

  21. SIGNS OF MENTAL DEGENERATION • Loss of memory • Irritability • Depression • Gradual dementia

  22. SIGNS OF MORAL DEGENERATION • Criminal attitude • Distorted personality

  23. HEROIN (BROWN SUGAR) • It’s a synthetic derivative • Most potent addictive drug • Smack,junk,dope & brown sugar • Can be smoked, inhaled or injected

  24. SHOOTING GALLERY: Is the place where heroin activities are conducted. BOOTING/ FOOLING: Is the process of injecting small amount of drug, withdrawing some blood to ensure that the needle is in the vein & to keep the lumen open, helps to asses the potency of drug & for intermittent injection.

  25. Tolerance develops rapidly Withdrawl symptoms are: • Sweating • Malaise • Anxiety • Depression • General feeling of heaviness • Cramps in limbs In case of severe addiction there is also twitching & convulsions.

  26. Heroin is rapidly metabolized, blood samples can be negative after 30 – 60 min. • Urine samples may show morphine alkaloids for hours or days even after a single dose

More Related