Deliriant Poisons

Poisons of this groups exhibit well-marked deliriant effect.Eg: 1. Datura 2. Atropa Belladonna 3. Hyoscyamus Niger 4. Cannabis Indica 5. Cocaine.

Datura Fastuosa ( Dhatura)

Types: 1. Datura Alba 2. Datura Niger

Flowers: Bell shapedFruits: Spherical with spines contains 400-500 seedsSeeds: Yellowish-brown resembling capsicum seeds.

All parts or the plants are poisonous.Seeds and fruits are most toxic.They contains 0.2-0.4% of hyoscine, hyoscyamine and traces of atropine.

Mode Of ActionExerts central and peripheral actionMainly anticholinergic effectsCNS, CVS, Eyes, Smooth Muscles, Glands, Body Temp, Local Anasthetics, decreases bronchial secretion, etc.

CNS EffectsIn small doses stimulates CNSLarge doses depresses CNS, causes delirium and coma.

Peripheral EffectsDepression of cholinergic fibers with parasymphatic paralysis.

Signs/SymptomsHot as hare.Dry as bone.Red as beet.Blind as bat.Mad as hen

These features appear in two stages:1. Stage of delirium2. Stage of coma

Stage of deliriumOnset: few min. to ½ hour.Dry as bone: Mouth & throat will be dryIntense thirstDifficulties in talking and swallowing Burning pain in abdomen

DizzinessConfusionDrunken gait Inability to standHoarseness of voice/aphoniaHot as hare: Skin becomes dry, hot & exfoliatiated

Body temp. may rise as high as 105-107 FRed as beet: Face becomes flusied, conjuntiva red.Blind as bat: Pupils dilated, photophobil, diplopia & loss of accomodation.

Pulse: increasedRespiration: increasedMuscle tone: decreasee deep reflx. muscular spasm.Convulsion.

Delirium sets in as patient may become restless, noisy, violent and may have to be kept controlled in bed by several persons, as he is inclined to run away from bed and wander about.

Mad as hen: Person may be silent or may mutter indistinct, incoherent & inaudible words.Visual, auditory hallucination

Show certain ludicrous movementsGrasping imaginary objectsPicking up bed clothes; imaginary threads from the tips of his fingers(car phologia)

May be in fits of laughter and at other times in tears.a/c delirium may pass off in an hour or so, when patient becomes drowsy & silent.

Person begins to improve & awakes with severe headache, vertigo, nausea and vomiting.Vision remains disordered for a few days until dilatation of pupil subsides.

Finally the patients recovers completely and remembers nothing of his illness or events that had happened.

Stage of ComaOccurs when drowsiness passes into stupor followed by convulsions and coma.Gen. sings of deterioration Death usually results from respiratory depression

Datura is excreted unchanged in urine for 10-20 Hrs. after ingestion.Urine should always be preserved for chemical analysis

Fatal Dose: 100-125 seeds confirms deathFor stupefacation:50-60seedsFatal Period: within 24 Hrs.

Treatment1. Stomach wash: Pot. Perm. 4-5% tannic acid. strong tea, coffee. purgatives by mouth.2. Emetics

3. Physostigmine 1mg i.v./i.m. per hour for 2-3 hours.4. Pilocarpine 5mg s.c.5. Short acting barbiturates for delirium.6. Light diet

Post-mortem AppearanceNot characteristic.CyanosisDilated pupilsGen. signs of poisoningSeeds resists putrefication hence can be recovered from decomposed body.

Medico-legal AspectsRarely used for homicide or sucide.Used as stupefying agent for theft, robbery, rape or kidnapping.Accidental poisoning.

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