Chapter 14 Toxicology

Learning Outcome: Students will learn the following;

 Be able to define Poison
 Have a ample knowledge regarding dosages
 Identify how the poison was administered and corresponding antidote

FORENSIC TOXICOLOGY

Toxicology – branch of science that treats of poison, their origin, physical and chemical
properties, physiological action, treatment of noxious effect and methods of detection.

Toxicology came from the words “toxico” that means poison and “ology” that means study or
science

Poison – from the medical point of view, is a substance that when introduced into the body is
absorbed through the blood stream and acting chemically is capable of producing noxious
effect.
Classification of Poison
1. According to Kingdom
a. Animal – e.g. Cantharides
b. Vegetable – e.g. Strychnine
c. Mineral – e.g. Hydrochloric Acid
2. According to Chemical Properties
a. Inorganic Poison – poison without carbon molecule
 Volatile – bromine, chlorine, iodine
 Non-volatile – sulfuric acid
 Mineral acid – HCl
 Mineral alkalis - NaOH
b. Organic Poison
 Volatile – alcohol, chloroform
 Alkaloid – are nitrogenous organic basic compound with a bitter taste that
occurs especially in seed plants. e.g.Strychnine
 Animal poison – snake venom
 Bacterial – ptomaine
 Organic poison - saly
3. According to Physiological Action
a. Corrosives – highly irritant poisons that cause local destruction of the tissues and
characterized by nausea, vomiting, great local distress. e.g. strong acids and alkalis
b. Irritants – one that produce irritation or inflammation of the mucus membrane and
characterized by vomiting, pain in the abdomen and purging. e.g. arsenic
c. Narcotics – one that produce stupor, complete insensibility or loss of feeling. e.g.
opium, domerol and cocaine
d. Neurotics – one that act chiefly on the nervous system producing delirium,
convulsion and respiration as the outstanding symptoms. E.g. CO, alcohol, opium
and strychnine
e. Tetanics – substances that act chiefly upon the spinal column producing such
spasmodic and continuous contraction of muscles as a result of stiffness or
immobility of the parts to which they are attached.
f. Depressants or sedatives – agents that retard or depress the physiological action of
an organ. e.g. nicotine and cocaine
g. Aesthetics or exhaustive – agents that produce exhaustion and marked loss of vital
or muscular power. e.g. hydrocyanic acid
4. According to Pharmacological Function
a. Substances characterized by local action – volatile oils and skin irritants
b. Substances characterized by their action after absorption – alkaloid
c. Heavy metals and metalloids – ex. Phosphorus, arsenic and mercury
5. According to Methods of Isolation
a. Volatile poisons are those isolated by distillation with or without current or steam. e.g.
alcohol, phenol, chloroform
b. Non-volatile poisons are those isolated by extraction wth organic solvents. e.g.
alkaloids and organic acid
c. Metallic poisons that are isolated by refluxion. e.g. arsenic and mercury
 d. Substances for which special method of isolation are required. e.g. acids and alkali
metals are extracted with water

Two types of Poisoning

1. From the Medical Point of View
a. Acute Poisoning - one in which there is prompt and marked disturbance of function
or death within a short period of time and is due to taking a strong poison in
excessive single dose or several doses at short interval
b. Sub-acute poisoning – cases of short duration and extreme violence that may
include symptoms of chronic poisoning
c. Chronic Poisoning - kind of poisoning in which there is gradual deterioration of
functions of tissues and may or may not result in death. Either taking several small
doses at long intervals or taking only toxic doses of the drug.
2. From Legal Point of View
a. Accidental Poisoning – poison was taken without intention to cause death. It may be
taken by mistake or without knowing that it is poison
b. Suicidal poisoning – the victim voluntarily take the poison for the purpose of taking
his own life.
c. Homicidal poisoning – the poison was given wilfully, wantonly and with intent to
cause death to the victim.
d. Undetermined – the history is hazy as to how the poison was obtained and why it
was administered.

ACTION OF POISON
1. LOCAL – the changes or disturbance produced on the part with which the poison come
in contact. Ex:the corrosion produced by corrosive poisons
2. Remote – the changes or disturbance produced in distant parts away from the site of
application. Ex: dilation of the pupils when the belladonna is taken orally
3. Combined – the effect of the poison is not only localized at the site but also affects some
remote organs. Ex. Phenol causes corrosion of the gastro-intestinal tract (local) and
causes convulsion(remote)

POSOLOGY - science which deals with the study of the form and quantity of medicine to be
administered within a certain period

DOSE - is the quantity of medicine to be administered at one time.

The dosage concept is important. Whether a drug acts as a therapy or poison, it will
depend on the dose. Even water is poisonous if too much is ingested.

Kinds of Dose
1. Safe dose- is one that does not cause harmful effects. Sometimes however it may be too
small to produce the desired effects.
2. Toxic or poisonous dose- is one that is harmful both to the health and the sick.
3. Lethal or fatal dose- is the dose that kills
4. Minimum dose- is the smallest amount of medicine that can produce the desired therapeutic
effect without causing harm.
5. Maximum dose - the largest amount that will cause no injury but at the same time produce
desired therapeutic effects.
.
ENTRANCE OF POISON
POISON MAY ENTER THE BODY THROUGH:
1. Mouth and are absorbed into the circulation after passing the stomach and intestinal wall
2. Nose and enter the blood from the upper respiratory passages or lungs
3. Eyes
4. Rectum, vagina, urethra, bladder and ureter by injection
5. Hypodermic injection
6. Intravenous injection

ELIMINATION OF POISON
POISON MAY BE ELIMINATED BY:
1. Emesis 5. Milk
2. Respiration 6. Sweat
3. Feces 7. Saliva
4. Urine 8. Tears
GENERAL TREATMENT OF POISONING
1. Removal of poison from the stomach – if the poison is taken orally the removal of the poison
is brought about by:
A. Inducing vomiting using emetics (are substance or agents that produce vomiting)
Classes of emetics:
a) Local emetics – produce their effects by the irritation of the terminal nerve
filaments of the pharynx, esophagus or stomach
b) System or general emetics – produce their effects through the medium of
circulation

B. Use of stomach pump or tube

 If the poison is applied or instilled – wash
 If the poison is injected – ligatures and bleeding
2. Administration of antidotes
Antidote - Is any agent that neutralizes a poison or otherwise counteracts or opposes its
effects.
ACTION- to act as an antidote, it may:
a. Remove the poison from the body: emetic
b. It may mechanically prevent its absorption (demulcent): Cathartic
c. It may change the physical state or chemical composition.(ex. Na2SO4 to barium)
d. It may act upon the functions of the body so as to overcome the effects of its
absorption

Kinds of antidotes:
a) Mechanical Antidote - is an agent that removes the poison without changing it, it coats the
surface of the organ so that absorption is prevented.
Ex. stomach tube and pump, emetics, cathartics, demulcents, precipitants
ligatures, washes,injections, poultries.
Cathartic- Is an agent that produces intestinal evacuation.
Uses of Cathartics
 To remove the compound that is formed by the action of the chemical
antidote.
 To hasten elimination of poison
Demulcent - is an agent that forms a protective film; soothes and protects the parts
where demulcent is applied.
Precipitants - these are substances that prevent absorption os poisons by precipitating
them and rendering them insoluble.

b) Chemical Antidote – substance that make the poison harmless by chemically altering it.
c) Physiological Antidote – sometimes called “antagonist”. Agent that acts upon the system so
as to counteract the effect of the poison. It merely masks the symptoms produced.

3. Elimination of poison by excretion – poisons are eliminated through excretory organs. Made
by intravenous infusion of saline solution, dilute alkali solution or dilute solution of glucose.
The poison is generally excreted through the urine, feces, vomitus or saliva

4. Stimulation and other symptomatic treatment

a. For excessive pain – morphine or other analgesics
b. For convulsion – chloroform
c. For shock – oxygen inhalation

5. Special treatment
 If the is gas – immediate need is fresh air and artificial respiration
 If poisoning is external (like burn on the hand by concentrated acid) – wash with
plenty of water or with alcohol, sodium bicarbonate, lime water or milk of magnesia.
 If alkali burn – wash with lemon or other citrus fruits
 If the poison has come from a bite or injection – the poison can be checked from
spreading through the body by applying tourniquet or a restricting band tightly above
the wound. This retards the absorption of poison by the blood. The poison may be
removed by sucking.