SECTION 2 Corrosive (Caustic)

Poisons 3. Hydrochloric acid

Inorganic Acid - Most of the information Synonyms
mentioned in the foregoing section actually  Muriatic acid; Spirit of salts.
pertains to inorganic or mineral acids, while Physical Appearance
corrosion is not really a prominent feature of  It is a colourless, fuming liquid which
organic acids. may acquire a yellowish tinge on
exposure to air
1. Sulfuric acid Uses
 Bleaching agent (less than 10% HCl)
Synonym
 Dyeing industry
 Oil of vitriol; Oleum; Battery acid.
 Metal refinery
Physical Appearance
Usual Fatal Dose
 heavy, oily, colourless, odourless, non-
 About 30 to 40 ml.
fuming liquid, It is hygroscopic,
Diagnosis
1. Litmus test
Sulfuric acid is mainly used in two forms:
 Commercial concentrated sulfuric acid
4. Hydrofluoric acid
is usually a 93–98% solution in water.
 Fuming sulfuric acid is a solution of Physical Appearance
sulfur trioxide in sulfuric acid.  Hydrofluoric acid is a colourless, fuming
Usual Fatal Dose liquid.
 About 20 to 30 ml of concentrate Uses
sulfuric acid. Deaths have been  Industry:
reported with ingestion of as little as  Laboratory chemical.
3.5 ml.  Window cleaning.
Diagnosis Usual Fatal Dose
 Litmus test  Unclear, but is probably in the range
of 10 to 15 ml.
2. Nitric acid
5. Phosphoric Acid
Synonym
 Aqua fortis; Azotic acid; Engraver’s Physical Appearance
acid; Hydrogen nitrate.
 Phosphoric acid is a clear, colourless,
Physical Appearance
odourless, unstable, orthorhombic
 Nitric acid is a colourless or yellowish
crystalline
fuming liquid. with an acrid,
Uses
penetrating odour.
 Phosphoric acid is used as a flavouring
Uses/Sources
material,
 Nitric acid releases oxides of nitrogen
 Phosphoric acid is also utilised in
into the air upon exposure to light.
dental ceramics
Usual Fatal Dose
 About 20 to 30 ml.
Usual Fatal Dose
Mode of Action
 About 300 to 500 ml.
 NA is a powerful oxidising agent and
reacts with organic matter to produce
Diagnosis
trinitrophenol, liberating nitrogen
 Add 2 ml of ammonium molybdate
monoxide (xanthoproteic reaction).
solution,
Diagnosis
 Litmus test
6. Boric Acid 2. Formic Acid
 Boron is an inorganic, non-metallic Synonyms
element,  Aminic acid; Formylic acid; Hydrogen
Physical Appearance carboxylic acid; Methanoic acid.
 Boric acid is a white powder or Physical Appearance
crystalline solid.  Colourless liquid with a pungent,
Uses penetrating odour.
 Medical Uses/Sources
 Household  Formic acid is a natural constituent of
 Industial some fruits. Formic acid is an important
Usual Fatal Dose toxic metabolite produced in methanol
 About 15 to 30 gram poisoning.
 Industrial, therapeutic , agricultural uses.
7. Chromic Acid
 It is a derivative of the metal chromium, Usual Fatal Dose
being one of the hexavalent chromium  Ingestions of less than 10 grams in
compounds, children have resulted in oropharyngeal
Treatment burns; no deaths were reported
 Chelation therapy with BAL may be helpful.
 Dimercapto-propane-sulfonic acid (DMPS) 3. Carbolic Acid
is a new drug with promising results Synonyms
 Hydroxybenzene; Phenol; Benzenol;
ORGANIC ACIDS Phenyl alcohol.
Physical Appearance
1. Acetic Acid  Colourless, needle-like crystals which turn
Synonyms pink and liquefy when exposed to air
 Ethanoic acid; Ethylic acid; Methane Derivatives
carboxylic acid; Pyroligenous acid  Catechol, cresols, menthol, resorcinol,
Physical Appearance thymol: Toxic
 Colourless, volatile liquid with a  Hexyl resorcinol, naphthol: Less Toxic
characteristic pungent odour. Tannic acid: Least Toxic
Uses
 60% solution: printing, dyeing, plastics, Uses
and rayon manufacturing, hat making. Carbolic acid was introduced as a disinfectant
 6to40%solution:disinfectant,pharmace in the 19th century by Lemaire, and quickly
uticals, hair wave neutraliser. became popular ever since Lord Lister
 4 to 5% solution: vinegar
Usual Fatal Dose 4. Oxalic Acid
 About 50 to 100 ml of concentrate Synonyms
acetic acid.  Ethanediolic acid; Dicarboxylic acid; Salt of
Clinical Features sorrel.
 Local effects PhysicalAppearance/Derivatives
 Ingestion  Oxalic acid, the simplest dicarboxylic acid, is
 Inhalation a potentially toxic chemical which is
Diagnosis synthesised commercially and is also
 Odour of vinegar in the vicinity of the naturally present as a salt in many plants
patient Uses/Sources
 Oxalic acid occurs naturally in plants and
vegetables such as wood sorrel, rhubarb and
 spinach. Alkali extraction of sawdust and the
metabolism of many moulds will also produce
oxalic acid
Usual Fatal Dose
 About 15 to 30 grams of oxalic acid. Mode of
Action Liquid oxalic acid has moderate
corrosive action on skin and mucosa.
Alkalis and Other Caustics
 Alkalis commonly encountered in poisoning
include ammonia (usually in the form of
ammonium hydroxide), carbonates of sodium
and potassium, and hydroxides of sodium,
potassium, and calcium. Sodium hypochlorite
is also increasingly being implicated.
Physical Appearance
 Most of these occur as white powders or
colourless solutions. Ammonia gas is
colourless with a pungent, choking odour.
Uses
 Ammonia gas—Smelling salts.
 Ammonium hydroxide (32.5% ammonia)—
Paint, oil, and dirt remover, refrigerant.
 Sodium hydroxide (caustic soda)—Drain
cleaner, oven cleaner.
 Potassium hydroxide (caustic potash)—Drain
cleaner, hearing aid batteries.
 Sodium carbonate (washing soda)—
Household cleaning agent, detergent.
 Potassium carbonate—Household cleaning
 agent.
 Sodium hypochlorite—Household bleach.
Usual Fatal Dose
 About 10 to 15 gm for most alkalis.
 About 15 to 20 ml for ammonia.
Mode of Action
 Locally, alkalis produce liquefaction necrosis
which results in extensive penetrating
damage because of saponification of fats and
solubilisation of proteins
OTHER CAUSTICS
1. Potassium Permanganate
Synonyms
 Condy’s crystals; Chameleon mineral;
Purple salt.
Physical Appearance
 room temperature, potassium
permanganate exists as dark purple or
bronze-coloured, odourless, sweetish,
astringent orthorhombic crystals
Uses
 industrial uses include bleaching resins,
waxes, fats, oils, cotton, silk and other
fibres; dyeing wood; printing fabrics;
purifying air and water; etching rubber
and plastic; and tanning leathers.
 Therapeutically,it is used as a topical anti-
infective. In veterinary medicine it is used
as a topical antiseptic, astringent, and
deodorant.
Usual Fatal Dose
 About 5 to 10 grams.
Mode of Action
 potassium permanganate is an irritant, and
in highly concentrated form it acts as a
corrosive.
2. Iodine
Physical Appearance
 Blue-black, glittering crystals which
constantly give off violet coloured vapour
(a process called sublimation) with a
peculiar odour.
Uses
 Antiseptic preparations: Y Lugol’s iodine
(5% iodine with 10% potassium iodide in
water). Y Tincture of iodine (2.5% iodine
and 2.5% potassium iodide, or 2% iodine,
2.4% sodium iodide, 47% alcohol, and
water). Y Povidone-iodine (5 to 10%
iodophor, i.e. mixture of polyvinyl-
pyrrolidone and iodine).* Y Iodex (iodine
with methyl salicylate)
Usual Fatal Dose
 About 2 to 5 grams of free iodine, or 1 to 2
ounces of strong iodine tincture.
Mode of Action
 Locally, strong iodine solution can be an
intense irritant.
3. Hydrogen Peroxide
Synonyms
 Albone; Carbamide peroxide; Hydrogen  Fireworks
dioxide; Urea peroxide.  Military use
Physical Appearance  insecticed and rodenticide
 Commercial topical solution of hydrogen  Fertiliser
peroxide is a clear, colourless liquid with a Usual Fatal Dose
faint ozone-like odour and bitter taste  About 60 mg (roughly 1 mg/kg body
Uses weight).
■ Disinfectant Clinical Features
■ Radiology  Fulminant Poisoning
■Mouth wash/gargle.  Acute Poisoning
■ Hair and teeth bleaching.  Dermal Contact
■ Vaginal douche.  Chronic Poisoning
■ Industry  This usually results from long-
Usual Fatal Dose term occupational exposure to the
 Not clear. Fatalities are mostly associated fumes of phosphorus pentoxide
with industrial grade solutions. and results in the condition called
Mode of Action Phossy Jaw (Glass Jaw, Lucifer’s
 Hydrogen peroxide decomposes to water Jaw) which was first described by
and oxygen. Bristowe in 1862.
 Chronic exposure to red
4. Cetrimide phosphorus or phosphorus
 Cetrimide (atrimonium bromide) is a sesquisulfide may cause
quaternary ammonium compound. It is dermatitis
commonly
Use 2. Phosphoric Acid or Phosphine
 as a disinfectant Synonyms
Usual fatal dose  Hydrogen phosphide; Phosphoretted
 is said to be about 3 grams. Treatment is hydrogen.
the same as for all caustics. Administration Physical Appearance
of soap solution orally as a first-aid  Colourless, flammable gas with an odour of
measure may help inactivate its toxic effect. garlic or decaying fish.

Section 3 chemical poison

Non-Metallic Chemical Poisons  Uses
 Fumigant.
1. Phosphorus term as “light-bearing”.  Grain preservative in the form of
aluminium phosphide.
There are two main varieties
 Rat poison in the form of zinc
 Yellow (or White) Phosphorus This is a phosphide.
yellowish, waxy, crystalline solid with a Usual Fatal Dose
garlicky odour.is highly combustible and  Inhalation of phosphine at a concentration
ignites into flame at 34 °C . It is luminescent of 400 to 600 ppm can be lethal in 30
and glows in the dark (phosphorescence) minutes. Exposure to 50 ppm is considered
 Red Phosphorus This is a reddish or dangerous to life and health.
brownish, amorphous, odourless substance.
“Black phosphorus” is the inert, nontoxic 3. Aluminium Phosphide
allotropic form of elemental phosphorus.
Physical Appearance
Uses
 Matches
  Aluminium phosphide is marketed in
India under various trade names
(Alphos, Bidphos, Celphos, Chemfume,
Delicia, Fumigran, Phosphotek,
Phosphume, Phostoxin, Quickphos,
Synfume, etc.)
Uses
 Grain preservative: Aluminium
phosphide is said to be the most ideal
grain
Usual Fatal Dose
 One to three tablets.
Treatment
 Emesis is not to be induced.
4. Zinc Phosphide
Physical Appearance
 Zinc phosphide is available as dark grey
tetragonal crystals or crystalline powder
marketed under various trade names
(Agrophos, Commando, Sudarshan, Ratoff,
Ratol, Robart, etc.)
Uses - Rodenticide
Usual Fatal Dose - About 2 to 4 grams.
HALOGENS
 Iodine and iodides have been discussed
under Caustics. The other halogens of
importance include chlorine, bromine, and
fluorine.
1. Chlorine
Physical Appearance
 Chlorine is a greenish-yellow gas with a
pungent odour.
Uses/Sources
 Chlorine is not found free in nature due
to its reactivity with other chemicals.
 Chlorine is employed in purifying
drinking and swimming water, for
sanitation of industrial and sewage
wastes and other disinfecting uses.
 It has been used as a poisonous gas for
military purposes under the name
bertholite.
Usual Fatal Dose
 Concentrations of over 50 to 100 ppm
when inhaled can be rapidly fatal.
Instant death can occur at
concentrations over 1000
Mode of Action
 Chlorine is an extremely active oxidising
agent and causes rapid and extensive
destruction of organic tissue.
 swimming pools where chlorine is often
used as a disinfectant.
2. Bromine
 Bromine is a dark reddish-brown, heavy
liquid with irritant brown fumes.
 Methyl bromide is used in soil fumigation
which can result in bromide levels as high
as 380 mg/kg in vegetables such as lettuce,
spinach, tomatoes, radishes, and
cucumbers among others.
Usual Fatal Dose
 Blood bromide level of 300 mg/100 ml is
potentially lethal. Levels greater than 50 to
100 mg/100 ml are usually associated
with signs and symptoms of toxicity.
Clinical Features
 Bromine is extremely corrosive to the
eyes, skin, bronchial
tree and mucous membranes in liquid or
vapour form.
 When therapeutic drugs containing
bromides are taken for a long period,
chronic poisoning results refered to as
bromism
 Bromides cross the placenta and may be
detected in the milk of nursing mothers.
Case reports suggest that prenatal
exposure may cause growth retardation,
craniofacial abnormalities and
developmental delay.
Treatment
1. Acute Poisoning—
 Milk or water can be administered as a
first-aid measure.
 Activated charcoal in the usual
manner (for organic bromide
compounds).
 Treatment of convulsions with
diazepam or phenytoin or babiturates.
2. Chronic Poisoning—
 Stop bromide ingestion.
 Oral or intravenous sodium chloride. It
promotes excretion of bromides.
3. Fluorine
Physical Appearance
 Fluorine is a diatomic halogen gas. It is a
very corrosive and toxic gas, and is found in
the soil in combination with calcium
 Salts (referred to as fluorides) include
sodium fluoride and
 sodium fluoroacetate. Both are crystalline,
white, odourless, tasteless, and strongly
alkaline.
Uses
1. Sodium fluoride and sodium fluoroacetate are
widely used as cockroach and rat killers.
2.In dentistry, fluorides are used in toothpastes,
topical gels, and mouthwashes.
Usual Fatal Dose
 70 to 140 mg/kg of fluoride ion. In general,
2.2 mg of sodium fluoride contains 1 mg of
fluoride ion.
 Fatal blood fluoride level: more than 0.2
mg/100 ml.
 Urinary fluorine output of less than 5 mg/L
is used as an index of safe working level for
long-term exposure.
Mode of Action
 Fluorine and fluorides act as direct cellular
poisons by interfering with calcium
metabolism and enzyme mechanisms.
 Fluoride combines with hydrochloric acid
in the stomach to form hydrofluoric acid
which is a powerful corrosive
Clinical Features
1. Acute Poisoning—
 Fluorine is an extremely strong tissue
irritant, causing caustic irritation of eyes,
skin, and mucous membranes.
 Inhalation of fluorine gas leads to headache,
respiratory distress, polydipsia, and
polyuria.
2. Chronic Poisoning—
 Leads to a condition called fluorosis: This
is usually the result of high fluoride
content in water supply
Skeletal fluorosis is a different entity which is
also associated with high fluoride
concentration in water and soil.
Heavy Metals
1. Arsenic
 Arsenic is thought to occur throughout the
universe. It is the twentieth most common
element in the earth’s crust.
 Arsenic is today the commonest source of
acute heavy metal poisoning, and is second
only to lead in the incidence of chronic
toxicity
Physical Appearance
 Arsenic is a metalloid. Arsenic is a silver-
grey or tin-white, shiny, brittle, crystalline
and metallic-looking element.
Usual Fatal Dose
 200 to 300 mg for arsenic trioxide.
 In general, the pentavalent form of arsenic
(arsenate) is less toxic than the trivalent
form (arsenite) because it is less water
soluble.
 The most toxic form is arsine gas (25 to 30
ppm can be lethal in 30 minutes).
2. Lead
 Lead is the commonest metal involved in
chronic poisoning.
Physical Appearances and Uses
 Elemental lead exists as a highly lustrous,
heavy, silvery-grey metal Lead acetate
(sugar of lead) has been used in
therapeutics,*
 lead carbonate (white lead) is still used in
paints, lead oxide (litharge) is essential for
glazing of pottery and enamel ware, and
tetraethyl lead is mixed with petrol as an
antiknock to prevent detonation in
internal combustion engines.
Usual Fatal Dose
 This is not really relevant to lead since
acute poisoning is very rare. The average
lethal dose is said to be 10 gm/70 kg for
most lead salts, while it is 100 mg/kg for
tetraethyl lead.
Toxicokinetics  About 10 to 20 grams of copper
 Lead is absorbed through all portals of sulfate
entry. Occupational exposure results mainly
from inhalation, while in most other
situations the mode of intake is ingestion. Other Metals and Metallic Elements
Tetraethyl lead can be absorbed rapidly
through intact skin. 1. Antimony
Mode of Action  The important derivatives of antimony.
 Lead combines with sulfhydryl enzymes Uses
leading to interference with their action.  Alloys
Clinical Features  Plating
 Acute poisoning - This is rare  Pigments
 Chronic poisoning- Mild Toxicity  Batteries
Severe Toxicity – A bluish black lead line on  Ant paste (insecticide)
gums (Burton’s line)  Matches
 Therapeutics
3. Iron
Pysical Appearance 2. Barium
 Metallic iron is silvery white in colour,  Important derivatives include barium
occurring naturally as haematite, magnetite, sulfate, sulfide, chloride, and carbonate.
etc Uses
Uses/Sources  Rat poison—barium carbonate, hydroxide,
 Dietary Sources: or chloride.
 The required daily amount of iron of  Depilatory—barium sulfide.
10–20 mg for adults is supplied through  Gastrointestinal x-ray—barium sulfate
average diet. (the “barium meal”).
 Environmental Sources: Y Iron is found  Golf balls—barium sulfate (along with
in 5.1% of the earth’s crust. It is the calcium carbonate, zinc sulfide, castor oil,
second most abundant metal, and the and fish oils).
fourth most abundant element. Usual Fatal Dose
 Industrial uses  Barium carbonate—60 to 70 mg/kg
 Iron is primarily used in powder  Barium chloride—12 to 20 mg/kg
metallurgy and serves as a catalyst in  It has been reported that the LD50 for
chemical reactions barium ingestion is 1 gram.
 Biological uses 3. Cadmium
 Iron is essential to life.  Cadmium is a bluish, lustrous, and light
Usual Fatal Dose metal which is a common contaminant of
 The usual fatal dose corresponds to about several metal ores such as lead, copper,
200 to 250 mg of elemental iron per kg of and zinc
body weight Uses
 Welding.
4. Copper  Electroplating
Physical Appearance  Alloy in jewellery making.
 Copper is a lustrous, ductile, malleable,  Batteries (nickel-cadmium).
odourless solid with a distinct golden-  Pigments
red or reddish-brown colour.  Shampoo
 Copper salts produce toxicity. Soluble
salts, such as copper sulfate 4. Cobalt
Usual Fatal Dose
 Cobalt is a hard, steel-grey or silver-grey  Potassium is a soft silvery white metal
coloured. found in the earth’s crust and is an
Uses essential electrolyte.
 Manufacture of extremely hard steel and  potassium depletion, treatment of
cutting tools. arrhythmias that are potassium
 Cobalt compounds are contained in dependant, as a salt substitute, in
enamels, glazes, glass, pottery and paints. conjunction with anticholinesterase agents
Cobalt is often added to beer to promote the in restoring muscular strength, and in the
formation of foam. treatment of thallium poisoning.
 A component of vitamin B12  Potassium is the principal cation in
(cyanocobalamin), cobalt plays an intracellular fluid, and along with sodium
important role in human nutrition. Vitamin and chloride, is essential for regulation of
B12 is necessary for properdevelopment of osmotic pressure and acid-base balance.
red blood cells; its absence causes
pernicious anaemia 9. Thallium
 Thallium is a soft and pliable metal which
5. Lithium is acquiring an Increasingly notorious
 Lithium is strictly speaking not a heavy reputation as an ideal homicidal poison.
metal. Uses
 Lithium chloride was once used as a  Glass and dye industry
substitute for table salt in hypertensive  Rodenticide
patients Lithium is also used industrially in  Depilatory
nuclear reactors as a coolant, alkaline  Fireworks
storage batteries, and alloys.  Cardiac perfusion imaging.

6. Magnesium
 Magnesium is a white mineral element
which is an important component of the
human body present in soft tissue, muscle,
bone, and body fluids
 Magnesium salts are used in
pharmacotherapeutics as antacids
(magnesium trisilicate, magnesium
carbonate, magnesium hydroxide.
 Magnesium salts rarely cause poisoning
since the kidneys normally excrete the
magnesium ion with sufficient rapidity to
prevent its accumulation

7. Manganese
 Manganese is a grey-white, silvery, hard,
brittle, lustrous transition metal
Uses
Metallic manganese is primarily used in the
manufacture of steel and as an ingredient in the
production of ferrous and nonferrous alloys

8. Potassium Kalium