WHAT IS POISON?

NATURE OF POISON AND

CLASSIFICATION AND MAJOR DRUGS IN POISONING

HAFSA SHAHID

1
 What is poison?

The Renaissance physician Paracelsus (1493-1541) is famously credited

with offering the philosophical definition of poison:
“What is there that is not poison?
All things are poison and nothing is without poison. Solely the dose
determines that a thing is not a poison.”

Casarett & Doull's Essentials of Toxicology, Second Edition (Casarett and Doull's Essentials of Toxicology) 2nd Edition

2
Nature of Poisoning & Classification

https://www.slideshare.net/Muavia12/poisoning-managementwhat-is-poisoning-and-how-to-manage-poisoning-cases 3
 Nature of Poisoning & Classification
1. Homicidal poisoning
Killing of a human being by another human being by administering
poisonous substance deliberately.
• The prevalence of homicidal poisoning is found to be 0.3%–3.7%.
• Most common group of the poisons was pesticide, especially
organophosphate.
• Individual poisons involved were aluminium phosphide, arsenic,
formalin and, methanol.

https://dfsl.maharashtra.gov.in/1112/Toxicology?format=print
4
 Nature of Poisoning & Classification
2. Suicidal
When a person administer poison himself to end his/ her life.
E.g. easily available insecticides, anesthetic drugs, medicines,
acids and phenyls.

https://dfsl.maharashtra.gov.in/1112/Toxicology?format=print
5
 Nature of Poisoning & Classification
3. Accidental
Generally takes due to carelessness or negligence in home or at
work place. E.g.
Household poisons- nail polish remover, acetone.

Dart RC, Caravati EM, McGuigan MA, et al: Medical Toxicology, 3rd ed. Lippincott Williams & Wilkins, Philadelphia, 2004
6
 Nature of Poisoning & Classification
4. Occupational
It usually occurs in professional workers. e.g.
• Poisonous gases
• Organic solvents
• Pesticides

https://slideplayer.com/slide/13695283/
7
 Types of exposure
• Acute exposure
Is a single contact lasts for seconds, minutes, or hours, or several
exposures over about a day or less e.g. cosmetics, pesticides etc.
• Chronic exposure
Is a contact that lasts for many days, months or years e.g. metals,

organophosphates, carbamates etc.

https://www.slideshare.net/bekaaberra/poisoning-17110863?qid=9621ff6a-88a1-46c1-b452f5338004a9&v=&b=&from_search=6
8
 Common pathophysiologic mechanisms
• Interfere with transport or tissue utilization of O2 e.g. CO
• Depress or stimulate CNS
• Affect autonomic nervous system e.g. organophosphate
• Affect lungs by aspiration e.g. hydrocarbon
• Affect the heart and vasculature myocardial dysfunction e.g.
antidepressant
• Produce local damage e.g. corrosive
• Affect on the liver e.g. acetaminophen

https://www.slideshare.net/bekaaberra/poisoning-17110863 9
 Poisoning Evaluation: Toxidromes

Toxidrome = A collection of symptoms and signs that consistently

occur after ingestion of a particular toxin or drug class
• Often identified with a basic history and physical examination
• Rapid identification of the toxidrome saves time in evaluating and
managing a poisoned patient

Kinetic Anatomy with Web Resource, 3rd Edition

10
Poisoning Evaluation: Toxidromes

Kinetic Anatomy with Web Resource, 3rd Edition 11

 How poisoning may occur and poisonous
products
• Overdosing of medicine or using medicine that does not belong to
you
• Being bitten or stung by venomous animals
• Coming in contact with poisonous chemicals
• Touching poisonous plants
• Inhaling poisonous gases or fumes from strong cleaning products
• Pesticides
• Petrochemicals

Casarett & Doull's Essentials of Toxicology, Second Edition (Casarett and Doull's Essentials of Toxicology) 2nd Edition
12
 Factors that contribute in poisoning
• Developmental stage
• Gender
• Poverty
• Taking many different medications
• Mental illness
• Mixing alcohol with drugs
• Use of street drugs

https://www.emedicinehealth.com/drug_overdose/article_em.htm#what_are_risk_factors_for_drug_overdose
13
 Ideal poison characteristics

• Tasteless
• Odorless
• Colorless
• Readily soluble
• Delayed onset of action
• Exotic
• Undetectable
• Chemically stable before administration
Dart RC, Caravati EM, McGuigan MA, et al: Medical Toxicology, 3rd ed. Lippincott Williams & Wilkins, Philadelphia, 2004.
14
 Major drugs in poisoning
• Paracetamol
• Aspirin.
• Benzodiazepines
• SSRIs
• TADs
• Anticonvulsants
• Other analgesics including NSAIDs

Casarett & Doull's Essentials of Toxicology, Second Edition (Casarett and Doull's Essentials of Toxicology) 2nd Edition
15