1. Prepared By
Md. Feroz Mahmud
Dhaka International University (DIU)
Department of Pharmacy
10 th Batch
2. Forensic pharmacy
• Forensic pharmacy is the application of
pharmaceutical knowledge to the
investigation of crime particularly in
establishing the cause of injury or death.
3. Poisons
All the substances are poison there are no
such things as non poisonous.
Poison is any substance which when
introduced into the body or brought into
the contact of any part of the body will
produce ill effects or death by its local and
systemic effects or both.
4. Types of poison:
• Corrosive:
They are usually organic acid, inorganic acid, mineral acid, alkali etc.
- Citric acid, lactic acid, oxalic acid, formic acid.
- Citric acid, hydrochloric acid, phosphoric acid, Sulfuric acid,
hydrofluoric acid
- Sodium hydroxide, potassium hydroxide, calcium hydroxide etc.
• Irritant:
They are organic, inorganic and mechanical irritant.
Plant origin- Datura, vitex, asparagus,
Animal – some spiders, scorpion, toad, jelly fish
Metal – Antimony, arsenic, barium, cadmium.
• Neurotoxin:
They are cerebral, spinal, peripheral neurotoxin, excitatory,
psychotropics, somniferous, etc.
• Cardiovascular :
Anticoagulant: Dicoumarol, Warfarin, Heparin, Phenindione etc.
Antihypertensive : Ramipril, Verapamil, nifedifine, Captopril, Atenolol
etc.
• Miscellaneous:
Analgesics, non steroidal anti inflammatory drugs (NSAIDs), antipyretics,
antihistamine, hypoglycemic agents, food poisoning etc.
5. What is poisoning?
• It is the phenomenon that occurs by the
ingestion of any poisonous substances or
coming in contact of any poisonous
substances.
6. Types of poisoning
A). Based on effect-
Acute poisoning
Chronic poisoning
Sub-acute poisoning
Fulminant
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Acute Poisoning:
It is poisoning produce by single large dose and more than one small
dosage taken in a short period. Sign and symptom is not fully clear but headache, nausea,
sweating, irritation, swelling, seizures, dizziness, increase heart rate, pain, instigate other
medical problems such as asthma occurs.
Chronic poisoning:
It is the poisoning produce by small dosage taken over a long
period. Its onset is slow but harmful. The typical symptoms and conditions that may develop
over time due to poison includes such as Cancer, damage of kidney, damage of brain,
arsenic poisoning, damage of other organ.
Sub-acute poisoning:
These types of poisoning lie between the acute and
chronic poisoning. Sub-acute poisonings are CO poisoning, organophosphate poisoning
etc.
Fulminant:
It is poisoning produced by massive dose of the poison. Death occur very
rapidly sometimes without any sign and symptoms.
7. Continue
B). Based on the way or process:
• Poisons also may classify into three types. This areSuicidal
Accidental
Abuse
• Suicidal: Poisoning created by one self intentional is
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suicidal most of the poisoning are suicidal.
Accidental: Poisoning occurred by the administration of
the poison un intentionally is accidental.
Abuse: Poisoning occurs as a result of overdose of the
substances that is used by a person for psychological
and physical calmness.
e.g.: Morphine, Nicotine etc.
8. Antidote
An antidote is a substance which counteracts the effects of poison.
Types of antidote:
There are different types of antidotes. These are –
Mechanical and physical antidote
Chemical antidote
Physiological and pharmacological antidote
• Mechanical and physical antidote:
These antidotes act by minimizing the
absorption of the poison.
e.g.: - Demulcents for corrosive and irritant poisons.
- Activated charcoal for alkaloid poisons.
9. Continue
• Chemical antidote:
•
These types of antidotes act either by
chemical neutralization or formation of non-toxic complex
with the poison.
e.g.: - Chelating agents and heavy metal poisons.
- Acetic acid and vinegar for alkali poison.
- Magnesium oxide for acid poison.
Physiological and pharmacological antidote:
These antidotes produce physiological
effects which are opposite to that of the effect poisons.
e.g.: - Atropine for organophosphates.
- Nalorphine for morphine.
10. List of some poisons and their
antidotes
SL No.
Poisons
Antidotes
01
Paracetamol
Acetyl cysteine, Methionine.
02
Opioids
Naloxone
03
Anticholinergics
cholinergic
04
Organophosphates
Atropine and Pralidoxime
05
Heparin
Protamine sulphate
06
Iodine
Starch
07
Heavy metals
Chelating agents
08
benzodiazepines and barbiturates
flumazenil
09
vitamin K anticoagulants, e.g. warfarin
Vitamin k
10
Isoniazid
Pyridoxine
11. Different factors that affect
poisoning
These ares• Age
• location and time
• Responsible for family
• Accessibility to poison
• Poison container
• Individual’s psychological state
• Society
• Legal approach
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Age:
Children (teenager) 70℅, adult 30℅. Accidental poisoning is rare in children
bellow 1 year age, but occurs by immediate elders or by parents without knowing its
danger.
Vulnerable age is 1-3 years old.
46℅ of children’s are within 5-6 years old.
9-15 years old children take poison due to emotion.
Location:
80℅ accidental poisoning among the children occurs at home and home
premises of which 62℅ at kitchen, bedroom, bathroom, family automobile etc. In
bedroom poisoning occur at afternoon when the parents and elders take rest.
Common poisons are kerosene and medication. Poisoning at bathroom may occur
any time. Cleaning agents are culprit both in the kitchen and bathroom. In the kitchen
the poisoning usually takes place at late morning or just before lunch.
Response from family
Incidence of poisoning occurs due to lack of consciousness of the family about the
side, leaving poisonous or toxic material of household use like insecticide, kerosene,
medicine, cosmetics within the rich of children. While hosting some relatives or guest
the family members remain busy and childhood poisoning may occurs.
13. Continue
• Accessibility:
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Medicine, insecticide, cosmetics, all these are
poisons. If these are not kept in locker or out of reach of children, may
cause poisoning.
Poison container:
Removal of potentially toxic material from their
container is a significant cause of accidental poisoning, such as
keeping kerosene in soft drinks bottle.
Individual’s psychological state:
Love, Emotion, Frustration etc.
Society:
Social-economic status, Lack of social control etc.
Legal approach:
Poison act, listing illegal drugs, government control.
14. Prevention of childhood
poisoning
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To prevent childhood poisoning in case of any type of medicineAlways close the container immediately after using.
Use child resistant packing and keep it out of reach of children.
Keep pills in their original container.
Keep irons containing tablets and all medicines out of reach and
out of sight of children.
Child attracting medicine should be kept out of reach and out of
site of children.
Never keep medicine on a counter top or bed side table.
Follow medicine label directions carefully to avoid accidental over
doses or mix doses that would result in accidental poisoning.
15. Advice for hazardous
products:
1. Never transfer these substances to other
containers – milk carton, water bottle, soft drinks
etc.
2. Don’t store any medicine in kitchen or bathroom.
3. Potentially poisonous items should be locked in a
cabinet.
4. After any accidental poisoning at first call doctor
and take advice and then take the person being
poisoned to the hospital immediately.
16. Role of pharmacist in the
prevention of poisoning
cases:
• Community awareness about the consequence
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of drug abuse.
Blocking the production of poisonous material.
Conducting continuous basic health education
program.
Counseling the individual and his or her family.
Making and implementing poisoning act and
poison control legislation.