INEBRIANT POISONING.pptx

inebriants

1. INEBRIANT POISONING

2. CHARACTERIZED BY Excitement Narcosis Classical Inebriant Alcohol

3. ALCOHOL (ETHYL ALCOHOL)

4. APPEARANCE Transparent, colorless, volatile, spirit-like odor and burning taste. Examples Rum Whiskey Gin Wines Beers

5. METABOLISM Rapidly absorbed from GI tract which depends on 1 . Concentration of alcohol 2. Presence or absence of food in the stomach 3. Condition of the Stomach Wall 4. Rate of Drinking 5. Weight of person 6. Development of tolerance 90% of absorbed alcohol is oxidized in liver and 10% is excreted by kidneys and lungs.

6. ETHYL ALCOHOL POISOING(ACUTE) Depresses the CNS (from cortex to medulla) Depresses the higher centers that controls the judgement and behavior ( Stage of excitement) Depresses the motor centers (Stage of incoordination) Depresses the Vital centers in medulla (Stage of narcosis)

7. STAGE OF EXCITEMENT Laughs, converses well May disclose secrets Talk in vulgar language

8. Incoordination of thoughts, speech and action. Impaired Judgement, confusion, slurred speech and staggering Morose, euphoric or irritable Nausea, Vomiting Pupils are dilated STAGE OF INCOORDINATION

9. Deep sleep and responds well to stimuli. Rapid, temperature, subnormal, breathing, stertorous Pupils contracted MAC EWAN’S SIGN : Pinching the neck or face pupils dilate or reach to their original size STAGE OF NARCOSIS

10. FATAL DOSE Concentration of 0.35% (350mg) FATAL PERIOD 12 to 24 hours

11. TREATMENT Gastric Lavage(5 %solution of sodium bicarbonate) Saline purges and IV hypertonic glucose solution Hemodialysis/ Peritoneal dialysis

12. POSTMORTEM APPEARNCES Furred tongue Bruises all over the body Blood is fluid and dark Brain is edematous Oedema of larynx Fatty liver Stomach has gastritis

13. Liability to fatal complications such as head injuries, serious bleeding from trivial injuries , suffocation, drowning and exposure Medicolegal Importance

14. CHRONIC POISONING

15. CHARACTERIZED BY Gradual physical, moral and mental detoriation Lack of personal hygiene Loss of appetite Chronic gastroenteritis Wasting Peripheral neuropathies Impotence and sterility Fatty changes in liver and heart

16. State of excitement with hallucinosis Lasts 3 to 4 days Results from Unusual bout of drinking Sudden withdrawal of alcohol Acute infection Shock from injury Exposure to cold Treatment : Chlorpromazine 100mg QID IV hypertonic glucose to relieve cerebral oedema DELIRIUM TREMENS

17. KORSAKOFF’S PSYCHOSIS Syndrome characterized by hallucinations, disorientation, multiple neuritis Acute hallucinations Auditory with systematized delusions of persecution lasting from weeks to months. Treatment Antabuse Disulfiram Temposil (Calcium carbamide citrated)

18. POSTMORTEM APPEARANCE Degenerative changes in the liver, kidneys and brain, atrophic gastritis Cirrhosis of liver Cardiomyopathy