Neurotoxic Poisons.pptx.....pptx...........

Neurotoxic poision - vatsnabh, dhatura, kupilu...

1. NEUROTOXIC POISONS

2. धतुरा ( Dhatura )

3. Latin name - Datura metal Family - Solanaceae संस्कृत/हिन्दी नाम - उन्मत, कनक, मातुल, शिवप्रिया, धतुरा English name- Thorn apple Type of poison - Deliriant poison of Neurotoxin category. Toxic part- All parts of plant but specially Seed & fruit. Active principle – Hyocine , Atropine, Hyoscyamine, Scopolamine. Mode of action- Hyocine and Atropine had blocking action on acetylcholine receptors. Initially it stimulates the central nervous system (also in small doses) while later on produce Depression (also in large dose).

4. Fatal dose- Seed- 75-150 seed Alkaloids - 60 mg (Adult) & 4mg (children) Stupefying dose- 40-60 seeds Fatal period - with in 24 hours Signs and Symptoms As per Ayurveda : धूर्तबीजेऽतितृष्णा स्याद् भ्रमः स्वेदः प्रलापकः । मूर्च्छातिकृच्छ्रश्वासश्च मोह आक्षेपकस्तथा ।। Anupānamañjarī Signs and symptoms of poisoning due to seeds of dhūttūrā are: ■ atitṛṣṇā (non-satiating thirst ■ bhrama (giddiness) ■ svedapravṛtti (profuse sweating) ■ pralāpa (delirium) ■ mūrcchā (fainting) ■ atikṛcchra śvāsa ( labour breathing) ■ moha (stupor) ■ ākṣepaka (convulsions).

5. Clinical manifestation- Dryness of mouth and throat, bitter taste, pain in abdomen (Dry as bone). Inhibition of salvation resulting in Dysphagia and excess thirst. Face flushed due to dilation of cutaneous blood vessels of face leads to Redness in face and conjunctiva. (Red as beet) Diplopia occurs due to dilatation of pupil, it may develop a temporary blindness. (Blind as Bat) Dry & hot skin due to stimulation of heat regulating center, it also result due to inhibition of sweat secretion. (Hot as hare) Delusion, confusion, visual and auditory hallucination, exhibits typical pill- rolling movement, patient try to run away from his bed, unable to recognize relatives and friends. (Mad as wet hen) Giddiness, Restlessness, Unsteady gaits, patient is walking as a drunken man (Drunken gait), vomiting, Coma and death may occur due respiratory center failure.

6. Symptoms can be summarize under 9D- 1. Dryness of mouth, throat 2.Difficulty in talking (Dysarthria) 3. Dysphasia 4. Dilatation of cutaneous blood vessels 5. Dilatation of pupils 6. Drunken gait 7. Dry-hot skin 8 Delirium 9. Drowsiness

7. Treatment As per Ayurveda : ■ Juice of vrntāka phala (in dose of 1 pala ) for consumption ■ Go- dugdha (cow's milk) along with ghrta (ghee) and śarkarā (sugar) - गोदुग्धं प्रस्थमेकं तु शर्करायाः पलद्वयम् । तस्य पानाद्विषं याति धत्तूरस्य च निश्चितम् ।। Anupānamañjarī मोहे तु धत्तूरकखादेनोत्थे सशर्करं क्षीरमुशन्ति वैद्याः । Rājamārttanda ■ In emergency, if above mentioned are unavailable, then make the patient drink water mixed with salt; this helps in emesis of gastric contents. As per Modern Toxicology: Stomach wash (using weak solution) Purgation (in case of delayed management) Cold water irrigation over the head Diuretics Symptomatic management Inj physiostigmine 1-2 mg IV over 2 min Inj Neostigmine 2.5mg IV 3hourly still poisoning reverses.

8. Post-mortem Appearance- External- Cyanosis, signs of asphyxia, Red face and delayed purification etc Internal- Congestion & Inflammation found in gastric mucosa, seed residue may be found in stomach and small intestine, Edema and congestion in lungs, petechial hemorrhage may be found in endocardium of heart. Medico-legal Case- Accidental -In Children due to eating Dhatura seed Suicidal- not possible Homicidal - Not found Road/stupefying poison - used for purpose of robbery and kidnapping. आयुर्वेदिक योग - कनकसुन्दर रस , अगस्तसुतराज रस , महाज्वराकुश रस