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 • • • • 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 • • 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
12. Continue • • • 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: • • • • 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 • • • • • • • • To prevent childhood poisoning in case of any type of medicineAlways close the container immediately after
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 • • • • 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.
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 • • • • 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 • • 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
12. Continue • • • 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: • • • • 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 • • • • • • • • To prevent childhood poisoning in case of any type of medicineAlways close the container immediately after
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 • • • • 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.
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