OPIUM
🛑Opium normally known as "AFIM" is a narcotic poison under the cerebral neurotoxic group which causes narcosis.
🛑What is Narcosis and Narcotic?
Narcosis:It is a state of CNS depression characterized by deep sleep or death like sleep from where the individual can not be aroused by normal stimuli but can be aroused by painful stimuli.
Narcotic:The drug responsible for narcosis🤷♂
🛑Opium also known as "Somniferous Agent" means sleep inducing agent.
🛑Plant name:White Poppy Plant
From its capsule juice is collected at night because sunlight destroys its properties.
🛑Botanical name:Papaver Somniferum
⭕️⭕️Fatal dose:
Opium:2 gm
Morphine:0.2 gm
codiene:0.5 gm
⭕️⭕️Fatal period:6 to 12 hours
🛑Poisonus and non poisonus part:
1.Milk exude from the incision on the unripe poppy capsule is air dried to obtain dark brown opium,that is POISONUS.🥵
2.Ripe and dry poppy capsule contains trace of opium(0.1-0.3%)that is often non poisonous.
3.Poppy seeds(pesta dana) are used in different food preparation such as polao.They are not poisonous.
4.Oil from poppy seeds is used for cooking purpose.
🛑Classification of opium:
(According to source)
Natural:Morphine,Codeine
Semisynthetic:Heroin,Hydromorphine
Synthetic:Meperidine,Methadone
🛑Routes of opium:
1.Hypodermic injection
2.Inhalation
3.Raw surface or wound.
4.Smoke with cigarette.
5.It is obtained from mucous membrane.
Then detoxify in liver and finally excrted through kidney.
❎Action of opium:
Opium and its compound action mecahnism is similar to natural substance called Endonephrine.
Opium depresses all centre except occulomotor,vomiting and sweating.
It is peripherally acting analgesic.
🛑Sign symptoms:
3 stages.
❎Stages of excitement:
1.Increase sense of well being.
2.Increase mental activity
3.Talkativeness
4.Restlessness
❎Stages of stupor:
1.Headache,Nausea,Vomiting
2.Giddiness,Drowsiness
3.Pupil contracted
4.Disorientation
❎Stages of coma:
1.Deep coma from which patient can not be aroused
2.All muscles ar flaccid
3.Reflexes are lost.
4.BP low.
5.Pulse slow.
6.Death occur from asphyxia😑
⭕️⭕️Triad of opium poisoning:
1.Respiratory depression
2.Pin point pupil
3.Impairment of sensation
🛑Treatment of acute opium poisoning:
1.Airway maintainance:Adequate airway should be established.Endotrachial intubation if needed.
2.Stomach wash with 1:5000 Pottasium parmenganate solution.
3."NALOXONE" 0.4 to 0.8 mg I/V or I/M repeated every 15 minutes.
"Nalmefene" can also be used.
4.Correction of fluid and electrolyte.
5.Enema should given 2 times a day to prevent absorption.
❎COMA COCKTAIL:Mixture of NALOXONE+THIAMINE+GLUCOSE give to the coma patient when cause of coma is unknown.
🛑Cause of death:
1.Depression of respiratory centre.
2.Paralysis of respiratory muscle.
🛑Post mortem findings:
External Findings:
1.Cyanosis of face and nails.
2.Froth in mouth and nose.
3.Prominent post mortem staining.
4.Smell of opium in opening chest.
Internal finding:
1.Stomach contain small opium lump.
2.Right side of heart full left side empty.
3.Lung,brain congested.
🛑Differntial Diagnosis:
1.Acute alcohol poisoning.
2.Barbiturate poisoning.
3.Carbolic acid poisoning.
4.CO poisoning.
5.Encephalitis.
6.Meningitis.
🛑Medicolegal importance:
1.Mostly use as suicidal poison because because death is painless.
2.Accidental poisoning is common in patient who use it as aphrodisiac agent.
3.Rarely use as homicide beacuse of bitter taste.But can be used in infanticide.
4.Used for doping race horse.