CHAPTER XVIII: TOXICOLOGY

•Toxicology - is a scientific study of poisons, their

nature, properties, effects and detection and the
treatment in case of poisoning.

Toxicology - deals with poisons, their origin,

physical and chemical properties, effects and
treatment and methods of detection.
Importance of Toxicology
a. to verify if it is a case of poisoning
b. to be able to treat as the occasion
demands
c. to forward justice
Poison - is the substance that when introduced in
to or absorbed by a living organism causes death
or injury.
Types of Poisons
1. True poison- is one that still poisons no matter how
diluted it is.
E.g. Hydrogen Cyanide (HCN)

2. Corrosive Poison- is one which by contact with it

chemically produces local destruction of tissues.
E.g. Nitric acid (HNO3)

3. Cumulative Poison- is one that increases suddenly in its

intensity of action after gradual additions of it.
E.g. digitalis; arsenic
Types of Poisoning
A. Acute poisoning - one in which there is prompt
and marked disturbance of function or death within a
shorter of time and is due to:
1. taking a strong poison
2. excessive single dose
3. several doses, small but frequent.

B. Chronic Poisoning – kind of poisoning in which there

is gradual deterioration of functions of tissues and may or may
not result in death.
1.taking several small doses at long intervals
2.Taking only toxic doses of the drug
Three Major Case Load Areas

1. Police Cases - toxicological aspects of

criminal investigations.

2. Postmortem cases - analytical studies

In support of the medical examiner to
determine the cause of death.

3. Drug Abuse Cases - resulting from the

illegal use of drugs
Evidence of Poisoning

1. Circumstantial or moral evidence - Is an evidence deduced from

occurrence of facts and circumstances.
Ex. Motives for poisoning, purchasing the poison, keeping
the materials used.
2. Symptomatic evidence - includes the symptoms observed during
the poisoning.
Ex. Arsenic poisoning is like choler; alcoholic coma may
stimulate diabetic coma.
3. Chemical evidence - obtained by chemical analysis of the suspect
substance or the vomit or secretion of the body.
4. Postmortem evidence – obtained from the examination of the
tissues and organs after death.
5. Experimental evidence - obtained by administering the suspected
substance to some living animal and noting the effect of
symptoms.
 2 Stages of Methods of Examination
1. Isolation - when the submitted specimen is in pure form, the
poison must first be isolated.
A. Volatile poisons - isolated by extraction with alcohol
and chloroform.
B. Non-volatile poisons - isolated by extraction with
organic solvents such as strychnine and other alkaloids.
C. Metallic poisons - these are poisons such as arsenic,
mercury and lead
d. Other substances requiring special methods of
isolation like corrosive acids.
2. Identification - the method employed for the identification
of poison is specific. Preliminary tests should be conducted.
Such test include microscopic examination and flame tests.
History of Modern Technology

Paracelsus - (16th Century) German Swiss

physician/alchemist who first stressed the chemical nature of
poison and its action by experimentation. He introduced dose
concept.
Prof. Matthieu Orfila - (19th Century) attending physician
to Louis XVIII, correlated chemistry of toxins with the biological
effects it produces in a poisoned individual.

Four Elements Of Poisoning

1. Poison
2. The Poisoned Organism
3. The injury to the cells
4. The symptoms and the signs of death
CLASSIFICATION OF POISONS
A. Classification based on origin
1. Animal/toxin - a poison produced by living
organism stimulating antibodies.
2. Vegetable - Poison Ivy and Jimsonwood weed
plants
3. Mineral - Hydrochloric Acid, caustic alkali
4. Microbial - produced by microscopic organisms
ex. Bacteria and fungi
5. Synthetic - manufactured by chemists such as
drugs, pesticides as well as chemical purified from natural
sources such as metals from ores and solvents from
gasoline.
B. According to chemical properties
1. Volatile poisons - compounds that can be isolated using
steam distillation and analyzed using Gas Chromatography with
thermal head attached on it.
Ex. (acidic medium) cyanide, ethanol, methanol,
nitrobenzene.
2. Non-volatile poisons - most drugs are non-volatile
3. Anions – carbonate, sulfite, nitrate
4. Metallic
5. Miscellaneous (e.g. Pesticides)
C. Classification based on Physical Form or Property
1. Solid – not well absorbed into the blood
2. Liquid
3. Gas
4. Vapor
5. Aerosol - hairspray
D. According to action (Physiological)
1. Irritants – by direct contact, this poison inflames the mucous
membrane o parts it comes in contact with.
ex. Bromine
True Irritants - bromine, chloride, cotton oil
2. Corrosives - direct contact, chemically produces local
destruction of tissues. Ex. Disinfectant
3. Neurotics - affect the central nervous system
a. Cerebral neurotics: Narcotics
ex. Alcohol, opuim, tabacco
b. Spinal Neurotics: Tetanics
ex. Strychnine, picrotoxin
c. Cerebrospinal Neurotics
i. Deliriants- ex. Cannabis indica, cocaine
ii. Depressants- ex. Antipyrine, lobella
4. Aesthetics/Exhaustive - cause mark loss of vital or muscular power
or general weakness.
Ex. Acotine, KCN, Digitalis
According to their effects on the body/target sites
1. those which cause local destruction (skin)-
phenol, HCI
2. Blood Poisons- carbon Monoxide (CO) Hydroxide
Cyanide
3. Nervous Poisons (nervous system)
4. Cardiac poisons (Cardiovascular system)

Factors in Determining the Dissolution Rate

1. Solubility
2. size of Granules
Solubility of the Drugs

Dose - the greater the size the greater the effect. This is not
always true.

The Physical State or Form of Poison

Dilution- when the poison is diluted, the absorption is rapid,

thus, resulting to intense toxic effect.

Mode of administration
poison is more rapidly absorbed when injected in the
veins than when taken orally.
Associations with other poisons
association with other kinds of poisons may
increase the toxic effect.

Entrance and Elimination of Poisons

Poison may enter the body through: They may be eliminated by:

Mouth Emesis
Skin Respiration
Nose and eyes Feces
Rectum and Vagina Urine
Hypodermically Milk
intravenously Sweat, Saliva and tears
Posology - is a science which deals with the study of the
dosage of medicine to be administered within a certain
period.

Medicine - any substance which can be administered to

correct or to alleviate the disease or disordered state of
the system.

Dose- quantity of medicine to be administered at one time.

 Types of Dose
 SAFE DOSE – is one that does not cause harmful effects.
Sometimes, however, it may be too small to produce the
desired effects.
 MINIMUM DOSE – is the smallest amount of medicine that
can produce the desired therapeutic effect without causing
harm
 MAXIMUM DOSE – is the largest amount that will cause no
injury but at the same time produce the desired therapeutic
effects
 TOXIC or POISONOUS DOSE – is one that is harmful both to
the healthy and the sick
 LETHAL or FATAL DOSE – is the dose that kills
 ANTIDOTES
 Is any agent that neutralizes a poison or otherwise
counteracts or opposes its effects.
 ACTION – to act as an antidote, it may:
 Remove the poison from the body:emetic
 It may mechanically prevent its absorption
(Demulcent):cathartic
 It may change the physical state or chemical composition (e.g.
Na2SO4 for Barium)
 It may act upon the functions of the body so as to overcome
the effects of its absorption.
 Kinds of Antidotes

 Chemical or true or specific

 Mechanical antidote or antidotal measure
 Physiological antidote or antagonist or
symptomatic antidote
 Chemical, True or Specific
Antidote

 Is one that makes the poison harmless by

chemically altering it.
 Mechanical Antidote or Antidotal
Measure

 Is an agent that removes the poison without

changing it; coats the surface of the organ so that
absorption is prevented.
 Physiological Antidote/
Symptomatic (Antagonist)

 Is an agent that acts upon the system so as to

counteract the effects of the poison
 Emetics – is an agent that causes vomiting.

 Cathartic – is an agent that produces intestinal

evacuation

 USES of CATHARTICS:
 To remove the compound that is formed by the action of
the chemical antidote.
 To hasten elimination of poison
 Demulcent – is an agent that forms a protective
film; soothes and protects the parts where
demulcent is applied

 Precipitants – are substances that prevent

absorption of poisons by precipitating them and
rendering them insoluble.
 Causes of Death in Poisoning

1. Cardiac Failure
2. Respiratory Failure
3. General Devitalizing
4. Shock t the nervous system