Organic Irritant Poisons

Question 1

Abrus precatorius / Ratti / Indian Liquorice / Jequirity / Rosary pea

Answer 1

Ratti seed
Oval
Red /white + black spots
May be whole black
Active (Abrin, Abrine, Abralin, Abric acid)
FD - 1-2 seeds (crushed)
Non poisonous as whole / boiled
More toxic via subcutaneous
FP - 3-5 days
Cause of death - cardiac failure

Question 2

Features of Abrus / Ratti

Answer 2

Locally in eyes
conjunctivitis
Ingestion
Nausea + vomit
Gastric irritation
Haemorhhagic gastritis
Abdominal pain
Bloody diarrhoea
Pupil constricted
Cold perspiration
Weakness
Trembling of hands
Convulsion

Question 3

Autopsy features of Abrus

Answer 3

Ingestion - Gatric mucosa
Congested
Haemorhhagic
Injection (Sui / Sutari)
Painful swelling
Oedema
Ecchymoses
Inflammation
Oozing haemorhhagic fluid
Necrosis

2 needle prick marks ( needle + Sui)

Question 4

Management of Abrus

Answer 4

Admit
Gastric lavage / induced emesis
Activated charcoal
Sodium bicarbonate (prevents RBC agglutination)

Question 5

MLI of Abrus

Answer 5

Arrow poison (powder)
Malingering (powder) (by army for medical leave) (induces unilateral conjunctivitis)

Question 6

MOA of Abrus(Ratti) , Ricinus(Castor)

Answer 6

2 chains (A + B + disulphide bond)
B - binds
Entry by endocytosis
A - inactivated ribosomes

Question 7

Ricinus communis / Castor / Arandi

Answer 7

Fruit
Green
Spiny
3 lobed capsule (1 seed each)
Seed (2 types)
Larger type
Red colour + brown blotches
Smaller type
Gray colour + brown spots/mottling

Active (Ricin)
FD - 8-10 seeds (crushed) / 6mg ricin
FP - 3-5 days
Intact whole / cooked seed is non-poisonous.
Used as Purgative

Fruit confused with Datura
Seeds (shiny) confused with croton seeds (dull)

Question 8

Clinical features of Castor / Ricinus

Answer 8

Clinical features
Nausea
Vomit
Bloody diarrhoea (dehydration)(hypotension)
Abdominal pain
Liver + Renal failure

Question 9

Management of Ricinus / castor

Answer 9

Management
Iv fluids + vasopressors
Gastric lavage
Demulcents
Whole bowel irrigation

Question 10

MLI of Ricinus

Answer 10

Most toxic in plant kingdom(rating 6)
X2 toxic as cobra venom

Classified as potential biological threat category B (2nd highest priority).

Homicide (umbrella assassination)
Malingering (powder)(conjunctivitis)

Question 11

Croton tiglium

Answer 11

Seeds equal to small type castor seeds
Active principles
Crotin
Crotonol
Crotonic acid
Methyl crotonic /tiglic acid
Crotonoleic acid
Crotonoside
FD - 4 seeds / 1-2 ml oil
FP - 6h - 3 days
Poisoning by press cake / oil (disagreeable odour).

Question 12

Signs of Croton tiglium

Answer 12

Nausea
Vomit
Diarrhoea
Hot burning pain (mouth - stomach)
Vertigo
Prostation
Collapse
Death

Castor oil
Burning
Redness
Vesication
Suppuration (skin)

Autopsy features
Organs congested

Question 13

Management of croton tiglium

Answer 13

Gastric lavage
Demulcents
Symptomatics

Question 14

MLI of croton

Answer 14

Accidental
Suicidal
Homicidal
Abortifacient (oil + root)
Arrow poison
Ayurvedic oil
Ordeal poison

Question 15

Semecarpus Ancardium / Marking nut / Dhobi nut / Bhilwa

Answer 15

Fruit
Used by washermen for marking (Dhobi mark dermatitis)
2-3 cm long
Ovoid
Heart shaped
Pericarp has bitter irritant juice (brown oily resinous fluid)(black in air)

Active (Bhilawanol, Semicarpol)
FD - 5-10g

Question 16

Symptoms of semecarpus

Answer 16

Vomit
Diarrhoea
Dyspnea
Hypotension
Tachycardia
Delirium
Coma
Death

Management
Gastric lavage
Demulcents

Question 17

Autopsy features of semecarpus

Answer 17

Blisters
Mouth
Throat
Congested stomach

Question 18

MLI of semecarpus

Answer 18

Artificial bruising (false bruise)
Lesions
Raised
Blackish
Painful
Itchy blister (margins)
Scratching cause finger tip blisters
Acid serum
Eczematous eruptions (skin around)
Ulcers

Accidental
Criminal abortion
Malingering (conjunctivitis)
Vitriolage (thrown on face)
Dhobi mark dermatitis (+ chemical urushiol)

Question 19

Capsicum / chillies / Red pepper

Answer 19

Active (Capsaicin, Capsicin)
Not fatal
Hunan’s hand
Burning lesions of fingers
Occupational (bare hands)
Burning pain
Hyperalgesia
Erythema
Dermatitis

Question 20

MOA of capsicum

Answer 20

Release substance P from afferent sensory neurons
Causing pain

Question 21

MLI of capsicum

Answer 21

Criminal purpose (robbery)
Defence against potential rapist
Hyderabadi goli
Lathi + chilli powder into anus
Torture
Extort confession (police)
Accidental
Datura poisoning (seeds confused)
Superstition
Scare ghost / spirits
Decrease negative energy effects

Question 22

Calotropis / Madar / Milkweed / Akdo

Answer 22

Weed
Milky latex when leaves / stem cut
2 Species (gigantean , procera)
Active ( Calotropin, Calatoxin, Calactin, Uscharin)

FP - 6-12 hr

Management
Gastric lavage
Demulcents
Symptomatics

Question 23

Symptoms of calotropis

Answer 23

Skin
Redness
Vesication
Bullous eruption
Eyes
Conjunctivitis
Keratitis
Corneal edema
Vision diminision
Ingestion
Acrid bitter taste
Burning pain(mouth,throat,stomach)
Vomit
Diarrhoea
Dilated pupils
Convulsion
Coma
Death

Question 24

MLI of calotropis

Answer 24

Artificial Bruise
Redness
Vesication
Abortifacient (abortion stick)
Infanticide
Root - poisonous to snakes (+cobra)
Cattle poisoning (cloth + poison in rectum)
Folk medicine

Question 25

Catharides / Spanish fly / Lutta vesicatoria / Cantharis vesicatoria

Answer 25

Emerald green bettle
Active (catharidin milky fluid from male beetle’s joint)
FD - 10-80 mg
FP - 24-36 h

Management
Gastric lavage
Demulcents
Vasopressor (peripheral vascular collapse)

Question 26

Symptoms of cantharide

Answer 26

Skin
Burning pain
Redness
Blister
Ingestion
Blister (lips + tongue)
Burning (mouth + epigastrium)
Thirst
Dysphagia
Dysarthria
Nausea
Vomit
Abdominal colic
Tenesmus
Bloody Diarrhoea
Strangury(desire to urinate+less urine)
Priaprism (persistant painful erection)
Abortion
Convulsion
Coma
Death

Question 27

MLI of Cantharides

Answer 27

Aphrodisiac (actually priaprism)
Abortion

Question 28

Autopsy features in Cantharide

Answer 28

GIT mucosa (congested + shiny green particles)