Cardiac poisons

\
Cardiac poisons
Nicotiana Tabacum

Nerium Odorum

Cerebera thevetia

Cerebra Odallam
 Nicotina Tabacum

All parts are poisons except ripe seeds

Dried leaves contains ~1-8% of Nicotine
Toxic Alkaloids
Nicotine
Anabasine
Nornicotine
 Fumigation ,

spraying , insecticide , worm powder in Agriculture.

Each cigarette contains 15-20mg Nicotine

Cigar ~15-40 mg
 Action
Absorbed from mucus membrane , skin , lungs
90% is metabolized by liver,
Remaining metabolized by kidney and lungs
Excreted by Kidneys.
Acts on Autonomic ganglia first stimulates and then
depresses and blocks.
Also acts on somatic NMJ and afferent fibers from
sensory receptors
 Acute poisoning
GIT
Cardiopulmonary Arrhythmias
CNS- Mydriasis
Death- Respiratory failure

Chronic Poisoning
Amblyopia
 FD > 50-100 mg of Nicotine.
Crude Tobacco -> 15-30mg.
NRT -> 6-12 Weeks of maintenance , followed by gradual reduction
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TREATMENT
1. Stomach Wash and Colonic Washout
2. Specific Antidote -> Inversine/ Mecamylamine
3. Atropine / hexamethonium chloride\
4. VD
5. Oxygen
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PM Findings
Asphyxia
 Nerium Odorum
White oleander or kaner
All parts except roots , including nectar are poisonous
Cardiac glycosides
Oleandroside - > digitalis in action
Nerioside -> digitalis in action
Folinerin
Rosagenin
 Signs and Symptoms
Contact dermatitis
Emanations - > Headaches, dizziness, respiratory
difficulty , Nausea
Ingestion -> difficulty in swallowing and articulation ,
profuse frothy salivation and diarrhea , abdominal pain
Pulse is 1st slow and later rapid and weak
Arrhythmias , block
Mydriasis , tetanic spasm , lock jaw,
Death usually results from Cardiac Failure
 FD - > 15-20g of root ,5 to 15 leaves
FP -> 20-36 hours
Treatment -> symptomatic
PMA