1. Opoids PoisoningSarojYadav

2. Introduction Opium is Latex obtained from Papaver somniferium Also called Poppy It is a alkaloid( Morphine, Codeine, Narcotine, & Papaverine) Used as analgesic , cough suppressant Derivative heroin, apomorphine, oxymorphine Other synthetic derivative are pethidine andpentazocine,methadone 3. Mechanism of toxicity. generally, opioids share the ability to stimulate a number ofspecific opiate receptors in the CNS, causing sedation andrespiratory depression. Death results from respiratory failure, usually as a result ofapnea or pulmonary aspiration of gastric contents. 4. Pharmacokinetics. peak effects occur within 23 hours, but absorption may beslowed by their pharmacologic effects on gastrointestinalmotility. Most drugs have large volumes of distribution (35 L/kg). 5. Toxicity Acute Poisoning When dose exceeds therapeuticdoseSymptoms include: Euphoria Hallucination Tachycardia Vomiting Lethargy Constricted pupil Constipation 6. Severe toxicSymptoms include: Hypotension Relaxation of muscle Hypothermia Respiratory depression Pin point pupil (may dilate in terminal stage) 7. Diagnosis Marquiss Test:Mix 3ml of sulphuric acid with 3 drops of formalin and addthis to suspected tissue or fluid .A purplish colour develops which gradually turns blue 8. Treatment Maintain ABC If needed use endotracheal incubation Stomach levage Naloxone as an antidote Administer naloxone, 0.42 mg IV. As little as 0.20.4 mg isusually effective for heroin overdose. Repeat doses every 23 minutes if thereis no response, up to a total dose of 1020 mg if an opioidoverdose is strongly suspected. 9. IV Dextrose 50% with vitaminB1 Nalfemen as superior antidote Nalmefene may be given in doses of 0.12 mg IV, withrepeated doses up to 1020 mg if an opioid overdose isstrongly suspected. Supportive treatment for hypotension and pulmonary edema 10. Chronic PoisoningSymptoms include: Depression Amnesia Withdrawal from family, friends and social activities Pinpoint pupils Anorexia Weight loss Chronic constipation 11. Treatment Drug usually stopped A less potent drug given Antispasmodic can be given Tranquilizer for bed time sedation Psychiatric counselling