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CNS Depressants

  1. Ethyl Alcohol
    • Absolute alcohol: 99.5%
    • Rectified spirit: 90%
    • Denatured alcohol: 95% alcohol + 5% wood naptha
      1. Symptoms
        1. State of excitement (flippant stage): alcohol gaze nystagmus occurs at 50 - 150 mg%, jerky movement is in the direction of the gaze and independent of the position of the head.
        2. stage of in-coordination: occurs at 150 - 300 mg%
        3. stage of coma: occurs at >300 mg%, Mac Ewan’s sign is positive, death due to paralysis of respiratory centre.
    1. Saturday Night Palsy
      1. acute intoxication rarely leads to death. recovery usually takes place after some hours of sleep with left-over  (hangover) symptoms like headache, nausea and dizziness.
      2. Hangover is due to resultant hypoglycemia and cerebral edema.
      3. It may also lead to pressure on the radial nerve or trunk when the arm hangs over a chair.
      4. Fatal dose : > 400 mg%
    2. Tests for estimation of alcohol
      Widmark’s formula: A = PCR
      A – amount of alcohol in grams
      C – amount of alcohol in gms/kg in blood
      P – person’s weight
      R – constant (+/- 0.085 for men and +/- 0.55 for women
    3. Tests:
      1. Breath analyzer test is based on Henry’s Gas law – Primary screening test.
      2. Gas Chromatography* – most desirable for MLCs ( simple, sensitive, small quantity of sample required, not interfered with by other ingredients.
      3. Chemical methods – based on the principle of reduction of Potassium – bichromate
      4. Micro method – cavett’s test
      5. Macro method – Hine and Kozelka method (color/spot test)
      6. Tryptophan metabolism is disrupted in chronic alcoholism
Extra Edges
Legal limit prescribed by Motor Vehicle act is 30 mg% of Blood Alcohol Level (BAL)
Critical limit leading to in-coordination of muscles is 150 mg% BAL
Rate of fall in BAC is 12 - 15 mg%/hr, ethanol follows Zero Order Kinetics
Sec 85 IPC gives the same immunity to a person intoxicated involuntarily as
Sec 84 IPC gives to a person of unsound mind.
Sec 86 IPC dealing with voluntary drunkenness imputes the same knowledge
to such a man as he would’ve had, had he not been intoxicated
Sec 510 IPC prescribes punishment for a person who in a state of intoxication, appears at a public place or any other place where he commits trespass and causes annoyance to any person

Methyl alcohol poisoning

  1. Methanol alcohol dehydrogenase formaldehyde
  2. Formaldehyde aldehyde dehydrogenase formic acid
  3. Toxic form : formic acid & formaldehyde
  4. S/s :  Nausea , vomiting, abdominal pain, headache, vertigo

    Retinal injury, Pancreatitis, Metabolic acidosis, seizure, coma
  5. T/t : 
    1. Gastric aspiration
    2. Volume replacement
    3. Sodium bicarbonate
    4. Ethanol or Fomepizole when:
      1. Methanol conc > 6 mmol /l
      2. Increased anion gap acidosis
      3. Visual symptoms 


  1. Dried juice from unripe capsule of Papaver somaniferum (white poppy).
  2. KHAS KHAS: The poppy seeds, are harmless. The oil is used for cooking.
  3. Apomorphine prepared from morphine ,used as an EMETIC
  4. PAINLESS DEATH SO POISON OF CHOICE FOR SUICIDE (because of black color, characteristic odour and bitter taste it is not used for homicide).


S/S:  Stage Of Excitement
  1. Sense of well being , euphoria, maniacal condition.
  2. Erythema, urticaria & itching dermatitis of skin.
  3. Hallucination and rapid heart rate.
  1. Stage of Stupor
    1. Headche , heaviness and drowsiness.
    2. Pin point immobile pupils,
    3. Cyanosis,
  2. Stage Of Coma:
    1. Low respiratory rate followed by Chyne stokes respiration ( sighing and irregular)
    2. Low BP, rapid pulse , dilated pupil.
    3. Moist perspiring skin (all secretion suspended except sweat)  hypothermia.
  3. Withdrawal Systems:
    Tend to be opposite to the acute affects of drug.

Marquis Test

  1. Chemical test to detect the presence of opium.
  2. PM APP. – Raw flesh like smell of opium.
  3. Face is deeply cyanosed almost BLACK (PM Staining – black)
  4. Froth at the mouth ( neither fine nor copious )
  5. Stomach shows brownish lump of opium.
  6. In suspected poisoning viscera + BLOOD , BRAIN & BILE is preserved.


Fatal dose – 2 gms opium = 200 mgs of morphine
Fatal period – 9 to 12 hrs


  1. Emetics don’t act as it depresses the respiratory center.
  2. Gastric lavage with water and then with potassium permanganate.
  3. (some solution left in the stomach as opium is excereted in the        
  4. Stomach after absorption.)Gastric lavage is indicated even     
  5. After hypodermic injection as the alkaloid is reexcreted in the            
  6. Stomach after absorption.
  7. Antidote : naloxone, nalorphine.

Narcotic Analgesic but Non Narcotic

  1. Alkaloids: Phenanthrene
  2. Isoquinoline
  3. Morphine     (10%)                                       
  4. Papaverine (10%)
  5. Codine        (.5%)                             
  6. Narcotine    (6%)
    1. hebaine (◊ convulsion)
    2. Heroin (BROWN SUGAR).

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