Tobacco (Cardiac Poison) PDF

TOBACCO (CARDIAC POISON) DR JAYANTI JAIN (BAMS, MD ) ASSISTANT PROFESSOR DR VASANT PARIKH AYURVEDIC MEDICAL COLLEGE, VADNAGRA  INTRODUCTION  Botanical Name – Nicotiana tabacum  Family- Solanaceae  Ver...

TOBACCO (CARDIAC POISON) DR JAYANTI JAIN (BAMS, MD ) ASSISTANT PROFESSOR DR VASANT PARIKH AYURVEDIC MEDICAL COLLEGE, VADNAGRA  INTRODUCTION  Botanical Name – Nicotiana tabacum  Family- Solanaceae  Vernacular Name : 1. Hindi Name – Tambaku 2. English Name – Tobacco  Synonyms- Tamraparni  Toxic Part- All Parts Of The Plant Are Poisonous, Except The Ripe Seeds. 2  INTRODUCTION All parts of the plant are poisonous, except the ripe seeds. Dried leaves contain 1–8% nicotine. Leaves contain toxic alkaloids, like nicotine, anabasine, nornicotine and lobeline (in Indian tobacco). An average cigarette delivers 1–3 mg of nicotine. Nicotine is Colorless, Volatile , Bitter hygroscopic oily liquid. Burning acrid taste and disagreeable odor. It is used in agricultural and horticultural work for fumigation and spraying, as insecticides worm powders. 3  TOXIC CHEMICAL CONSTITUENT (ACTIVE PRINCIPLE)  Nicotine  Anabasine  Nornicotine – less toxic 4  RAS PANCHAK  Ras – Katu , Tikt  Guna – Laghu , Ruksha  Virye –Ushna  Vipaka -Katu 5  MODE OF ACTION It acts on the autonomic ganglia, which are stimulated initially, but are depressed and blocked at the Later stages. It also acts on the somatic neuromuscular junction and afferent fibers from sensory receptors. 6  ABSORPTION AND METABOLISM Each cigarette contains about 15 to 20 mg of nicotine of which 1 to 2 mg is absorbed by smoking; each cigar contains 15 to 40 mg. Nicotine is rapidly absorbed from all mucous membranes, lungs and the skin. 80 to 90 percent is metabolized by the liver, but some may be metabolized in the kidneys and the lungs. It is excreted by the kidneys. 7  SIGNS AND SYMPTOMS ACUTE POISONING CVS: Tachycardia followed by bradycardia, hypotension, arrhythmia, tachypnea followed by respiratory depression and collapse. GIT: Burning acid sensation, nausea, vomiting abdominal pain, salivation and odor of tobacco. CNS: Headache, restlessness, confusion, vertigo, sweating, convulsions and coma 8  SIGNS AND SYMPTOMS CHRONIC POISONING RS: Cough, wheeze, dyspnea, chronic bronchitis and lung cancer may develop. CVS: Anemia, palpitations, irregularity of heart, angina pectoris and Berger's disease. GIT: Anorexia, vomiting and diarrhea. CNS and others: Impaired memory, blindness, tremors, insomnia, anxiety and headache. 9  SIGNS AND SYMPTOMS Withdrawal Symptoms Intense urge to smoke, anxiety, impaired concentration and memory, depression or hostility, headache, muscle cramps, sleep disturbances, increased appetite and weight gain, diaphoresis (excessive sweating due to secondary condition) and rapid respirations. 10  FATAL DOSE & FATAL PERIOD FATAL DOSE FATAL PERIOD  Nicotine: 60–100 mg. 5–15 minutes.  Tobacco: 15–30 g. 11  TREATMENT Wash the stomach with warm water containing charcoal, tannin or potassium per magnate A purge and colonic wash out Mecamylamine (inversine) is a specific antidote given orally. Atropine to correct hypotension, and diazepam for convulsions. Cardiac Monitoring Symptomatic Treatment 12  POSTMORTEM EXAMINATION Brownish froth at mouth and nostrils. Stomach may contain fragments of leaves or smell of tobacco. Features of asphyxia are seen. 13  MEDICO -LEGAL ASPECTS  Accidental poisoning results from ingestion, excessive smoking and application of leaves or juice to wound or skin.  Common drug of addiction.  Suicidal/homicidal cases are rare. 14