Theme of the lecture: "Forensic toxicology " Professor Z.A. Giyasov
The purpose of the lecture: Familiarize with the forensic toxicology necessary for the activities of a general practice doctor.
Plan of the lecture: 1. The concept of poison and poisoning 2. Toxicology and direction 3. Factors affecting the development of poisoning 4. Toxicodynamics, toxicokinetics 5. Steps of the proof in case of poisoning. 6. Classification of toxic agents. 7. Food poisoning. 8. Alcohol poisoning 9. Overdose by narcotic drugs
Toxicology: - Court - Industry - Agriculture - Home - Food - Military
Factors affecting the development of poisoning: A. dependent by poison B. dependent by body C. dependent by route of introduction D. dependent by the environmental conditions.
Factors depending on poison: 1) quantity 2) concentration 3) aggregate state 4) solubility 5) vehiculum 6) cummulation 7) stability
Factors depending on the body: 1) age 2) weight 3) sex 4) disease 5) gastric contents 6) genetic features 7) idiosyncrasy 8) tolerance 9) tachyphylaxis
Toxicodynamics poison primary action sequence activity remote effect
Tropism of the poisons Compound of arsenium- blocks - SH groups of enzymes cyanides - blocks cytochrome oxidase POS- blocking cholinesterase botulinum toxin - inhibits secretion acetylcholine curare - inhibits the action of acetylcholine receptors in muscles
Toxicokinetics poisons methanol formaldehyde CH3OH CH2O (H2C-O) methanol formaldehyde C2H5OH CH3 – CHO ethanol acetaldehyde CH2OH COOH ethyleneglycol oxalic acid
Deposition of toxins in the body fat-soluble toxins (benzene, CCl4 dichloroethane) -PKZHK, brain, liver water-soluble poisons - Brain, liver, kidney, muscle, As, Pb, P - Hair, bones
Elimination of toxins from the body lungs - Volatile, gaseous poisons GIT - Alkaloids heavy metals bile - Alcohol, drugs, essential oils saliva, breast - Alcohol, drugs, heavy metals sweat glands - Phenol, halides kidneys - non-volatile, water-soluble poison
2. post-mortem examination Steps of the proof for poisoning 1. CSI 2. post-mortem examination 3. laboratory studies
Classification agents Local - caustic II. General - resorptive: a) destructive b) Blood c) functional
Carboxyhemoglobin forming methemoglobin forming hemolytic other Blood poisons 1. Carboxyhemoglobin forming 2. methemoglobin forming 3. hemolytic 4. other
acting on the CNS and PNS Functional poisons 1. paralyzing CNS 2. CNS stimulants 3. CNS depressants 4. acting on the CNS and PNS
Food poisoning toxicoinfections intoxications I. Bacterial: II. а) toxicoinfections б) intoxications II. Non-bacterial Vegetable origin Animal origin в) impurities: 1) chemical 2) vegetable
Poisoning by alcohol 1. Period of resorption 2. Period of elimination
Death associated with taking alcohol 1. poisoning 2. contributing factor in various diseases. 3. reflex sudden death
Calculation of ethyl alcohol CТ = С 0 – βT A = P * τ ( CТ + βT) A = P * τ ( CТ + βT)+ АS АS = а * б 1000
Narcotic drug acidotic Defeat CNS 1. 2. 3. Clinical stages methanol poisoning 1. Narcotic drug 2. acidotic 3. Defeat CNS
ethylene glycol poisoning Clinical stages ethylene glycol poisoning 1. intoxication 2. hidden 3. cerebral phenomenon 4. Defeat liver, kidney,
Narcotic Drugs: 1. Sedative action 2. Psychostimulant action
Narcotic drugs 1. natural - morphine, hashish, cocaine, thebaine, codeine, omnopon (the amount of opium alkaloids) 2. semisynthetic - Heroin, mescaline, ephedrine 3. synthetic - Amphetamines, methadone, LSD, promedol, methaqualone
DRD - drug related death (death associated with taking drugs)
death due to prolonged use DRD - versions 1. overdose 2. death due to prolonged use 3. aggravating factor in the non-violent death 4. murder 5. suicide 6. accident
Non-specific changes: Overdose specific changes Non-specific changes: a) associated with the regular introduction of foreign substances into the body b) infectious diseases related to drug use c) related with drug addicts lifestyle