Toxicology: Poisons and Alcohol “If all those buried in our cemeteries who were poisoned could raise their hands, we would probably be shocked by the numbers.” —John Harris Trestrail, “Criminal Poisoning”

Kendall/Hunt Publishing Company Toxicology Definition—the study of the adverse effects of chemicals or physical agents on living organisms. Types: Environmental — air, water, soil Consumer — foods, cosmetics, drugs Medical, clinical, forensic Kendall/Hunt Publishing Company

Kendall/Hunt Publishing Company Forensic Toxicology Postmortem — medical examiner or coroner Criminal — motor vehicle accidents (MVA) Workplace—drug testing Sports—human and animal Environment—industrial, catastrophic, terrorism Kendall/Hunt Publishing Company

Kendall/Hunt Publishing Company Toxicology Toxic substances may: Be a cause of death Contribute to death Cause impairment Explain behavior Kendall/Hunt Publishing Company

Historical Perspective of Poisoners Olympias — a famous Greek poisoner Locusta — personal poisoner of Emperor Nero Lucretia Borgia — her father was Pope Alexander VI Madame Giulia Toffana — committed over 600 successful poisonings, including two Popes. Hieronyma Spara—formed a society to teach women how to murder their husbands Madame de Brinvilliers and Catherine Deshayes—French poisoners. AND many others through modern times. Kendall/Hunt Publishing Company

People of Historical Significance Mathieu Orfila — known as the father of forensic toxicology, published in 1814 “Traite des Poisons” which described the first systematic approach to the study of the chemistry and physiological nature of poisons. Kendall/Hunt Publishing Company

Kendall/Hunt Publishing Company Aspects of Toxicity Dosage The chemical or physical form of the substance The mode of entry into the body Body weight and physiological conditions of the victim, including age and sex The time period of exposure The presence of other chemicals in the body or in the dose Kendall/Hunt Publishing Company

Kendall/Hunt Publishing Company Aspects of Toxicity The time period of exposure Chronic exposure Larger amounts spread out over a long period of time Causes medical problems such as weakness, sluggishness, hair & weight loss, mental instability, and skin & liver cancer. Acute exposure Refers to a dose large enough to cause immediate problems, including death. Kendall/Hunt Publishing Company

Kendall/Hunt Publishing Company Aspects of Toxicity The presence of other chemicals in the body or in the dose or in the dose of the toxin: Synergism the combination of two chemicals increases their individual effects ex: sedatives and alcohol Antagonism the combination of two chemicals decreases their individual effects ex: some blood-pressure medicines and OTC cold medicines with decongestants Kendall/Hunt Publishing Company

Kendall/Hunt Publishing Company Lethal Dose LD50—refers to the dose of a substance that kills half the test population (lab rats), usually within four hours. Expressed in milligrams of substance per kilogram of body weight Kendall/Hunt Publishing Company

Kendall/Hunt Publishing Company Toxicity Classes LD50 (rat,oral) Correlation to Ingestion by 150 lb Adult Human Toxicity <1mg/kg a taste to a drop extremely 1-50 mg/kg to a teaspoon highly 50-500 mg/kg to an ounce moderately 500-5000 mg/kg to a pint slightly 5-15 g/kg to a quart practically non-toxic Over 15g/kg more than 1 quart relatively harmless Kendall/Hunt Publishing Company

Kendall/Hunt Publishing Company Some Lethal Doses Material LD50, mg/kg, rats, oral Sucrose (sugar) 29,700 Ethanol (ethyl alcohol) 7,060 Sodium chloride (table salt) 3,000 Caffeine 192 Sodium cyanide (spy novels – poison capsules) 6.4 Ricin 0.020 Botulin toxin 0.000005 – 0.00005 Kendall/Hunt Publishing Company

Kendall/Hunt Publishing Company It’s All in the Dose? Hormesis refers to the concept that substances that kill at high dosages are actually beneficial at low dosages. Ex: botulin used to erase wrinkles and ease migraines. “All substances are poisons. There is none which is not. The right dose differentiates a poison and remedy.” —Paracelsus (1495-1541). Swiss physician and chemist Kendall/Hunt Publishing Company

Federal Regulatory Agencies Food and Drug Administration (FDA) – deals with pharmaceuticals, food additives, and medical devices. Environmental Protection Agency (EPA) – works with agricultural and industrial chemicals released to the environment. Kendall/Hunt Publishing Company

Federal Regulatory Agencies Consumer Product Safety Commission – concerned with toxins in consumer products. Department of Transportation (DOT) – watches over the shipment of toxic chemcials Occupational Safety and Health Administration (OSHA) – is concerned with exposure to chemicals in the workplace. Kendall/Hunt Publishing Company

Symptoms of Various Types of Poisoning Type of Poison Symptom/Evidence Caustic Poison (lye) Characteristic burns around the lips and mouth of the victim Carbon Monoxide Red or pink patches on the chest and thighs, unusually bright red lividity Kendall/Hunt Publishing Company

Symptoms of Various Types of Poisoning Type of Poison Symptom/Evidence Sulfuric acid Black vomit Hydrochloric acid Greenish-brown vomit Nitric acid Yellow vomit Phosphorous Coffee-brown vomit; onion or garlic odor Kendall/Hunt Publishing Company

Symptoms of Various Types of Poisoning Type of Poison Symptom/Evidence Cyanide Burnt almond odor Arsenic, Mercury Pronounced diarrhea Methyl alcohol Nausea & vomiting, aka wood alcohol unconsciousness Isopropyl alcohol Possibly blindness aka rubbing alcohol Kendall/Hunt Publishing Company

Critical Information on Poisons —John Trestrail from “Criminal Poisoning” Form Common color Characteristic odor Solubility Taste Common sources Lethal dose Mechanism Possible methods of administration Time interval of onset of symptoms. Kendall/Hunt Publishing Company

Critical Information on Poisons —John Trestrail from “Criminal Poisoning” Symptoms resulting from an acute exposure Symptoms resulting from chronic exposure Disease states mimicked by poisoning Notes relating to the victim Specimens from victim Analytical detection methods Known toxic levels Notes pertinent to analysis of poison List of cases in which poison was used Kendall/Hunt Publishing Company

Kendall/Hunt Publishing Company To Prove a Case Prove a crime was committed Motive Intent Access to poison Access to victim Death was caused by poison Death was homicidal Kendall/Hunt Publishing Company

Kendall/Hunt Publishing Company Forensic Autopsy Look for: Irritated tissues Characteristic odors Mees lines—single transverse white bands on nails. Order toxicological screens Postmortem concentrations should be done at the scene for comparison No realistic calculation of dose can be made from a single measurement Kendall/Hunt Publishing Company

Human Specimens for Analysis Blood Urine Vitreous Humor of Eyes Bile Gastric contents Liver tissue Brain tissue Kidney tissue Hair/nails Kendall/Hunt Publishing Company