Poisning Center - Pediatric On Call

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

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Rakesh Kumar, Binay Ranjan, Manjul Vijay Department of Pediatrics, Katihar medical college, Katiha...

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POISIONING CENTER

Drug

Treatment Details

Dhatura (Thorn apple)

It is also known as a ROAD SIDE POISON since it is used for road side crimes like robbery, theft, kidnapping and rape, after stupefying the person. Dhatura seeds may be given in food, wine or cigarettes. Commonly used in fairs, railways and by sadhus and pujaris.

There are two varieties of dhatura` dhatura alba {white flowers} and dhatura niger{ black or dark purple flowers}. Each fruit of dhatura has 300-500 yellowish brown seeds. all parts of the plant are poisonous though seeds and fruits are most poisonous.
The seeds are odowebsiteess, hard, flattened, kidney shaped, bitter with a double ridged convex border.

Route : Ingestion

Fatal Period : 24 hours

Mechanism of action : Active principle : Dhaturine containing hyoscine, hyoscyamine and atropine

Clinical picture : The features are classically described as dry as a bone, red as a beet, blind as a bat, hot as a hare and mad as a wet hen.
1. Stage of delirium
2. Stage of coma.

The manifestations are:
• Bitter taste, vomiting
• Dryness of mouth and throat, difficulty in talking and swallowing
• Unquenchable thirst
• Face is flushed
• Pupils are dilated and insensitive to light, paralysis of power of accommodation hence diminution of vision
• Increased body temperature. Skin is dry and hot
• Giddiness and unsteady gait
• Patient becomes restless, confused and later delirious

• Carphologia – has a tendency to grasp at imaginary objects, may be seen pulling out something from fingers or threading an imaginary needle.
• May be noisy and violent and may experience hallucinations
• After an hour – drowsiness, stupor and later death

Treatment : • Stomach wash
• Antidote : 1. Pilocarpine 15mg or
2. Prostigmine 1mg s.c
3. Repeated doses of 0.5-1.0 mg1.m. or 1.v.
Physostigmine
• Barbiturates or ether inhalation
• Purgatives
• Symptomatic

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Should teicoplannin, colistin be used in case of neonatal sepsis where culture does not reveal any organism_?

No, it should be used only after drug sensitivity report

Yes, under guidance of an infectious disease expert

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