Forensic Chemistry and Toxicology

*Amarnath Mishra*

## **Abstract**

The current chapter deals with forensic chemistry & toxicology which is completely based on the introduction and classification of poisons and their impacts on the body and the factors affecting them and detection and examination of poisons. The purpose of this chapter is to discuss their mode of action and function once they reached in the human body. The impacts of poisons are severe and even cause death if not treated properly.

**Keywords:** poison, mode of action, alcohol, forensic analysis

## **1. Introduction**

Four hundred years back, Paracelsus stated that, "All substances are poisons; there is none which is not a poison." If the right dose is taken, it could become a remedy, otherwise poisonous [1, 2]. The therapeutic index or ratio, i.e., LD50/ ED50, tells whether the chemical is safe or not.

Poisons are generally found in cases of homicides, suicides, or accidents. They have a significant role to play as the silent weapon to destroy life mysteriously and secretively.

## **2. Action of poisons**

Every poison has almost similar action on the victim's body. In many cases, they either stop the transfer of O2 to the tissues or create an obstacle in the respiratory system by inhibition of enzymes which are associated with the process. In this, the myoneural junction and the ganglions and synapses are the sites of action. In some cases of insecticidal poisoning, hyperexcitement of voluntary and involuntary muscles can cause death. There are four categories of action of poisons—(i) local action, (ii) remote action, (iii) local and remote actions, and (iv) general action.

**Local action:** Local action means direct action on the affected site of the body. Examples include irritation and inflammation in strong mineral acids and alkalis, congestion and inflammation by irritants, the effect on motor and sensory nerves, etc.

**Remote action:** Remote action affects the person due to absorption of that poison into the system of that person. For example, alcohol is absorbed in the system and then it affects the person.

**Local and remote actions:** Some poisons can affect both local and remote organs. Thus, they not only affect the area with contact to the poison but also cause toxic effect after absorption into the system, for example, oxalic acid.

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**General action:** General action means the absorbed poison affects more than one system of the body, for example, mercury, arsenic, etc.

• **Sleep**: The body functions are slower during sleep; thus toxin circulation

• **Health**: Healthy persons can tolerate a toxin better than a weak or ill

6.**Dosage:** The effect of the poison depends upon its dosage. It is said that the dose determines whether a substance is a poison or remedy. A substance is usually considered a poison after a certain fixed quantity. Although this quantity is not fixed for all people, it is considered according to the average effect on the population. There are two considerable effects of poison on the body of a person; these are the subtle long-term chronic toxicity and immediate fatality.

Some poisons are lethal in microquantities, while others can affect in large doses. The significance of a dose can be understood by taking an example of a metal essential in the food, for example, iron, copper, manganese, zinc, etc.;

• **Effective dose (ED)**: The effective dose is the quantity of a substance at which it shows its effect in the population. In most cases, ED50 is measured as a dose which induces a response in half of the targeted

• **Lethal dose**: The lethal dose (LD) 50 is the amount of drug which is

7.**Hypersensitivity:** It is basically the type of reaction initiated by the body against any other substances. Sometimes, it could be related to allergy. There is an assumption that hypersensitivity does not depend on wrong doses. Every person who is hypersensitive to a particular substance has a dose related that defines the quantity required to cause hypersensitivity to that person. The allergic response is actually a toxic response and can be

8.**Idiosyncrasy:** It is defined as a reaction produced by the body to a chemical genetically. It is a type of person that affects only those people who are genetically sensitized to that particular chemical or substance but will show no effect on others. In such cases, the person experiences discomfort for several hours or if the dose is high can be fatal also. For example- peanut

9.**Tolerance:** It is the capability of a person to not produce any effect against a chemical that usually causes reaction to normal persons. It is a state of reduced or no reaction to a chemical. There are basically two types of mechanism that induces tolerance. First is when the toxin reaches the effective site, its quantity is very less. This is called dispositional tolerance. The second is because the tissues show reduced response to the toxin. Tolerance can also be achieved if a drug is taken in a small quantity on a regular basis. This can be explained by taking the example of alcohol. When any human consume alcohol for the first time, he/she will show an effect even when the quantity is small, but eventually the effect will decrease and the

if its dose is higher than the body requires, it can be lethal.

expected to cause death of 50% population.

in the body is also slower.

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person.

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population.

sometimes fatal.

allergy in some people.

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person can tolerate a large amount also.

## **3. Factors modifying the action of poisons**

Toxicity of a poison depends upon its inherent properties such as physiochemical as well as pharmacological properties.

The action of poisons mainly depends upon the following factors discussed below:

## 1.**Forms of poison:** There are three forms of poison:

• **Physical form:** Gaseous/volatile/vaporous forms of poisons act faster than liquid poisons as they are quickly absorbed. Similarly, liquid poisons act faster than solid poisons.

Gaseous or volatile > liquid > solid.

For solid poisons, powdered poisons act quickly than the lumps. For example, there are certain seeds that escape the gastrointestinal tract as they are solid, but when crushed, they can be fatal.

For solids: powdered > lumps

• **Chemical form:** Few substances like mercury or arsenic are not poisonous as they are insoluble and cannot be absorbed when they are in combination with other substances like mercuric chloride, arsenic oxide, etc.

In other cases, the action is vice versa. For example, there are some substances that become inert in combination with silver nitrate and hydrochloric acid and are deadly and poisonous when present in pure forms.

	- **Age**: Children and older people are more affected than an adult by the same quantity of toxin.

**General action:** General action means the absorbed poison affects more than

The action of poisons mainly depends upon the following factors discussed below:

• **Physical form:** Gaseous/volatile/vaporous forms of poisons act faster than liquid poisons as they are quickly absorbed. Similarly, liquid poisons

For solid poisons, powdered poisons act quickly than the lumps. For example, there are certain seeds that escape the gastrointestinal tract as they are solid, but

with other substances like mercuric chloride, arsenic oxide, etc.

when they are combined with inert substances.

3.**Concentration:** The absorption speed of poison is dependent on

but the absorption rate is high and so it is more dangerous.

increase or decrease of the effect of a poison on the body:

thus the intensity of the toxin is reduced.

same quantity of toxin.

In other cases, the action is vice versa. For example, there are some substances that become inert in combination with silver nitrate and hydrochloric acid and are deadly and poisonous when present in pure forms.

• **Mechanical combination:** The effect of poisons is significantly altered

2.**Quantity:** Large doses of toxin cause much lethal effect. But this statement is not always true. For example, sometimes when a toxin is taken in very large amount, the body produces a mechanism against it such as vomiting, and

concentration; thus poison of higher concentration is fatal. However, there are still some exceptions. For example, a dilute oxalic acid is less corrosive,

4.**Methods of administration:** It has a unique role in the process of absorption. It is fastest through inhalation and then through injection as compared to the

5.**Condition of the body:** Different persons react differently when exposed to a poison. It is because the condition of our body is also responsible for the

• **Age**: Children and older people are more affected than an adult by the

• **Chemical form:** Few substances like mercury or arsenic are not poisonous as they are insoluble and cannot be absorbed when they are in combination

one system of the body, for example, mercury, arsenic, etc.

Toxicity of a poison depends upon its inherent properties such as

**3. Factors modifying the action of poisons**

*Medical Toxicology*

physiochemical as well as pharmacological properties.

act faster than solid poisons.

Gaseous or volatile > liquid > solid.

when crushed, they can be fatal. For solids: powdered > lumps

oral mode.

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1.**Forms of poison:** There are three forms of poison:


Some poisons are lethal in microquantities, while others can affect in large doses. The significance of a dose can be understood by taking an example of a metal essential in the food, for example, iron, copper, manganese, zinc, etc.; if its dose is higher than the body requires, it can be lethal.


Tolerance can also be achieved if a drug is taken in a small quantity on a regular basis. This can be explained by taking the example of alcohol. When any human consume alcohol for the first time, he/she will show an effect even when the quantity is small, but eventually the effect will decrease and the person can tolerate a large amount also.

10.**Individual susceptibility:** It is defined as the different kinds of responses produced by different individuals to a particular harmful compound. It can be due to occupational or environmental factors and exposures. It is determined by complex genetic factors. Its effect depends upon the intensity of exposure. There is a gene uniqueness that varies from person to person; thus the same amount of exposure can show no effect in one individual, cause illness to other individual, and also could be fatal to someone as well.

• **Oral route:** Generally absorption takes place in the tongue and the gums of the oral passage. The pH of the buccal cavity and mouth ranges from 4 to 5. Sublingual and supralingual routes have a significant role in absorption. The sublingual absorption is faster as the toxin is transformed directly to the heart,

• **Rectal route:** Administration of drugs can be done through anus which directly absorbed in bloodstream through membrane of mucous. This administration can cause the burning of tissues or bleeding in rectum as the

• **Parental route:** It includes all the other routes that does not involve the

death might be caused by this type of drug.

mode is greater than other parental modes.

gastrointestinal tract. It has a systemic effect on the body. It has the following

◦ **Intradermal:** Here, the administration of drugs takes place from surface of skin. This type of poisoning is mostly found in chronic poisoning cases.

◦ **Intravenous:** It is one of the fastest modes of drug administration as the injection is directly taken and the drug is transferred directly into the veins and thus is directly circulated into the blood quickly. Immediate

◦ **Intraosseous:** It involves an administration of a drug directly into the bone marrow. This mode is actually used for administration of drugs for

◦ **Intra-arterial:** It involves an administration of a drug into the artery directly through injection. It is a fast mode of administration.

◦ **Intramuscular:** In this mode, the drug or poison is administered into the muscle of the thigh, upper arm, or buttock. The time required in this

◦ **Subcutaneous:** In this mode, the drug is injected into the layer beneath the skin, i.e., the subcutaneous layer. The drug then goes to the small blood vessels and then to the bloodstream. This mode is used for mostly those protein drugs that would be destroyed if administered through the

◦ **Inhalation:** In this mode, the nose is the primary path. Because of the presence of mucous membrane, the nasal aperture is very absorptive. The microparticles of poisons are easily absorbed and transported quickly to

the lungs. From the lungs, they are circulated into the blood.

but it takes more time.

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area is very sensitive.

categories of administration:

medical purposes.

gastrointestinal tract.

Poisons are classified into two ways:

i. Based on their action on the body.

ii. Based on their physical and chemical properties [1].

**5. Classification of poisons**

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## **4. Route of administration of poison**

The route of administration is the path through which a drug, toxin, or poison is taken or administered into the body of a person which is distinguished by the location where any drug is applied. It is mostly classified on the basis of its target:


Poisons are given or taken so that death can occur at once by shock due to stoppage of body's vital systems. Drug addicts take drugs through inhalation or injection.

Route of administration plays a very important role in determination of death by poison as time in which death occurs are fastest in inhaled poisons, relatively slow in injected and lastly when ingested orally.

Some important features that are considered during the administration of poisons and can make a poison fatal are:


Routes of administration can be classified into two categories:


**Enteral routes:** When the drug is administered through the gastrointestinal tract, it is defined as an enteral route. It has both oral and rectal routes. It also includes sublingual and sublabial routes. It is comparatively a slower mode of action for absorption of drugs:

## *Forensic Chemistry and Toxicology DOI: http://dx.doi.org/10.5772/intechopen.91961*

10.**Individual susceptibility:** It is defined as the different kinds of responses produced by different individuals to a particular harmful compound. It can be due to occupational or environmental factors and exposures. It is determined by complex genetic factors. Its effect depends upon the intensity of exposure. There is a gene uniqueness that varies from person to person; thus the same amount of exposure can show no effect in one individual, cause illness to

The route of administration is the path through which a drug, toxin, or poison is

Poisons are given or taken so that death can occur at once by shock due to stoppage

Route of administration plays a very important role in determination of death by poison as time in which death occurs are fastest in inhaled poisons, relatively slow

of body's vital systems. Drug addicts take drugs through inhalation or injection.

Some important features that are considered during the administration of

• The surface area affected at the site of administration of the poison

• The solubility of the poison, i.e., lipid soluble or water soluble

Routes of administration can be classified into two categories:

• Rate of dissolution of the poison that depends upon the physical form of the

• The time required by the poison to be absorbed completely from the site of

**Enteral routes:** When the drug is administered through the gastrointestinal tract, it is defined as an enteral route. It has both oral and rectal routes. It also includes sublingual and sublabial routes. It is comparatively a slower mode of action

taken or administered into the body of a person which is distinguished by the location where any drug is applied. It is mostly classified on the basis of its target:

• Enteral—which has a wide effect, i.e., affect the whole system

other individual, and also could be fatal to someone as well.

**4. Route of administration of poison**

*Medical Toxicology*

• Topical—which has a local effect

in injected and lastly when ingested orally.

poisons and can make a poison fatal are:

• The concentration of the poison

1.Enteral routes/gastrointestinal routes.

administration

2.Parenteral routes.

for absorption of drugs:

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• Parental—which follows a systemic action

poison, i.e., gaseous, vapors, liquid, solid, etc.

• The circulation rate of blood in that route

	- **Intradermal:** Here, the administration of drugs takes place from surface of skin. This type of poisoning is mostly found in chronic poisoning cases.
	- **Intravenous:** It is one of the fastest modes of drug administration as the injection is directly taken and the drug is transferred directly into the veins and thus is directly circulated into the blood quickly. Immediate death might be caused by this type of drug.
	- **Intraosseous:** It involves an administration of a drug directly into the bone marrow. This mode is actually used for administration of drugs for medical purposes.
	- **Intra-arterial:** It involves an administration of a drug into the artery directly through injection. It is a fast mode of administration.
	- **Intramuscular:** In this mode, the drug or poison is administered into the muscle of the thigh, upper arm, or buttock. The time required in this mode is greater than other parental modes.
	- **Subcutaneous:** In this mode, the drug is injected into the layer beneath the skin, i.e., the subcutaneous layer. The drug then goes to the small blood vessels and then to the bloodstream. This mode is used for mostly those protein drugs that would be destroyed if administered through the gastrointestinal tract.
	- **Inhalation:** In this mode, the nose is the primary path. Because of the presence of mucous membrane, the nasal aperture is very absorptive. The microparticles of poisons are easily absorbed and transported quickly to the lungs. From the lungs, they are circulated into the blood.

## **5. Classification of poisons**

Poisons are classified into two ways:


Classification based upon the effect of poison on the body:

1.Corrosive: The poisons burn the tissues or organs when they come in contact with them, e.g.:

c. Poisonous food articles

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g. Radioactive substances

adult persons.

ii. Nonmetallic poisons:

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respiratory failure [4].

naphthalene

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i. Metallic poisons:

A. Inorganic poisons

e. Fuels—petroleum and kerosene

d. Industrial poisons—methyl isocyanate (MIC)

Classification of poisons based upon their properties:

the ages to poison men and animals [1].

e.g., cooked food, milk, tea, liquors, or medicines.

are used in chemical industry and as fungicides.

e.g., Sindoor adulterated with red lead oxide.

e. Thallium: Thallium salt is used as rat poison [6].

a. Cyanides: Cyanides of potassium and sodium are extremely poisonous, even in small quantities. They react with the acid of gastric juices in the stomach to form hydrocyanic acid, which

c. Iodine: Only elemental iodine in high quantity is poisonous.

f. Antimony: Its effect is like that of arsenic.

several times proved highly poisonous.

f. Insecticides—endrin, dichlorodiphenyltrichloroethane (DDT), and

a. Arsenic: It has been the most known and exclusively used throughout

It is a white tasteless powder and a pinch of the poisons can kill two

Arsenic for homicidal purposes is mixed with various food articles,

b. Mercury: Chloride and nitrites of mercury are highly poisonous. They

c. Lead: Most of its compounds are poisonous. This is a slow poison,

d. Copper: Its salts are used in electroplating; copper sulfate is a poison.

paralyzes the respiratory center in the brain resulting in death due to

b. Yellow phosphorus: In olden days it was used in match industry and

Arsenic in a metal form is not poisonous; its oxides are highly poisonous. It is extensively used in insecticides, etc. [5].

	- a. Inorganic:
		- Nonmetallic phosphorous, chlorine, bromine, iodine, etc.
		- Metallic salts of arsenic, antimony, mercury, copper, lead, zinc, etc.
	- b. Organic:
		- Vegetable—castor oil, madar, croton oil, etc.
		- Animals—snake venom, cantharides, insect bites, etc.
		- Mechanical—glass powder, needles, diamond dust, hair, etc.

3.Neurotics: Poisons affect the nervous system and the brain [3]:

	- Narcotic—opium and its alkaloids
	- Inebriant (depressant)—alcohol, ether, chloroform, and chloral hydrate
	- Excitant (stimulants)—nux vomica and strychnine
	- Depressant—gelsemium
	- Cardiac—aconite, digitalis, oleander, and hydrocyanic acid (HCN)
	- Asphyxiants—carbon monoxide, carbon dioxide, and hydrogen sulfide
	- a. Animal poisons
	- b. Curare (an arrow poison)

Classification of poisons based upon their properties:

A. Inorganic poisons

Classification based upon the effect of poison on the body:

a. Strong acids such as H2SO4, HNO3, HCL, etc.

b. Strong alkalis such as hydroxides of Na, K, NH4, etc.

• Vegetable—castor oil, madar, croton oil, etc.

• Animals—snake venom, cantharides, insect bites, etc.

3.Neurotics: Poisons affect the nervous system and the brain [3]:

• Excitant (stimulants)—nux vomica and strychnine

• Narcotic—opium and its alkaloids

• Depressant—gelsemium

c. Cardiorespiratory:

included in this group [4]:

b. Curare (an arrow poison)

a. Animal poisons

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• Mechanical—glass powder, needles, diamond dust, hair, etc.

• Inebriant (depressant)—alcohol, ether, chloroform, and chloral hydrate

• Cardiac—aconite, digitalis, oleander, and hydrocyanic acid (HCN)

4.Miscellaneous: A number of chemicals having diverse actions on their body are

• Asphyxiants—carbon monoxide, carbon dioxide, and hydrogen sulfide

with them, e.g.:

*Medical Toxicology*

with them [3]:

a. Inorganic:

b. Organic:

a. Cerebral:

b. Spinal:

1.Corrosive: The poisons burn the tissues or organs when they come in contact

2. Irritants: The poisons irritate the tissues or organs when they come in contact

• Nonmetallic phosphorous, chlorine, bromine, iodine, etc.

• Metallic salts of arsenic, antimony, mercury, copper, lead, zinc, etc.

	- a. Arsenic: It has been the most known and exclusively used throughout the ages to poison men and animals [1].

It is a white tasteless powder and a pinch of the poisons can kill two adult persons.

Arsenic for homicidal purposes is mixed with various food articles, e.g., cooked food, milk, tea, liquors, or medicines.

Arsenic in a metal form is not poisonous; its oxides are highly poisonous. It is extensively used in insecticides, etc. [5].

	- a. Cyanides: Cyanides of potassium and sodium are extremely poisonous, even in small quantities. They react with the acid of gastric juices in the stomach to form hydrocyanic acid, which paralyzes the respiratory center in the brain resulting in death due to respiratory failure [4].
	- b. Yellow phosphorus: In olden days it was used in match industry and several times proved highly poisonous.
	- c. Iodine: Only elemental iodine in high quantity is poisonous.

d. Strong acids and alkalis: These are highly poisonous with corrosive effects, e.g., sulfuric acid, nitric acid, sodium, potassium hydroxides, etc.

substances, such as alkaloids, polypeptides, amines, glycosides, oxalates, resins,

An alcohol is a drink that contains ethanol. Ethanol is made by fermentation of grains, fruits, and some resources of sugar. Chemically, it is a group of compounds whose saturated carbon chain has a "-OH" group. Alcohol is also a depressant, and in low dose, it can reduce tension, cause euphoria, and improve sociability, but in high dose it can cause stupor, drunkenness, and even death. Regular alcohol intake can cause cancer, alcoholism, dependency, etc. 33% of the total people in the world consumes alcohol. Drinks containing alcohol are broadly classified into three classes, i.e., beer, spirit, and wine, whose alcohol content varies between 3% and 50%. When diluted, alcohol has nearly sweet taste, but when concentrated it gives a burning sensation. 90% of the absorbed alcohol is metabolized by the liver and broken down into less toxic metabolites. Alcohol acts on the central nervous system (CNS) as a depressant on the cells of the cerebral cortex. Its adverse effects like a decrease in cognitive and psychomotive skills are well documented. Alcohol percentage (ABV) differs from one brand to another, for example, beers contain 5%, wines contain typically 13.5%, fortified wines contain 15–22%, spirits contain 30–40%, fruit juice

contains less than 0.1%, and cider/wine coolers contain 4–8% ABV [1].

and rest are given out from exhalation and urine [5].

The goal of blood alcohol test is to check the concentration of alcohol in the body. This test result is known as blood alcohol concentration (BAC) which indicates alcohol % in the blood. It is directly proportional to the alcohol in the body, and alcohol hinders with people's decision, control on them and other characteristics [3]. This test can tell the presence of alcohol in blood for 12 hours [4]. Blood quickly absorbs alcohol and is measured within minutes of consuming alcoholic drink. The highest level of BAC result can be reached within an hour of consuming alcohol. Intake of food can vary the result. Liver breaks down almost 90% of alcohol

In case of deaths due to alcoholic intoxication, the viscera is collected and preserved in saturated saline. Preservation of sample is very important as if wrongly preserved it

A sterile needle must be cleaned up by the swab of a nonalcoholic disinfectant like aqueous mercuric chloride and aqueous benzalkonium chloride (Zephiran) before the suspect's skin is punctured with it. The use of an alcoholic disinfectant either may give false-positive results or may contribute to falsely high alcohol contents of blood. About 5–10 ml of the sample (blood) is taken in a test tube; an anticoagulant such as potassium oxide and EDTA and a preservative such as NaF are added and stored in the refrigerator at 40°C. The anticoagulant will prevent blood from clotting, and the preservative will inhibit the presence of microorganisms. The urine sample is also collected in the usual manner and preserved with

can ruin the examination. Generally, urine and blood are taken as samples.

30 mg of phenyl mercuric nitrate for every 10 ml of urine [6].

toxalbumins, etc.

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**7. Blood alcohol test**

**8. Sample collection**

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**6. Alcohol**

e. Gases: Phosphine gas kills rats when used on the rat holes and is poisonous for infants. MIC killed over 2000 persons and invalidated several others in a gas leak tragedy in Bhopal in 1984. Some other poisonous gases are HCN, carbon monoxide, hydrogen sulfide, arsine, etc. [3].

## B. Organic poisons

	- a. Ethyl alcohol: It is poisonous if taken in excess.
	- b. Other alcohols: Methyl alcohol and isopropyl alcohol are poisonous. Methanol, used in polish and chemical industries, is used in illicit liquor, and its intake causes paralysis, blindness, and death [3].
	- c. Phenol: Phenol or carbolic acid could be poisonous. It is mostly used as a disinfectant [6].
	- d. Miscellaneous substances: Various industrial chemicals like chlorinated hydrocarbons, benzene, chloral hydrate, etc. are poisonous. In several cases of poisoning, chloral hydrate could be used in illicit liquors.
	- a. Alkaloids: Several narcotics and vegetable poisons contain alkaloids, e.g., strychnine, morphine, cocaine, nicotine, etc.
	- b. Barbiturates: These drugs are synthetic and induce sleep [1].
	- c. Glycosides: These drugs can cause cardiac arrest and could be fatal such as aconite, oleander digitalis, etc.
	- d. Insecticides and pesticides

**Poisoning:** It is known as the injurious effect caused by the action of a poison or a detrimental chemical substance. It leads to the development of adverse reaction toward the harmful chemicals or drugs. It is basically differentiated in three categories: suicidal, homicidal, and accidental. Cattle poisoning is the poisoning related to animals. Accidental poisoning is caused by negligence and carelessness. Homicidal poisoning includes the killing of a person due to the poison. Suicidal poisoning refers to the use of toxic chemicals in order to kill oneself.

Corrosive poisoning: It is caused by poisons such as acids and alkalis. They produce a corrosive action on the human body by causing ulcers and acute inflammation.

Metallic poisoning: Metals such as arsenic, mercury, lead, etc., when ingested, cause a deleterious effect. This is known as metallic poisoning.

Plant poison: The study of plant poisons is known as phytotoxicology. Plant poisons, or phytotoxins, comprise a vast range of biologically active chemical

substances, such as alkaloids, polypeptides, amines, glycosides, oxalates, resins, toxalbumins, etc.

## **6. Alcohol**

d. Strong acids and alkalis: These are highly poisonous with corrosive

e. Gases: Phosphine gas kills rats when used on the rat holes and is poisonous for infants. MIC killed over 2000 persons and invalidated several others in a gas leak tragedy in Bhopal in 1984. Some other poisonous gases are HCN, carbon monoxide, hydrogen sulfide,

b. Other alcohols: Methyl alcohol and isopropyl alcohol are poisonous. Methanol, used in polish and chemical industries, is used in illicit liquor, and its intake causes paralysis, blindness, and death [3].

c. Phenol: Phenol or carbolic acid could be poisonous. It is mostly used

a. Alkaloids: Several narcotics and vegetable poisons contain alkaloids,

c. Glycosides: These drugs can cause cardiac arrest and could be fatal

d. Miscellaneous substances: Various industrial chemicals like chlorinated hydrocarbons, benzene, chloral hydrate, etc. are poisonous. In several cases of poisoning, chloral hydrate could be

e.g., strychnine, morphine, cocaine, nicotine, etc.

such as aconite, oleander digitalis, etc.

b. Barbiturates: These drugs are synthetic and induce sleep [1].

**Poisoning:** It is known as the injurious effect caused by the action of a poison or a detrimental chemical substance. It leads to the development of adverse reaction toward the harmful chemicals or drugs. It is basically differentiated in three categories: suicidal, homicidal, and accidental. Cattle poisoning is the poisoning related to animals. Accidental poisoning is caused by negligence and carelessness. Homicidal poisoning includes the killing of a person due to the poison. Suicidal poisoning

Corrosive poisoning: It is caused by poisons such as acids and alkalis. They produce a corrosive action on the human body by causing ulcers and acute inflammation. Metallic poisoning: Metals such as arsenic, mercury, lead, etc., when ingested,

Plant poison: The study of plant poisons is known as phytotoxicology. Plant poisons, or phytotoxins, comprise a vast range of biologically active chemical

effects, e.g., sulfuric acid, nitric acid, sodium, potassium

a. Ethyl alcohol: It is poisonous if taken in excess.

hydroxides, etc.

arsine, etc. [3].

as a disinfectant [6].

used in illicit liquors.

d. Insecticides and pesticides

refers to the use of toxic chemicals in order to kill oneself.

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cause a deleterious effect. This is known as metallic poisoning.

ii. Nonvolatile substances:

B. Organic poisons

*Medical Toxicology*

i. Volatile poisons:

An alcohol is a drink that contains ethanol. Ethanol is made by fermentation of grains, fruits, and some resources of sugar. Chemically, it is a group of compounds whose saturated carbon chain has a "-OH" group. Alcohol is also a depressant, and in low dose, it can reduce tension, cause euphoria, and improve sociability, but in high dose it can cause stupor, drunkenness, and even death. Regular alcohol intake can cause cancer, alcoholism, dependency, etc. 33% of the total people in the world consumes alcohol. Drinks containing alcohol are broadly classified into three classes, i.e., beer, spirit, and wine, whose alcohol content varies between 3% and 50%. When diluted, alcohol has nearly sweet taste, but when concentrated it gives a burning sensation. 90% of the absorbed alcohol is metabolized by the liver and broken down into less toxic metabolites. Alcohol acts on the central nervous system (CNS) as a depressant on the cells of the cerebral cortex. Its adverse effects like a decrease in cognitive and psychomotive skills are well documented. Alcohol percentage (ABV) differs from one brand to another, for example, beers contain 5%, wines contain typically 13.5%, fortified wines contain 15–22%, spirits contain 30–40%, fruit juice contains less than 0.1%, and cider/wine coolers contain 4–8% ABV [1].

## **7. Blood alcohol test**

The goal of blood alcohol test is to check the concentration of alcohol in the body. This test result is known as blood alcohol concentration (BAC) which indicates alcohol % in the blood. It is directly proportional to the alcohol in the body, and alcohol hinders with people's decision, control on them and other characteristics [3]. This test can tell the presence of alcohol in blood for 12 hours [4]. Blood quickly absorbs alcohol and is measured within minutes of consuming alcoholic drink. The highest level of BAC result can be reached within an hour of consuming alcohol. Intake of food can vary the result. Liver breaks down almost 90% of alcohol and rest are given out from exhalation and urine [5].

#### **8. Sample collection**

In case of deaths due to alcoholic intoxication, the viscera is collected and preserved in saturated saline. Preservation of sample is very important as if wrongly preserved it can ruin the examination. Generally, urine and blood are taken as samples.

A sterile needle must be cleaned up by the swab of a nonalcoholic disinfectant like aqueous mercuric chloride and aqueous benzalkonium chloride (Zephiran) before the suspect's skin is punctured with it. The use of an alcoholic disinfectant either may give false-positive results or may contribute to falsely high alcohol contents of blood. About 5–10 ml of the sample (blood) is taken in a test tube; an anticoagulant such as potassium oxide and EDTA and a preservative such as NaF are added and stored in the refrigerator at 40°C. The anticoagulant will prevent blood from clotting, and the preservative will inhibit the presence of microorganisms. The urine sample is also collected in the usual manner and preserved with 30 mg of phenyl mercuric nitrate for every 10 ml of urine [6].

## **9. Extraction of ethyl alcohol from biological materials**

Ethyl alcohol is isolated from biological materials by acid distillation. Viscera, vomit, stomach contents, and other materials should be analyzed separately. About 50–100 g of the viscera is taken and is finally minced by thin gruel and adding water (3–5 times) and sulfuric acid. It is passed to steam distillation which is generally heating it on the water bath. The condenser and the receiving flask should be well cooled with ice especially in the hot season, the outlet of the condenser being dipped in little water or NaOH solution. Some pieces of pumice stone are stored in the flask to avoid bumping. It is better to collect the distillate in 4–5 fractions, out of which the first one should not exceed 20 ml and the remaining fractions should be 50 ml each. The distillate contains alcohol and other volatile acids, etc. [6].

junction of both liquids, a ring will be formed which is deep blue in color. On shaking, the whole mixture will become deep blue which is due to ethyl alcohol. This test is very sensitive and it gives a negative result with acetone, acetaldehyde, and dilute solution of methyl alcohol. Only the strong solution of methyl alcohol

Mix two drops of benzoyl chloride with 2 ml of the distillate. Add 10% of sodium hydroxide drop by drop till the solution becomes alkaline. By providing heat the irritating smell of benzoyl chloride will be replaced by sweet fruity odor of ethyl benzoate. Methyl alcohol gives this test also but not the iodoform test [6].

In case of drunkenness, alcohol detection in the body is very important. Observing behavioral abnormalities of the suspect is the best method, but analyzing the breath, blood, and urine is the only way of confirming it. The analysis of breath alcohol can be performed on the spot with the help of breath-analyzer instruments like Alco-Sensor, Breathalyzer, etc. However, the alcohol content of the blood could be determined by using the modified version of the Kozelka and Hine/Cavett method [6]**.** In recent years, several methods in determining the alcohol in body fluids are described. Kent-Jones and Taylor reported the results of an investigation into the merits of two methods—the micro Cavett and that of Kozelka and Hine. The micro Cavett method is more accurate, but it suffered from serious inconsistencies in reproducibility, but the Kozelka and Hine method is less accurate and more time-

Nickolls modified the micro Cavett method which appears to give a more accurate result in comparison with the unmodified method. The simplicity of this pro-

The principle behind this method is the oxidation of alcohol, which is easy with acetic acid in the presence of oxidizing agents such as sulfuric acid and potassium dichromate. Reduction of each mL of N/20 potassium dichromate solution takes

This formula is used to estimate the amount in which alcohol is present in the body.

a ¼ cpr*:*

a ¼ 3*=*4qpr*:*

Here, a = Total amount of alcohol absorbed in the body; p = Weight of the person; c = Concentration of alcohol in the blood; r = Constant which is 0.5 in

gives a light blue color after several minutes [6].

**11. Determination of ethyl alcohol in blood/urine**

cedure increases its use for routine work in laboratory [8].

consuming but gives good reproducibility.

**11.1 Cavett method/Kozelka and Hine method**

place that is equivalent to 0.575 mg of alcohol [6].

**11.2 Widmark's formula**

a. For blood analysis

women and 0.68 in men

**307**

b. In urine analysis.

**10.3 Ethyl benzoate test**

*Forensic Chemistry and Toxicology*

*DOI: http://dx.doi.org/10.5772/intechopen.91961*

## **10. Chemical analysis of ethyl alcohol**

There are some tests which show the presence of ethyl alcohol in the exhibits.

#### **10.1 Iodoform test**

Also known as triiodomethane reaction, it is used in the detection of CH3CH (OH) which is present in alcohol. There are mainly two types of different mixtures used in this reaction which are mainly chemically equivalent. A pale yellow precipitate occurs if the result is positive [6].

In the above structure, "R" can be hydrogen or alkyl group or any other hydrocarbon group. In case when R denotes hydrogen, then the compound we have the possibility to find is primary alcohol ethanol. Ethanol is the only alcohol that gives an iodoform reaction. In case R is any hydrocarbon group, then it gives secondary alcohol groups. Tertiary alcohol is not able to contain R group because of the absence of hydrogen atom [7].

In 1 ml of distillate, a few drops of 10% NaOH are added dropwise till the solution becomes brown and warmed for a few minutes. A few drops of iodoform solution are added to change the color to yellow. The mixture has to be again heated on low flame/water bath; a yellow-colored precipitate is formed on standing. The precipitate has to be observed under a microscope. Characteristic hexagonal crystals of iodoform are seen which usually shows the presence of ethanol, acetaldehyde, isopropanol which on standing for long time breaks into flower like structure. This test initially involves oxidation followed by substitution and hydrolysis [6].

#### **10.2 Sulphomolybdic acid test**

Add 1 gm of molybdic acid in 25 ml of a concentrated sulfuric acid which has the reagent. Mix 2 ml of this reagent when hot and with 2 ml of distillate. At the

#### *Forensic Chemistry and Toxicology DOI: http://dx.doi.org/10.5772/intechopen.91961*

junction of both liquids, a ring will be formed which is deep blue in color. On shaking, the whole mixture will become deep blue which is due to ethyl alcohol. This test is very sensitive and it gives a negative result with acetone, acetaldehyde, and dilute solution of methyl alcohol. Only the strong solution of methyl alcohol gives a light blue color after several minutes [6].

## **10.3 Ethyl benzoate test**

**9. Extraction of ethyl alcohol from biological materials**

each. The distillate contains alcohol and other volatile acids, etc. [6].

**10. Chemical analysis of ethyl alcohol**

precipitate occurs if the result is positive [6].

the absence of hydrogen atom [7].

**10.2 Sulphomolybdic acid test**

**306**

**10.1 Iodoform test**

*Medical Toxicology*

Ethyl alcohol is isolated from biological materials by acid distillation. Viscera, vomit, stomach contents, and other materials should be analyzed separately. About 50–100 g of the viscera is taken and is finally minced by thin gruel and adding water (3–5 times) and sulfuric acid. It is passed to steam distillation which is generally heating it on the water bath. The condenser and the receiving flask should be well cooled with ice especially in the hot season, the outlet of the condenser being dipped in little water or NaOH solution. Some pieces of pumice stone are stored in the flask to avoid bumping. It is better to collect the distillate in 4–5 fractions, out of which the first one should not exceed 20 ml and the remaining fractions should be 50 ml

There are some tests which show the presence of ethyl alcohol in the exhibits.

Also known as triiodomethane reaction, it is used in the detection of CH3CH (OH) which is present in alcohol. There are mainly two types of different mixtures

used in this reaction which are mainly chemically equivalent. A pale yellow

In the above structure, "R" can be hydrogen or alkyl group or any other hydrocarbon group. In case when R denotes hydrogen, then the compound we have the possibility to find is primary alcohol ethanol. Ethanol is the only alcohol that gives an iodoform reaction. In case R is any hydrocarbon group, then it gives secondary alcohol groups. Tertiary alcohol is not able to contain R group because of

In 1 ml of distillate, a few drops of 10% NaOH are added dropwise till the solution becomes brown and warmed for a few minutes. A few drops of iodoform solution are added to change the color to yellow. The mixture has to be again heated on low flame/water bath; a yellow-colored precipitate is formed on standing. The precipitate has to be observed under a microscope. Characteristic hexagonal crystals of iodoform are seen which usually shows the presence of ethanol, acetaldehyde, isopropanol which on standing for long time breaks into flower like structure. This test initially involves oxidation followed by substitution and hydrolysis [6].

Add 1 gm of molybdic acid in 25 ml of a concentrated sulfuric acid which has the

reagent. Mix 2 ml of this reagent when hot and with 2 ml of distillate. At the

Mix two drops of benzoyl chloride with 2 ml of the distillate. Add 10% of sodium hydroxide drop by drop till the solution becomes alkaline. By providing heat the irritating smell of benzoyl chloride will be replaced by sweet fruity odor of ethyl benzoate. Methyl alcohol gives this test also but not the iodoform test [6].

## **11. Determination of ethyl alcohol in blood/urine**

In case of drunkenness, alcohol detection in the body is very important. Observing behavioral abnormalities of the suspect is the best method, but analyzing the breath, blood, and urine is the only way of confirming it. The analysis of breath alcohol can be performed on the spot with the help of breath-analyzer instruments like Alco-Sensor, Breathalyzer, etc. However, the alcohol content of the blood could be determined by using the modified version of the Kozelka and Hine/Cavett method [6]**.**

In recent years, several methods in determining the alcohol in body fluids are described. Kent-Jones and Taylor reported the results of an investigation into the merits of two methods—the micro Cavett and that of Kozelka and Hine. The micro Cavett method is more accurate, but it suffered from serious inconsistencies in reproducibility, but the Kozelka and Hine method is less accurate and more timeconsuming but gives good reproducibility.

Nickolls modified the micro Cavett method which appears to give a more accurate result in comparison with the unmodified method. The simplicity of this procedure increases its use for routine work in laboratory [8].

## **11.1 Cavett method/Kozelka and Hine method**

The principle behind this method is the oxidation of alcohol, which is easy with acetic acid in the presence of oxidizing agents such as sulfuric acid and potassium dichromate. Reduction of each mL of N/20 potassium dichromate solution takes place that is equivalent to 0.575 mg of alcohol [6].

## **11.2 Widmark's formula**

This formula is used to estimate the amount in which alcohol is present in the body.

a. For blood analysis

$$\mathbf{a} = \mathbf{c} \mathbf{p} \mathbf{r}.$$

Here, a = Total amount of alcohol absorbed in the body; p = Weight of the person; c = Concentration of alcohol in the blood; r = Constant which is 0.5 in women and 0.68 in men

b. In urine analysis.

$$\mathbf{a} = 3/4 \text{qpr.}$$

## *Medical Toxicology*

Here, a = Total alcohol content present in the body; p = Total weight of the person; q = Alcohol concentration in the urine; r = Constant, namely, 0.68 for men and 0.5 in women [6].

**13. Conclusion**

*Forensic Chemistry and Toxicology*

**Author details**

Amarnath Mishra

**309**

provided the original work is properly cited.

and even cause death if not treated properly.

*DOI: http://dx.doi.org/10.5772/intechopen.91961*

The purpose of this chapter is to discuss the mode of action and function of poisons once they reached in the human body. The impacts of poisons are severe

Amity Institute of Forensic Sciences, Amity University Uttar Pradesh, Noida, India

© 2020 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium,

\*Address all correspondence to: drmishraa1@gmail.com; amishra5@amity.edu

## **12. Instrumental technique of analysis of ethyl alcohol**

## **12.1 Gas chromatography**

There are several methods in determining ethanol in the blood, urine, and serum. One of the most important methods is gas chromatography (GC). The sample is injected in a heating chamber, and due to its high temperature, alcohol converts in vapors which are carried by inert carrier gas such as nitrogen through the column which is packed by an adsorbent material. Separation of different types of components depends on their different affinity, i.e., partition coefficient toward adsorbent phase which is stationary and later detected as shown in the figure below. A chromatogram so obtained helps in qualitative as well as quantitative analysis [6].

Various components of gas chromatography are [9]:


The area covered by the peak represents the amount and position of a particular type of compound [6].

Operating conditions [10]:

**Column:** Porapak polymer bead 80–100 mesh or its equivalent, which can separate or resolve the ethanol. **Column temperature:** 1600°C. **Carrier gas:** Nitrogen. **Rate of gas flow:** 50 ml/minute. **Detector:** Flame ionization detector.

Alternative operating conditions:

**Column:** 0.3% Carbowax 20 M on 80–100 mesh Carbopak C, 2 m 2 mm ID or its equivalent.

**Column temperature:** 350°C for 2 minutes and then programmed at 50°C per minute to 1750°C and hold for at least 8 minutes. **Carrier gas:** Nitrogen at 30 ml/minute [6].

## **13. Conclusion**

Here, a = Total alcohol content present in the body; p = Total weight of the person; q = Alcohol concentration in the urine; r = Constant, namely, 0.68 for men

There are several methods in determining ethanol in the blood, urine, and serum. One of the most important methods is gas chromatography (GC). The sample is injected in a heating chamber, and due to its high temperature, alcohol converts in vapors which are carried by inert carrier gas such as nitrogen through the column which is packed by an adsorbent material. Separation of different types of components depends on their different affinity, i.e., partition coefficient toward adsorbent phase which is stationary and later detected as shown in the figure below. A chromatogram so obtained helps in qualitative as well as quantita-

The area covered by the peak represents the amount and position of a particular

**Column:** 0.3% Carbowax 20 M on 80–100 mesh Carbopak C, 2 m 2 mm ID or

**Column temperature:** 350°C for 2 minutes and then programmed at 50°C per

**Column:** Porapak polymer bead 80–100 mesh or its equivalent, which can

**12. Instrumental technique of analysis of ethyl alcohol**

Various components of gas chromatography are [9]:

and 0.5 in women [6].

*Medical Toxicology*

**12.1 Gas chromatography**

tive analysis [6].

• Carrier gas

• Injector

• Column

• Oven

• Detectors

• Display device

type of compound [6].

its equivalent.

**308**

Operating conditions [10]:

**Carrier gas:** Nitrogen.

separate or resolve the ethanol. **Column temperature:** 1600°C.

**Rate of gas flow:** 50 ml/minute. **Detector:** Flame ionization detector.

Alternative operating conditions:

minute to 1750°C and hold for at least 8 minutes. **Carrier gas:** Nitrogen at 30 ml/minute [6].

• Flow regulator

• Stationary phase

The purpose of this chapter is to discuss the mode of action and function of poisons once they reached in the human body. The impacts of poisons are severe and even cause death if not treated properly.

## **Author details**

Amarnath Mishra Amity Institute of Forensic Sciences, Amity University Uttar Pradesh, Noida, India

\*Address all correspondence to: drmishraa1@gmail.com; amishra5@amity.edu

© 2020 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

## **References**

[1] Macht DI. A drug or poison? The Scientific Monthly. 1938;**47**(1):34-40

[2] Bajgar J. Organophosphates/nerve agent poisoning: Mechanism of action, diagnosis, prophylaxis, and treatment. Advances in Clinical Chemistry. 2004; **38**(1):151-216

[3] Prinzmetal M, Sommer H, Leake CD. The pharmacological action of "mussel poison". Journal of Pharmacology and Experimental Therapeutics. 1932;**46**(1): 63-73

[4] Wasserman D, Dawson CR. The toxic principle of poison ivy and other related plants. Journal of Chemical Education. 1943;**20**(9):448

[5] Yip L, Dart RC, Hurlbut KM. Intravenous administration of oral Nacetylcysteine. Critical Care Medicine. 1998;**26**(1):40-43

[6] Dedrick RL, Myers CE, Bungay PM, DeVita VT. Pharmacokinetic rationale for peritoneal drug administration. Cancer Treatment Reports. 1978;**62**:1-13

[7] De Boer AG, Moolenaar F, De Leede LGJ, Breimer DD. Rectal drug administration. Clinical Pharmacokinetics. 1982;**7**(4):285-311

[8] Peter JV, Sudarsan TI, Moran JL. Clinical features of organophosphate poisoning: A review of different classification systems and approaches. Indian Journal of Critical Care Medicine: Peer-reviewed, official publication of Indian Society of Critical Care Medicine. 2014;**18**(11):735

[9] Donaldson AE, Larsen GY, Fullerton-Gleason L, Olson LM. Classifying undetermined poisoning deaths. Injury Prevention. 2006;**12**(5):338-343

[10] Choi WY, Kim HJ, Na JY, Lee SJ, Lee YJ, Park JT, et al. Analysis of death due to poisoning in Gwangju and Jeollanam-do areas. Korean Journal of Legal Medicine. 2016;**40**(3):72-77

**311**

**Chapter 16**

**Abstract**

Detoxification of Drug and

Detoxification is a process of abolishing a substance of dependence from the body in a way which does not hinder the body's physiology. Detoxification often takes a couple of days and half a month to finish, which is contingent upon the substance being abused, the seriousness of reliance and the help accessible to the client. Metabolism plays an important role in an effective detoxification process; some of the eminent enzymes are discussed in this review, which helps in excretion of xenobiotics. Psychosocial treatments nearby pharmacological medicines are fundamental to improve result. The over reliance conditions considered in this review are detoxification from opioids with clonidine-naltrexone, buprenorphine and other procedures, detoxification of benzodiazepines through adjunctive therapies and medications. Detoxification of psychostimulants with propranolol and amantadine

Detoxification is the process of disengaging a person from a specific psychoactive substance in a safe and effective manner. The choice of which strategy to use for detoxification can depend on many factors, involving clinical judgment, the user's personal preference and circumstances, lifestyle and expectations, degree of dependence and concomitant health problems. Detoxification does not imply that a patient has been given the diagnosis of substance use disorder such as addiction, abuse, or misuse of medications. Although addiction may necessitate detoxification in order to begin drug rehabilitation treatment, there are many reasons that patients must undergo detoxification. Detoxification refers to a decrease in biological activity of a drug after it has been metabolized in the body. Biotransformation is a critically essential pathway for drug detoxification and elimination in humans. Biotransformation of drugs leads to termination or alteration of their biologic activity, otherwise most drugs would have a prolonged duration of action. Despite the fact that probably every organ in the human body is capable of metabolizing drugs but the liver and small intestine serves as the dominant sites of expression of the major drug metabolizing enzymes. Broad spectrums of enzymes are present in a human that can catalyze biotransformation reactions, and they have been classified precisely into Phase I and Phase II processes. Whereas Phase I represents oxidation, reduction, and hydrolytic reactions, Phase II involves conjugation of the drug with an endogenous molecule that generally increases the hydrophilicity of the adducted

Substance Abuse

*Sreemoy Kanti Das*

is also discussed in detail.

**1. Introduction**

**Keywords:** opioids, cannabis, amphetamine, detoxification

## **Chapter 16**

**References**

*Medical Toxicology*

**38**(1):151-216

63-73

[1] Macht DI. A drug or poison? The Scientific Monthly. 1938;**47**(1):34-40 due to poisoning in Gwangju and Jeollanam-do areas. Korean Journal of Legal Medicine. 2016;**40**(3):72-77

[2] Bajgar J. Organophosphates/nerve agent poisoning: Mechanism of action, diagnosis, prophylaxis, and treatment. Advances in Clinical Chemistry. 2004;

[3] Prinzmetal M, Sommer H, Leake CD. The pharmacological action of "mussel poison". Journal of Pharmacology and Experimental Therapeutics. 1932;**46**(1):

[4] Wasserman D, Dawson CR. The toxic principle of poison ivy and other related plants. Journal of Chemical

Education. 1943;**20**(9):448

1998;**26**(1):40-43

2014;**18**(11):735

**310**

[5] Yip L, Dart RC, Hurlbut KM. Intravenous administration of oral Nacetylcysteine. Critical Care Medicine.

[7] De Boer AG, Moolenaar F, De Leede LGJ, Breimer DD. Rectal drug administration. Clinical

Pharmacokinetics. 1982;**7**(4):285-311

[8] Peter JV, Sudarsan TI, Moran JL. Clinical features of organophosphate poisoning: A review of different classification systems and approaches. Indian Journal of Critical Care Medicine: Peer-reviewed, official publication of Indian Society of Critical Care Medicine.

[9] Donaldson AE, Larsen GY, Fullerton-Gleason L, Olson LM. Classifying undetermined poisoning deaths. Injury Prevention. 2006;**12**(5):338-343

[10] Choi WY, Kim HJ, Na JY, Lee SJ, Lee YJ, Park JT, et al. Analysis of death

[6] Dedrick RL, Myers CE, Bungay PM, DeVita VT. Pharmacokinetic rationale for peritoneal drug administration. Cancer Treatment Reports. 1978;**62**:1-13
