DELIRIANT POISONS: Dhatura,Strychnine

DELIRIANT POISONS: Dhatura,Strychnine

Q. 1

Signs and symptoms usually develop within 15–30 minutes of strychnine ingestion. What is the fatal dose of strychnine?

 A

10-15 mg

 B

20-40 mg

 C

60-100 mg

 D

100-120 mg

Q. 1

Signs and symptoms usually develop within 15–30 minutes of strychnine ingestion. What is the fatal dose of strychnine?

 A

10-15 mg

 B

20-40 mg

 C

60-100 mg

 D

100-120 mg

Ans. C

Explanation:

Strychnine poisoning:

  • It is an alkaloid derived from the seeds of the tree Strychnos nux-vomica.
  • The potentially fatal dose of strychnine is approximately 50–100 mg (1 mg/kg) and fatal period is 1-2 hours.
  • Strychnine competitively antagonizes glycine, an inhibitory neurotransmitter released by postsynaptic inhibitory neurons in the spinal cord.
  • Muscular stiffness and painful cramps precede generalized muscle contractions, extensor muscle spasms, and opisthotonus. 
  • Death usually is caused by respiratory arrest that results from intense contraction of the respiratory muscles.
 
Ref: Nordt S.P. (2012). Chapter 145. Strychnine. In K.R. Olson (Ed), Poisoning & Drug Overdose, 6e.

Q. 2

Which of the following is the site of action of strychnine poison for its toxicity?

 A

Heart

 B

Anterior horn cells

 C

Posterior horn cells

 D

All of the above

Q. 2

Which of the following is the site of action of strychnine poison for its toxicity?

 A

Heart

 B

Anterior horn cells

 C

Posterior horn cells

 D

All of the above

Ans. B

Explanation:

Strychnine competitively blocks ventral horn motor neuron postganglionic receptor sites in the spinal cord and prevents the effects of glycine, an inhibitory neurotransmitter released by postsynaptic inhibitory neurons in the spinal cord.
Strychnine binds to the chloride ion channel, causing increased neuronal excitability and exaggerated reflex arcs.
This results in generalized seizure-like contraction of skeletal muscles.
Simultaneous contraction of opposing flexor and extensor muscles causes severe muscle injury, with rhabdomyolysis, myoglobinuria, and, in some cases, acute renal failure.
 
Ref: Nordt S.P. (2012). Chapter 145. Strychnine. In K.R. Olson (Ed), Poisoning & Drug Overdose, 6e.

Q. 3

True about strychnine poisoning is :

 A

All muscles affected at the same time

 B

Shoulder girdle affected first

 C

Pelvic girdle affected first

 D

None of the above

Q. 3

True about strychnine poisoning is :

 A

All muscles affected at the same time

 B

Shoulder girdle affected first

 C

Pelvic girdle affected first

 D

None of the above

Ans. A

Explanation:

A i.e. All muscles affected at same time

Quiz In Between


Q. 4

Nux vomica seeds contain 2 alkaloids, strychnine and :

 A

Hyoscine

 B

Hyoscyamine

 C

Brucine

 D

Atropine

Q. 4

Nux vomica seeds contain 2 alkaloids, strychnine and :

 A

Hyoscine

 B

Hyoscyamine

 C

Brucine

 D

Atropine

Ans. C

Explanation:

C i.e. Brucine


Q. 5

The active principles of Dhatura are all of the following except :

 A

Pyricatachol

 B

Hyoscyamine

 C

Atropine

 D

Hyoscine

Q. 5

The active principles of Dhatura are all of the following except :

 A

Pyricatachol

 B

Hyoscyamine

 C

Atropine

 D

Hyoscine

Ans. A

Explanation:

A i.e. Pyricatachol


Q. 6

All the following are characteristic of Dhatura poisoning except:

 A

Delirium

 B

Diplopia

 C

Pin-point pupils

 D

Dysphagia

Q. 6

All the following are characteristic of Dhatura poisoning except:

 A

Delirium

 B

Diplopia

 C

Pin-point pupils

 D

Dysphagia

Ans. C

Explanation:

C i.e. Pinpoint pupil

Quiz In Between


Q. 7

Following is not present in dhatura:           

JIPMER 11

 A

Hyoscine

 B

Hyoscyamine

 C

Muscarine

 D

Atropine

Q. 7

Following is not present in dhatura:           

JIPMER 11

 A

Hyoscine

 B

Hyoscyamine

 C

Muscarine

 D

Atropine

Ans. C

Explanation:

Ans. Muscarine


Q. 8

Treatment of dhatura poisoning is done with:

NEET 15

 A

Pilocarpine

 B

Naloxone

 C

Physostigmine

 D

Neostigmine

Q. 8

Treatment of dhatura poisoning is done with:

NEET 15

 A

Pilocarpine

 B

Naloxone

 C

Physostigmine

 D

Neostigmine

Ans. C

Explanation:

Ans. Physostigmine


Q. 9

Strychnine acts by inhibiting:       

COMEDK 15

 A

GABA

 B

Glycine

 C

Acetylcholine

 D

Dopamine

Q. 9

Strychnine acts by inhibiting:       

COMEDK 15

 A

GABA

 B

Glycine

 C

Acetylcholine

 D

Dopamine

Ans. B

Explanation:

Ans. Glycine

Quiz In Between


Q. 10

Antidote for strychnine poisoning is:          

NEET 13

 A

Fomepizole

 B

Physotigmine

 C

Barbiturates

 D

Naloxone

Q. 10

Antidote for strychnine poisoning is:          

NEET 13

 A

Fomepizole

 B

Physotigmine

 C

Barbiturates

 D

Naloxone

Ans. C

Explanation:

Ans. Barbiturates


Q. 11

In dhatura poisoning 9 ‘Ds’ include all except ‑

 A

Diarrhea

 B

Dysphagia

 C

Dilated pupil

 D

Drowsiners

Q. 11

In dhatura poisoning 9 ‘Ds’ include all except ‑

 A

Diarrhea

 B

Dysphagia

 C

Dilated pupil

 D

Drowsiners

Ans. A

Explanation:

Ans. is ‘a’ i.e., Diarrhea

9-D’ manifestations of Dhatura (anticholinergic) poisoning

  1. Dry hot skin i.e. ‘Hot as a hare’.
  2. Dialation of cutaneous blood vessels 1/t facial i.e. ‘Red as a beet’.
  3. Dialation of pupils with loss of accomodation and unresponsiveness to light i.e. ‘Blind as a bat’.
  4. Dryness of mouth and throat i.e. ‘Dry as a bone’.
  5. Difficulty in talking.
  6. Dysphagia (difficulty in swallowing)
  7. Drunken gait
  8. Drowsiness
  9. Delirium i.e. ‘Mad as wet hen’
  • So symptoms are described as ‘Dry as a bone, Red as a beet, Hot as hare, Blind as a bat and Mad as a wet hen’.

Quiz In Between



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