A patient with history of prolonged intake of some unknown poison presents with digestive disturbances, anorexia, dilated pupils, hallucinations and blackened teeths and tongue. Most likely agent is: March 2012

Ans: D i.e. Cocaine Poisons and effects On swallowing crushed seeds/ alkaloid of strychnos nux vomica, bitter taste in mouth, sense of uneasiness and restlessness, feeling of suffocation and difficulty in swallowing occurs. - Convulsions are preceded by such prodromal symptoms as increased acuity of perception, increased rigidity of muscles, and muscular twitchings 8 D's of datura poisoning include Dryness of mouth, Dysphagia, Dilated pupils, Dry and hot skin, Drunken gait, Delirium, Drowsiness and Death (due to respiratory failure) When opium is taken by mouth, it first stimulates, then depresses and finally paralyses the nerve centres. (stage of excitement, stage of stupor and stage of coma). The pupils are contracted Chronic cocaine abuse causes digestive disturbances, anorexia, salivation, tachycardia, tachypnoea and insomnia. The face is pale, eyes sunken, pupils dilated and the gaze is shifty. The tongue and teeths are black. -- Degeneration of the CNS occurs and the patient may suffer from hallucinations (Magnan's symptoms/ cocaine bugs), convulsions, delirium and insanity.