Morphine poisoning treatment

For the treatment of poisoning, a selective antidote (which antagonises the action) may be given e.g., nalorphine and naloxone in case of morphine poisoning, atropine in case of anticholinergic drugs, dimercaprol in mercury and penicillamine in lead poisoning, etc. 

It is inactive orally because of high first pass metabolism in liver. Metabolised by glucuronidation in liver. The main use of naloxone is in the treatment of acute opioid overdose (acute morphine poisoning). It also precipitates withdrawal syndrome when administered to morphine addicts. The constricted pupils of addicts dilate after administration of naloxone. This has been used as a diagnostic tool for opioid addiction. 

In mammals, phenobarbital and phenytoin increase serum ceruloplasmin concentrations (Aaseth and Norseth 1986). Chronic copper poisoning in sheep is exacerbated when diets contain heliotrope plants (Heliotropium sp., Echium spp., Senecio sp.). Aggravated effects of the heliotrope plants include reduced survival and a twofold to threefold increase in liver and kidney copper concentrations when compared to control animals fed copper without heliotropes (Howell et al. 1991). Rats given acutely toxic doses of 2,3,7,8-tetrachlorodibenzo-para-dioxin had elevated concentrations of copper in liver and kidney because of impaired biliary excretion of copper (Elsenhans et al. 1991). Morphine increases copper concentrations in the central nervous system of rats, and dithiocarbam-ates inhibit biliary excretion (Aaseth and Norseth 1986). In human patients, urinary excretion of copper is increased after treatment with D-penicillamine, calcium disodium EDTA, or calcium trisodium diethylenetriamine penta acetic acid (Flora 1991). 

Henbane has from 12-15 species, mostly native to the Mediterranean. Black henbane is the one that is used mainly for drags, its principal alkaloid beit hyoscy-amine. It is a small annual or perennial with hairy, coarsely lobed leaves with an unpleasant odor. It is used as a pain reliever for spasms and as a sedative. Henbane is also sometimes used as an antidote to meicuiy poisoning and in the treatment of morphine addiction. 

Lobeline has also been advantageous for the treatment of victims who have been electrocuted or asphyxiated by toxic gasses. Moreover, it was useful in the case of the paralysis of respiratory centers after drug poisoning with alcohol, soporifics, or morphine or after narcosis. Lastly, it has also been used to treat asphyxia in newborn infants. 

In the opinion of Daubney and Nickolls the quantitative determination of comparatively large amounts of alkaloids is relatively easy by the classical methods, since in cases where a large dose of poison has been consumed, death usually follows rapidly and the bulk of the poison is in the stomach contents, but difficulty arises in the extraction of relatively small amounts of alkaloids from tissues. A technique was evolved from experiments with a range of alkaloids, sufficiently wide for the method to be assumed of general applicability. Morphine was shown to be unique in being extracted from tissue by saturated ammonium sulphate solution and required special treatment. The general method finally adopted was as follows ... 

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