Take the patient to a Hospital. This is a Medico legal case. Typical smell and constricted pupils make the diagnosis obvious.

Insert a stomach tube and give a thorough stomach wash.

-          Preserve the sample of stomach contents in a empty saline bottle.

-          Continue stomach wash every hour for 2 days.

Start I.V. drip of 5% dextrose.

Inj. ATROpine 10 amps I.V. stat.

-          if pupils do not dilate within 10 minutes, repeat 10 amps ATROpine, every 10 minutes till pupils dilate.

-          Then give 2-5 amps of ATROpine every 1 hr plus more if pupils constrict again.

If patient has tremors or convulsions on First day, then Prognosis is poor.

Patient may recover initially, but die of Respiratory paralysis on 6th to 8th day. Warn the relatives in severe poisoning cases, that nothing can be said for 8 days till all poison is driven out of the body.

In any ingested poison, stomach wash is as important as the specific antidotes.

High dose ATROpine may precipitate acute retention of urine (inert catheter) and in old patients glaucoma.

In P.A.M. 2 amps I. V. slow x stat then 1-2 amps everyday if dose of poison was high.

If patient becomes violent or agitated due to ATROpine toxicity

Inj. Largactil 2-4cc IM. (Chlorpromazine = 4-1)

Inj. Largactil