Alcohol Poisoning MCQs

Medico-legal Aspects of delirium tremens: It is a medical emergency and should be treated on an inpatient basis. When a person is in delirium tremens commits any illegal act, he is not held responsible by the reason that he is considered to be mentally unsound during this state (Sec. 22 BNS). 22 BNS: Act of a person of unsound mind. - Nothing is an offence which is done by a person who, at the time of doing it, by reason of unsoundness of mind, is incapable of knowing the nature of the act, or that he is doing what is either wrong or contrary to law. Reference: Review of Forensic medicine and toxicology, Gautam Biswas, 5 th edition. Page No. 606

Sec. 22 BNS: Act of a person of unsound mind.-Nothing is an offence which is done by a person who, at the time of doing it, by reason of unsoundness of mind, is incapable of knowing the nature of the act, or that he is doing what is either wrong or contrary to law. Delirium tremens is a psychiatric condition arising as a result of abstinence from alcohol. In case of delirium tremens, he doesn't know that what is he doing. So, he is not criminally responsible for his act under section 22 BNS. Reference: The Bharatiya Nyaya Sanhitha, 2023

Explanation: Delirium tremens is a psychiatric condition arising as a result of abstinence from alcohol. In case of delirium tremens, he doesn't know what he is doing. So, he is not criminally responsible for his act under section 22 BNS. Sec. 22 BNS: Act of a person of unsound mind. Nothing is an offence which is done by a person who, at the time of doing it, by reason of unsoundness of mind, is incapable of knowing the nature of the act, or that he is doing what is either wrong or contrary to law.

According to Motor Vehicle Act 1988, the maximum permissible BAC while driving is 30mg/dl. In India, driving under the influence of alcohol or drunk driving is punishable if the BAC exceeds 30mg/dl. In India, according to Motor Vehicles (Amendment) Act 2019, for the first offence, punishment is imprisonment up to 6 months with/without fine up to Rs. 10,000. For the subsequent offence, the punishment is up to 2 years of imprisonment with or without fine up to Rs. 15,000. Under this Act, there can be arrest without warrant, a breath test and a laboratory test can also be carried out. Reference: Review of Forensic medicine and toxicology, Gautam Biswas, 5 th edition. Page No. 604

Widmark’s formula is used to estimate the blood alcohol level in the body. a = cpr where, a - the total amount of alcohol (in grams) absorbed in the body c - the concentration of alcohol in blood (in g/kg) p - the weight of the person (in kg) r- constant (0.68 in men and 0.5 in women) Alcohol level from urine is estimated with the formula: a = 3/4 qpr where, q - concentration of alcohol in urine (in g/l) and 'a' 'p' and 'r' are the same as above. Reference: Review of Forensic medicine and toxicology, Gautam Biswas, 5 th edition. Page No. 604

Treatment (For both withdrawal symptoms and delirium tremens): Diazepam (40-80 mg/day in divided doses) is used. Oral multi-B vitamins, including thiamine 50-100 mg is given daily for a week or more. Chlordiazepoxide (80-200 mg/day in divided doses) or haloperidol 20 mg or more/day may be used. Intravenous fluids are avoided, unless there is evidence of bleeding, vomiting or diarrhoea. In some withdrawal symptom cases, only restoration of alcoholic drinks helps. In cases of urgent sedation as in delirium tremens- phenobarbitone or chlorpromazine injection can be given, and then detoxification and maintenance of nutrition is carried on with 5% dextrose solution IV and thiamine. Symptomatic treatment. Reference: Review of Forensic medicine and toxicology, Gautam Biswas, 5 th edition. Page No. 606

Both ethanol and methanol are metabolized by hepatic alcohol dehydrogenas e 4-methylpyrazole (fomepizole) is a competitive inhibitor of alcohol dehydrogenase. It blocks the formation of formaldehyde and formic acid and can be used instead of ethanol. Dose: Loading dose of 15 mg/kg over 30 minutes, followed by 10 mg/kg every 12 hours for 4 doses, then 15 mg/kg every 12 hours. Reference: Review of Forensic medicine and toxicology, Gautam Biswas, 5 th edition. Page No. 609

Ans. is 'd' i.e., Heroin Amongst the given options, heroin is the most commonly abused substance : Alcohol → 43.9 % Opioids (including heroin) → 26% Cannabis → 11.6 %