Toxic plants Plants Cell Types: Eukaryotic versus Prokaryotic produce a vast and complicated array of chemical compounds in order to protect themselves. These compounds include amatoxins, tropane alkaloids, urushiol, amygdalin Amygdalin A cyanogenic glycoside found in the seeds of rosaceae. Cyanide Poisoning, and cardiac Cardiac Total Anomalous Pulmonary Venous Return (TAPVR) glycosides. The clinical presentation Presentation The position or orientation of the fetus at near term or during obstetric labor, determined by its relation to the spine of the mother and the birth canal. The normal position is a vertical, cephalic presentation with the fetal vertex flexed on the neck. Normal and Abnormal Labor varies depending on the chemical involved, and some of these chemicals are capable of causing life-threatening conditions. The diagnosis is generally based on the exposure Exposure ABCDE Assessment history and clinical presentation Presentation The position or orientation of the fetus at near term or during obstetric labor, determined by its relation to the spine of the mother and the birth canal. The normal position is a vertical, cephalic presentation with the fetal vertex flexed on the neck. Normal and Abnormal Labor. Early recognition is critical to allow prompt supportive therapy and administration of antidotes (if available).
Last updated: 18 Aug, 2021
A. phalloides is the most toxic of the world’s cyclopeptide-containing mushrooms Mushrooms Mycology.
Amanita phalloides mushroom
Image: “Amanita Phalloides” by _Alicja_ . License: Pixabay LicenseThe toxicity Toxicity Dosage Calculation of A. phalloides is caused by amatoxins and phallotoxins.
Amatoxins:
Phalloidin:
Toxicity Toxicity Dosage Calculation occurs over several days and usually develops in 3 characteristic stages:
Stage I:
Stage II:
Stage III:
The diagnosis typically relies on the history and presentation Presentation The position or orientation of the fetus at near term or during obstetric labor, determined by its relation to the spine of the mother and the birth canal. The normal position is a vertical, cephalic presentation with the fetal vertex flexed on the neck. Normal and Abnormal Labor.
Laboratory abnormalities:
Amatoxin levels:
No definitive antidote Antidote An antidote is a substance that counteracts poisoning or toxicity. Substances that can cause poisoning include heavy metals (from occupation, treatments, or diet), alcohols, environmental toxins, and medications. Antidotes of Common Poisonings is available, so management is largely supportive.
Jimson weed
Image: “Brugmansia” by WebLab24_Siti_Web. License: Pixabay LicenseBerries of Atropa belladonna
Image: “Berries of Atropa belladonna” by Intensive Care Unit, Mother and Child Hospital, University Hospital Hassan II, Fes, Morrocco. License: CC BY 2.0Atropa belladonna
Image: “Belladonna” by pixel2013. License: Pixabay LicenseToxicity Toxicity Dosage Calculation from tropane alkaloids causes anticholinergic Anticholinergic Anticholinergic drugs block the effect of the neurotransmitter acetylcholine at the muscarinic receptors in the central and peripheral nervous systems. Anticholinergic agents inhibit the parasympathetic nervous system, resulting in effects on the smooth muscle in the respiratory tract, vascular system, urinary tract, GI tract, and pupils of the eyes. Anticholinergic Drugs poisoning through antagonism of central and peripheral muscarinic receptors Receptors Receptors are proteins located either on the surface of or within a cell that can bind to signaling molecules known as ligands (e.g., hormones) and cause some type of response within the cell. Receptors.
Symptoms usually occur 30–60 minutes after ingestion and may continue for 24–48 hours, manifesting as a classic anticholinergic Anticholinergic Anticholinergic drugs block the effect of the neurotransmitter acetylcholine at the muscarinic receptors in the central and peripheral nervous systems. Anticholinergic agents inhibit the parasympathetic nervous system, resulting in effects on the smooth muscle in the respiratory tract, vascular system, urinary tract, GI tract, and pupils of the eyes. Anticholinergic Drugs toxidrome Toxidrome A toxidrome describes a group of signs, symptoms, and/or characteristic effects associated with exposure to a particular substance or class of substances. General Principles of Toxidromes.
Mnemonic:
The presentation Presentation The position or orientation of the fetus at near term or during obstetric labor, determined by its relation to the spine of the mother and the birth canal. The normal position is a vertical, cephalic presentation with the fetal vertex flexed on the neck. Normal and Abnormal Labor of an anticholinergic Anticholinergic Anticholinergic drugs block the effect of the neurotransmitter acetylcholine at the muscarinic receptors in the central and peripheral nervous systems. Anticholinergic agents inhibit the parasympathetic nervous system, resulting in effects on the smooth muscle in the respiratory tract, vascular system, urinary tract, GI tract, and pupils of the eyes. Anticholinergic Drugs toxidrome Toxidrome A toxidrome describes a group of signs, symptoms, and/or characteristic effects associated with exposure to a particular substance or class of substances. General Principles of Toxidromes can be remembered with:
The diagnosis of tropane alkaloid toxicity Toxicity Dosage Calculation is clinical.
Toxicodendron radicans, also known as poison ivy, with the classic three leaflets
Image: “Poison Ivy” by SWMNPoliSciProject. License: CC BY 3.0An acute allergic dermatitis Dermatitis Any inflammation of the skin. Atopic Dermatitis (Eczema) generally occurs within 4–96 hours, and complete resolution is expected within 7–21 days. Characteristics of the rash Rash Rocky Mountain Spotted Fever include:
Blisters ( bullae Bullae Erythema Multiforme) on the arm Arm The arm, or “upper arm” in common usage, is the region of the upper limb that extends from the shoulder to the elbow joint and connects inferiorly to the forearm through the cubital fossa. It is divided into 2 fascial compartments (anterior and posterior). Arm: Anatomy from contact with poison ivy
Image: “Blisters from contact with poison ivy” by Larsonja. License: Public DOmainThe diagnosis of Toxicodendron dermatitis Dermatitis Any inflammation of the skin. Atopic Dermatitis (Eczema) is based on exposure Exposure ABCDE Assessment history and physical exam.
Many plants Plants Cell Types: Eukaryotic versus Prokaryotic contain cyanogenic glycosides, such as amygdalin Amygdalin A cyanogenic glycoside found in the seeds of rosaceae. Cyanide Poisoning.
Signs and symptoms of cyanide Cyanide Inorganic salts of hydrogen cyanide containing the -cn radical. The concept also includes isocyanides. It is distinguished from nitriles, which denotes organic compounds containing the -cn radical. Cyanide Poisoning poisoning are delayed until several hours after ingestion, but may include:
The diagnosis is generally based on the clinical history and examination. The following may support the diagnosis.
Cardiac Cardiac Total Anomalous Pulmonary Venous Return (TAPVR) glycosides are found in a number of plants Plants Cell Types: Eukaryotic versus Prokaryotic, including:
Pink common foxglove
Image: “Pink common foxglove with bee” by SylviaWetzel. License: CC0Lily of the valley
Image: “Lilies of the valley” by Mareefe. License: Pixabay LicenseConsuming plant parts or teas brewed from these plants Plants Cell Types: Eukaryotic versus Prokaryotic can lead to toxicity Toxicity Dosage Calculation.
Signs and symptoms of cardiac Cardiac Total Anomalous Pulmonary Venous Return (TAPVR) glycoside toxicity Toxicity Dosage Calculation include:
Cardiac Cardiac Total Anomalous Pulmonary Venous Return (TAPVR):
GI symptoms:
Neurologic symptoms:
The diagnosis will be suspected because of the history and clinical presentation Presentation The position or orientation of the fetus at near term or during obstetric labor, determined by its relation to the spine of the mother and the birth canal. The normal position is a vertical, cephalic presentation with the fetal vertex flexed on the neck. Normal and Abnormal Labor and supported by the workup.
Plant | Clinical features | Emergency management |
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Amanita phalloides (death cap mushroom) | Alpha-amanitin
toxicity
Toxicity
Dosage Calculation:
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Atropa belladonna, jimson weed |
Anticholinergic toxicity
Anticholinergic Toxicity
Adverse drug effects associated with cholinergic antagonists. Clinical features include tachycardia; hyperthermia; mydriasis, dry skin and dry mucous membranes, decreased bowel sounds and urinary retention in peripheral anticholinergic syndrome; and hallucinations; psychoses; seizures; and coma in central anticholinergic syndrome.
General Principles of Toxidromes:
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Poison ivy, poison oak, poison sumac | Type IV hypersensitivity reaction Type IV hypersensitivity reaction Type IV hypersensitivity reaction, or delayed-type hypersensitivity, is a cell-mediated response to antigen exposure. The reaction involves T cells, not antibodies, and develops over several days. Presensitized T cells initiate the immune defense, leading to tissue damage. Type IV Hypersensitivity Reaction: erythematous papules, vesicles Vesicles Female Genitourinary Examination, or bullae Bullae Erythema Multiforme in a linear configuration |
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Pits or seeds from cherry, apricot, peach, plum, pear, apple |
Cyanide
Cyanide
Inorganic salts of hydrogen cyanide containing the -cn radical. The concept also includes isocyanides. It is distinguished from nitriles, which denotes organic compounds containing the -cn radical.
Cyanide Poisoning
toxicity
Toxicity
Dosage Calculation:
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Lily of the valley, foxglove |
Cardiac
Cardiac
Total Anomalous Pulmonary Venous Return (TAPVR) glycoside
toxicity
Toxicity
Dosage Calculation:
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Digoxin-specific antibody fragments Digoxin-Specific Antibody Fragments Cardiac Glycosides |