1/5. Toad venom poisoning: resemblance to digoxin toxicity and therapeutic implications.A healthy man developed gastrointestinal symptoms after ingesting purported aphrodisiac pills. He had severe unrelenting bradycardia, hyperkalaemia, and acidosis. He rapidly developed severe life threatening cardiac arrhythmias and died after a few hours. He was found to have positive serum digoxin concentrations, although he was not taking digoxin. Toad venom poisoning is similar to digitalis toxicity and carries a high mortality. Cardiac glycoside poisoning can occur from ingestion of various plants and animal toxins, and the venom gland of cane toad (bufo marinus) contains large quantities of cardiac glycosides. Toad venom, a constituent of an aphrodisiac, was considered responsible for the development of clinical manifestations and death in this patient. digoxin specific Fab fragment has been reported to be beneficial in the treatment of toad venom poisoning. This report alerts physicians to the need to be aware of a new community toxic exposure, as prompt treatment with digoxin specific Fab fragment may be life saving. The treatment approach to patients with suspected toad venom poisoning is described.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/5. zigadenus poisoning.Significant toxicity can result from ingestion of certain species of the zigadenus plant, an herb occasionally confused with nontoxic wild onions. A 50-year-old man inadvertently ingested Z paniculatus and presented to the emergency department with profound gastrointestinal toxicity, hypotension, and bradycardia. The pathophysiology and management of zigadenus poisoning are reviewed. Emergency physicians, particularly in rural areas, should be aware of the morbidity caused by ingestion of some zigadenus species.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/5. Angel's Trumpet psychosis: a central nervous system anticholinergic syndrome.The authors warn physicians that intoxication by Angel's Trumpet (Datura sauveolens) is becoming more frequent due to its use by adolescents and young adults as a legal, readily available hallucinogen. Ingestion of Angel's Trumpet flowers or a tea brewed from them results in an alkaloid-induced central nervous system anticholinergic syndrome characterized by symptoms such as fever, delirium, hallucinations, agitation, and persistent memory disturbances. Severe intoxication may cause flaccid paralysis, convulsions, and death. Treatment with intravenous physostigmine reverses the toxic effects of Angel's Trumpet.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/5. The dangers of jimson weed and its abuse by teenagers in the Kanawha Valley of west virginia.Jimson weed (datura stramonium, a member of the Belladonna alkyloid family) is a plant growing naturally in west virginia and has been used as a home remedy since colonial times. Due to its easy availability and strong anticholinergic properties, teens are using Jimson weed as a drug. Plant parts can be brewed as a tea or chewed, and seed pods, commonly known as "pods" or "thorn apples," can be eaten. Side effects from ingesting jimson weed include tachycardia, dry mouth, dilated pupils, blurred vision, ballucinations, confusion, combative behavior, and difficulty urinating. Severe toxicity has been associated with coma and seizures, although death is rare. Treatment consists of activated charcoal and gastric lavage. Esmolol or other beta-blocker may be indicated to reduce severe sinus tachycardia. seizures, severe hypertension, severe hallucinations, and life-threatening arrhythmias are indicators for the use of the anticholinesterase inhibitor, physostigmine. This article reviews the cases of nine teenagers who were treated in hospitals in the Kanawha Valley after ingesting jimson weed. We hope this article will help alert primary care physicians about the abuse of jimson weed and inform health officials about the need to educate teens about the dangers of this plant.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/5. Mandrake toxicity. A case of mistaken identity.A 31-year-old man ingested an unknown amount of mandrake plant purchased at a local health food store and came to the emergency department with severe nausea and vomiting. He was hospitalized overnight but recovered uneventfully without obvious adverse systemic effects. This plant was almost certainly podophyllum peltatum based on chromatographic identification of podophyllotoxin in a sample. However, the patient had mistakenly believed he was taking the anticholinergic and hallucinatory plant mandragora officinarum, which is also known as mandrake. Other users of herbal substances and authors of the medical literature have also confused these 2 versions of mandrake. Given the growing popularity of alternative therapies, physicians should understand the distinction between these substances and should be aware of the medical effects of other commonly used herbal remedies.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |