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Toxicology > Mushrooms > Flashcards

Mushrooms Flashcards

1
Q

What features are best to avoid with mushrooms?

A

white caps, white gills, ring of death, speckled tops, little brown ones

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2
Q

What is the most common toxic mushroom exposed to? what are the clinical signs?

A

chlorophyllum, agaricus

GI signs

  • N,V,D (+/- bloody)
  • salivation, weakness, lathargy, dizziness
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3
Q

What is the onset and duration of GI irritant mushrooms?

A

15min-2h

lats 24h

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4
Q

What is the Tx for GI irritant mushrooms?

A

emesis, AC, baseline blood work, NPO, IV fluids, electrolytes, acid base support, antiemetics, GI protectants

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5
Q

What is the prognosis for GI irritant mushrooms?

A

good but death possible

R/O cyclopeptide toxin

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6
Q

What mushroom cause muscarine poisoning? whats the toxin?

A

inocybe, clitocybe

muscarine

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7
Q

what are the clinical signs of muscarine poisoning?

A

binds muscarine cholinergic receptors in the PNS

  • parasympathetic mimetic overload, targets smooth muscle, glands and heart
  • DDUMBBBELS signs
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8
Q

what is the onset and duration of muscarine poisoning?

A

5-30min

lasts several hours (max 24)

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9
Q

What is the Tx for muscarine poisoning?

A 
emesis and AC
supportive care (especially critical signs - BBB signs)
atropine (IV first dose then IM)
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10
Q

what is the prognosis for muscarine poisoning?

A

good

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11
Q

What mushroom contains ibotenic acid/Muscimol toxin?

A

amanita muscaria

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12
Q

What are the clinical signs of ibotenic acid/muscimol toxin mushrooms?

A

“drunk”
- depression, lethargy, paresis, somnolence, coma, resp depression, AV block

and/or
- agitation, disorientation, hyperactivity ataxia, visual hullucinations, tremors, seizures,

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13
Q

What is the onset and duration of Ibotenic acid/muscimol?

A

30-60min

lasts hours to days

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14
Q

What is the Tx for Ibotenic acid/muscimol? prognosis?

A

emesis and AC, S&S care, seizure control, metal state, resp effort, hypothermia

Px:usually good, death possible

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15
Q

What is the toxin in magic mushrooms?

A

psilocybin –> psilocin

- serotonin agonists (like ergot, LSD, mescaline)

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16
Q

What are the clinical signs of magic mushrooms?

A

tachycardia, mydriasis, hyperthermia, hypertension
CNS derangment/altered behaviour and mental –> agitation, aggression, vocalize, hyperreflexia, seizures and or drowsiness, weakness, ataxia, hullucinations

17
Q

What is the onset/duration of magic mushrooms?

A

mins to hours

lasts hours to days

18
Q

What is the Tx of magic mushrooms? prognosis?

A 
emesis, AC
sedation/seizure control
S&S care
minitor temp
safe dark room (low stim)

good but death possible

19
Q

What is important to keep in mind when inducing vomiting?

A

are they neurologically unstable?
can they control muscles?
aspiration pneumonia, choke

20
Q

What mushroom causes Coprine poisoning?

A

Coprinus spp (inky cap)

coprine converted to aminocycloproponal

21
Q

What are the signs of coprine poisoning?

A

inhibits acetyldehydrogenase blocks conversion to acetate

makes you feel bad

22
Q

is Coprine poisoning common in animals?

A

just dont share your beer

23
Q

What mushrooms cause monomethylhydrazine poisoning?

whats the toxin?

A 
false morels
few others (EU)

gyromitrin –> monomrthylhydrazine

24
Q

What are the clinical signs of false morels?

A

NVD –> dehydration

lethargy, fever, IV hemolysis, methemoglobinemia, hypoglycemia, liver and renal damage, ataxia, tremors, seizures, coma

25
Q

what is the onset and duration of false morels?

A

delayed (6-12h)

lasts several days

26
Q

What is the treatment of false morels? Px?

A

aggressive decontam
S&S care (IV fluid, electrolyte, acid-base and blood sugar control)
seizure control
treat methemoglinemia and multiple organ failure

guarded prognosis and death possible depending

27
Q

What mushrooms contain orellanine poisoning? whats the toxin?

A

cortinarious

orellanine +/- toxic peptides

28
Q

What are the clinical signs of orellanine toxicity?

A

N,V,D, thirst, muscle and joint pain, “headache”

progressive over days to weeks

renal failure –> polyuria –> anuria –> hyperkalemia, uremia –> tubularinterstitial nephrosis and fibrosis

29
Q

What is the onset and duration of orellanine toxicity?

A

delayed (36h to 20d)

lasts days to weeks

30
Q

What is the Tx of orellanine poisoning? Px?

A

emesis and AC
S&S
- IV fluid and electrolyte/acid base support
+/- furosemide and dopamine for ARF

Px: guarded but death possible

31
Q

what is the most common cause of lethal mushroom poisoning? whats the toxin

A

cyclopeptide poisoning

amatoxin (lots), phallotoxin, virotoxins

32
Q

What is the MOA of amatoxins? what do they target?

A

inhibiting intranuclear RNA poly 2, stopping protein synthesis
decrease mRNA production

target: crypt cells, hepatocytes and PRT cells

33
Q

What is the toxicity of cyclopeptide poisoning?

A

1-2 caps for large dog

very toxic

34
Q

What 3 phases occur with cyclopeptide poisoning?

A

initial GI
apparent recovery
hepatorenal phase

35
Q

what occurs in initial GI phase of cyclopeptide poisoning

A

delayed 6-24h
sudden onset of NVD (often bloody)
colic, lethargy, dehydration

lasts 24-48h (gets worse over time)
electrolyte, acid base imbalance, weakness, hyperthermia, brady/tachycardia

36
Q

How long does the latency period last in cylopeptide poisoning? what happens during this period

A

lasts 12-28h

kidney and liver damage continues

37
Q

what occurs in the final hepatorenal phase of cyclopeptide poisoning?

A

begins 36-84h after exposure
progressive liver nad kidney failure
- severe hypoglyemia, icterus, coagulopathy, azotemia, metabolic acidosis, hepatic encephalopathy, seizures, PU/PD, anuria, coma, death

38
Q

What is the treatment for cyclopeptide poisoning?

A

early Dx and treatment is critical

induce emesis, GL
AC 4-6h for 2-3 days with cathartic in first dose
aggressive supportive care
- IV fluids, electrolytes/acidbasae
- manage hypoglycemia
- manage coagulopathy (Vitk transfusions)
- antiemetics, H2 blockers, PPI,

hepatoprotectants (N-acetylcystein, S-adenosylmethionine,Vit E and IV silibinin)

  • lower toxic uptake by hepatocytes
  • protects form ROS damage
39
Q

What is the prognosis for cyclopeptide poisoning?

A

poor

Toxicology (27 decks)

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