Mushrooms Flashcards by Matt Woodman

What features are best to avoid with mushrooms?

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

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

chlorophyllum, agaricus

GI signs

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

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What is the onset and duration of GI irritant mushrooms?

15min-2h

lats 24h

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What is the Tx for GI irritant mushrooms?

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

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What is the prognosis for GI irritant mushrooms?

good but death possible

R/O cyclopeptide toxin

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What mushroom cause muscarine poisoning? whats the toxin?

inocybe, clitocybe

muscarine

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what are the clinical signs of muscarine poisoning?

binds muscarine cholinergic receptors in the PNS

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

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what is the onset and duration of muscarine poisoning?

5-30min

lasts several hours (max 24)

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What is the Tx for muscarine poisoning?

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

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what is the prognosis for muscarine poisoning?

good

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What mushroom contains ibotenic acid/Muscimol toxin?

amanita muscaria

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

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

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

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

30-60min

lasts hours to days

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

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

Px:usually good, death possible

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What is the toxin in magic mushrooms?

psilocybin –> psilocin

- serotonin agonists (like ergot, LSD, mescaline)

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What are the clinical signs of magic mushrooms?

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

What is the onset/duration of magic mushrooms?

mins to hours

lasts hours to days

What is the Tx of magic mushrooms? prognosis?

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

good but death possible

What is important to keep in mind when inducing vomiting?

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

What mushroom causes Coprine poisoning?

Coprinus spp (inky cap)

coprine converted to aminocycloproponal

What are the signs of coprine poisoning?

inhibits acetyldehydrogenase blocks conversion to acetate

makes you feel bad

is Coprine poisoning common in animals?

just dont share your beer

What mushrooms cause monomethylhydrazine poisoning?

whats the toxin?

false morels
few others (EU)

gyromitrin –> monomrthylhydrazine

What are the clinical signs of false morels?

NVD –> dehydration

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

what is the onset and duration of false morels?

delayed (6-12h) lasts several days

What is the treatment of false morels? Px?

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

What mushrooms contain orellanine poisoning? whats the toxin?

cortinarious orellanine +/- toxic peptides

What are the clinical signs of orellanine toxicity?

N,V,D, thirst, muscle and joint pain, "headache" progressive over days to weeks renal failure --> polyuria --> anuria --> hyperkalemia, uremia --> tubularinterstitial nephrosis and fibrosis

What is the onset and duration of orellanine toxicity?

delayed (36h to 20d) lasts days to weeks

What is the Tx of orellanine poisoning? Px?

emesis and AC S&S - IV fluid and electrolyte/acid base support +/- furosemide and dopamine for ARF Px: guarded but death possible

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

cyclopeptide poisoning amatoxin (lots), phallotoxin, virotoxins

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

inhibiting intranuclear RNA poly 2, stopping protein synthesis decrease mRNA production target: crypt cells, hepatocytes and PRT cells

What is the toxicity of cyclopeptide poisoning?

1-2 caps for large dog | very toxic

What 3 phases occur with cyclopeptide poisoning?

initial GI apparent recovery hepatorenal phase

what occurs in initial GI phase of cyclopeptide poisoning

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

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

lasts 12-28h kidney and liver damage continues

what occurs in the final hepatorenal phase of cyclopeptide poisoning?

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

What is the treatment for cyclopeptide poisoning?

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

What is the prognosis for cyclopeptide poisoning?

poor