Mushrooms Flashcards
What features are best to avoid with mushrooms?
white caps, white gills, ring of death, speckled tops, little brown ones
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
What is the onset and duration of GI irritant mushrooms?
15min-2h
lats 24h
What is the Tx for GI irritant mushrooms?
emesis, AC, baseline blood work, NPO, IV fluids, electrolytes, acid base support, antiemetics, GI protectants
What is the prognosis for GI irritant mushrooms?
good but death possible
R/O cyclopeptide toxin
What mushroom cause muscarine poisoning? whats the toxin?
inocybe, clitocybe
muscarine
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
what is the onset and duration of muscarine poisoning?
5-30min
lasts several hours (max 24)
What is the Tx for muscarine poisoning?
emesis and AC supportive care (especially critical signs - BBB signs) atropine (IV first dose then IM)
what is the prognosis for muscarine poisoning?
good
What mushroom contains ibotenic acid/Muscimol toxin?
amanita muscaria
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,
What is the onset and duration of Ibotenic acid/muscimol?
30-60min
lasts hours to days
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
What is the toxin in magic mushrooms?
psilocybin –> psilocin
- serotonin agonists (like ergot, LSD, mescaline)
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&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
