Poisonous Plants

Question 1

Plants -> GIT

Answer 1

Dumbcane, Monstera spp, Philodendron spp, Flamingo flower:
Poisonous parts: all (leaves)
Oxalate, proteolytic enzymes, Ca-Oxalate (4h)-> pain, hypersalivation, swelling of lips, tongue, throat -> RT obturation, GI signs, complete recovery is expected
Treatment: sedation, GI decontamination, symptomatic therapy (fluids, glucocorticoids, antihistamines, analgesics)

Poinsettia (E.Pulcherrima): poisonous part: leaves, sap, flower
Euphorbic acid => GI signs, salivation, blistered dermatitis, stomatitis, conjunctivitis, lacrimation
Treatment: GI decontamination, symptomatic therapy: fluids, local anaesthetics, coating agents, GC

Poet’s & Wild Daffodil (Narcissus)- poisonous part: all (bulb)
Alkaloid: Narcissine, lycorin, galanthamine => irritation, emesis
Glycoside: scillitoxin, Ca-oxalate, sinistrin => mechanical irritation
=> GI signs, salivation, skin: pruritis, erythema, severe: ataxia, shock, hypothermia, hypotension, bradycardia -> death (rare)
Treatment: GI decontamination, symptomatic therapy: antiemetic, fluids, atropin, K

Superb & Crowned Gloriosa Lily- entire plant (seed, bulb)
Colchicine (alkaloid) -> numbeness of lip, tongue, throat, GI signs, cardiotoxicity, dyspnoe, collapse, convulsions -> death
Treatment: GI decontamination, symptomatic therapy, coating drugs, fluids, analgesics, EPO

Autumn Crocus: colchicine

Hydrangea spp: entire plant
Coumarine glycoside: hydrangin -> GI signs, cyanide poisoning (rare), tachypnoe, resp distress, cherry-red blood
Treatment: GI decontamination, symptomatic therapy, Na-thiosulfate 500-1000 mg/kg IV -> cyanide

Question 2

NS

Answer 2

Golden chain/ Bean tree: all (pod, seed)
Alkaloid: Cytisine => nicotine-like: excitement, incoordination, GI signs, pu, lacrimation. Severe: convulsions, tremors, mm twitches, paralysis, tachycardia, collapse -> death (resp paralysis)
Treatment: GI decontamination, symptomatic therapy: cardioresp stimulants, sedatives, diuretics

Blue star (morning glory): seed
Indole alkaloids (~LSD), glycosides => Hallucinogenic!!!, GI signs, hypotension
Treatment: GI decontamination, Diazepam, Barbiturates (-> seizures)

Bleeding heart spp: all
Izoquinoline alkloid: Protopine => salivation, trembling, hyperexcitability, high D -> recumbancy, opisthotonus, seizures
Treatment: GI decontamination, symptomatic, recovery without treatm.

Larkspur spp: all
Alkaloi: delfinine => GI signs, mm weakness -> kneeling, convulsions, coma -> death
Treatment: GI decontamination, symptomatic, Physostigmine/ Neostigmine

Azalea (Rhododendron): all (nectar: “mad honey”)
Glycoside: Grayanotoxin => high influx of Na -> cells => delayed depolarization => heart, mm, CNS, GI signs, CNS signs
Treatment: GI decontamination, symptomatic

Angel’s trumpet: all
Tropane alkaloid: Atropine, Hyoscyamine, Scopalamine => mouth, resp, heart, motoric/sensory paralysis, convulsions, resp paralysis -> death
Treatment: GI decontamination, antidote, symptomatic

Pokeweed: all, modern pharmacological use
Saponine: Phytolaccatoxin
Glycoside: Phytolaccigenin, lectin => GI signs, tremors, convulsions
Treatment: GI decontamination, supportive

Question 3

Liver

Answer 3

Cycas palm, Sago palm: seed, root ball
Cycasine, Macromazine => GI signs, acute hepatotoxicity: pu/pd, coagulopathy -> petechiae, suffusions, bleeding
Treatment: GI decontamination, symptomatic, liver protecting agents, ionized Ca, fluids, vit.K

Question 4

Heart

Answer 4

Monkshood spp (Aconitum): all, skin
Aconitine => GI irritation, mydriasis, blindness, heart nerve impulses: bradycardia, arrhythmias -> death
Treatment: GI decontamination, symptomatic, Atorpine, Lidocaine, Mexiletin