A Mnemonic For Poisonous Mushrooms and Their Effects- GOTAA PPICEM

A Morel DilemmaSupport the showReview the show where ever your listeningGet Messages from Toxo (Join the Newsletter!)Join as a supporting memberAd free episodesBonus content and early accessDiscounts and give aways on GOTA PICCEM Mushroom card gameThe GOTTA PICCEM Poisonous Mushroom Game!The Poisonus Fungus Amongus Children's Book!Full book reading (6 minutes!)Tox trinkets (Rep the show at home!)Reach the showEmail: [email protected] Show ResourcesRyan's Medical Games and ResourcesShow Website If you are looking for links to Dr. Basset's initiatives check back later, they are not fully launched yet!Check it out on Dr. Hamilton's website as well Poison Mushrooms! Got’a Pic’em (GOTAAPPICEM) A mnemonic device to sort through mushroom ingestions – The Hot Stove League of EM/ToxThe GOTAA PPICCEM MnemonicLate-Onset (Severe) Toxic Mushrooms ("GOTA")These mushrooms have delayed symptoms (>6 hours) and are associated with significant toxicity:G – Gyromitrin (Gyromitra esculenta) – False morels; inhibits GABA, leading to seizures.O – Orellanine (Cortinarius spp.) – Causes renal failure; famously poisoned The Horse Whisperer author.T – Tricholoma equestre (Man on Horseback) – Leads to rhabdomyolysis.A – Amatoxin (Amanita phalloides, Galerina spp.) – Causes liver failure; the most lethal mushroom toxicity. Early Onset Nausea, Late Toxicity Mushrooms ("A²P²")A² – Allenic norleucine (Amanita smithiana) – Found in the Pacific Northwest; early GI symptoms followed by renal failure.These may present early but still cause significant toxicity.P² – Paxillus spp. – Can cause hemolytic anemia and multi-organ injury. Early-Onset Nausea Mushrooms ("PICCEM")P– Psilocybin (Psilocybe spp.) – Hallucinogenic, similar to LSD, typically low toxicity but may cause hyperthermia or seizures.Symptoms appear within 6 hours and are usually self-limited.I – Ibotenic Acid & Muscimol (Amanita muscaria, Amanita pantherina) – Acts like a “mushroom speedball”, causing both stimulant and sedative effects.C – Coprine (Coprinus spp., Inky Caps) – Induces disulfiram-like reaction with alcohol.E –  Emetic Mushrooms (LBMs: Little Brown Mushrooms) – Various species that cause self-limited vomiting and diarrhea.M – Muscarine (Clitocybe, Inocybe spp.) – Cholinergic crisis (SLUDGE symptoms), similar to nerve agents.Ryan's Modified Mnemonic GOTTAAA PICCEMThe GOTTA3  P2ICCEM Mnemonic (Ryan's Modification)Late-Onset (Severe) Toxic Mushrooms ("GOTTAA")These mushrooms have delayed symptoms (>6 hours) and are associated with significant toxicity:G – Gyromitrin (Gyromitra esculenta) – False morels; inhibits GABA, leading to seizures. While this is classically taught, newer data suggests its extremely rare, GI effects, with or without hepatoxicity or minor neurologic symptoms predominateO – Orellanine (Cortinarius spp.) – Causes renal failure; famously poisoned The Horse Whisperer author.T – Tricholoma equestre (Man on Horseback) – Leads to rhabdomyolysis.T- Tender nesting polypore (Hapalopilus rutilans) causes late GI effects,  altered mental status, acidosis, and purple urine!A – Amatoxin (Amanita phalloides, Galerina spp.) – Causes liver failure; the most lethal mushroom toxicity.A- Acromelic Acid is found in Clitocybe acromelalga in Japan and C amoenolens in France causes erythromelalgia. It can be treated with IV nicotinic acid!  Early Onset Nausea, Late Toxicity Mushrooms ("A²P²")A² – Allenic norleucine (Amanita smithiana) – Found in the Pacific Northwest; early GI symptoms followed by renal failure.These may present early but still cause significant toxicity.P² – Paxillus spp. – Can cause hemolytic anemia and multi-organ injury. Early-Onset Nausea Mushrooms ("PICCEM") P– Psilocybin (Psilocybe spp.) – Hallucinogenic, similar to LSD, typically low toxicity but may cause hyperthermia or seizures.Symptoms appear within 6 hours and are usually self-limited.I – Ibotenic Acid & Muscimol (Amanita muscaria, Amanita pantherina) – Acts like a “mushroom speedball”, causing both stimulant and sedative effects.C – Coprine (Coprinus spp., Inky Caps) – Induces disulfiram-like reaction with alcohol. Thee are actually many species that have been implciated here incuding Verpa bohemica (early morel) and Boletus luridus (luride bolete).C- Cholinergics (muscarine containing, Clitocybe, Inocybe spp.) Cholinergic crisis (SLUDGE symptoms), similar to nerve agents.E –  Emetic Mushrooms (LBMs: Little Brown Mushrooms) – Various species that cause self-limited vomiting and diarrhea.M – Morchella (morels) while an edible delicacy, they must be thoroughly cooked, recently multiple deaths have been links to eating morels, and the exact mechanism of toxicity is unclear but they result in incredibly fast GI effects.