Toxic Plants (Deep Dive R32)
from EM Clerkship Hosted by Zack Olson, MD and Michael Estephan, MD
Cardiac Glycoside containing plants : Foxglove, Lilly of the Valley, Oleander, Squill * Contain cardiac glycosides, which act as a negative chronotrope as well as a positive inotrope.* Patients present with nausea, vomiting, visual changes, bradycardia/arrhythmia, and may develop hyperkalemia – a poor prognostic factor* Treatment is Digibind/DigiFAB – look out for the side effects of hypokalemia as well as anaphylaxis. Anticholinergic Alkaloid containing plants: Jimson Weed, Angels Trumpet, Deadly Nightshade * Contain alkaloids that act as anticholinergics ; often used recreationally* Patients present with delirium/hallucinations, pupillary dilation, anhydrosis, hyperthermia, skin flushing, urinary retention* Treatment is support care, with physostigmine for severe cases – remember to go low and slow! Toxic Mushrooms * Important to distinguish between acute onset symptoms (Stone Heart Syndrome – LITFL Gyromitra – Indiana Poison Center Anticholinergic Intoxication – EMCrit
Embed this episode
No transcript yet.