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toxidrome

Parasympathomimetic toxidrome

botanicals

definition

parasympathomimetic toxidrome

the following toxicity information is largely derived from poisonings, overdoses and research on isolated constituents; used with appropriate clinical judgment and cautious prescribing, herbs are safe and efficacious

plants included:

» Physostigma venenosum

» Pilocarpus spp.

treatment of overdose: Atropine; strong digitalis glycosides have been used to treat cardiac disturbances (Theines and Haley, p. 109; von Oettingen, p. 500)

• Parasympathomimetic toxidrome; acetylcholinesterase inhibitor: produces bradycardia, intense salivation, nausea, lacrimation, perspiration, miosis, fasciculations, tremors, restlessness, confusion, coma and collapse. Pulse rate may increase or decrease. Death occurs following convulsions and cardiorespiratory collapse (Cain, p. 539; Duke, pp. 365-366; Morton, p. 173; Theines and Haley, p. 109; von Oettingen, p. 500)

• overdose signs and symptoms: colic, miosis, and profuse perspiration set this toxidrome apart from any other neural toxidromes; miosis occurs with rigidity of pupils, spasmodic accommodation, diplopia, nystagmus, and a widening of the visual field; occasionally, a decrease in intraocular pressure leads to glaucoma (Theines and Haley, p. 109)

• asphyxia may occur leading to pulmonary edema and an overproduction of bronchial mucus (Theines and Haley, p. 109)

• reflexes continue until death (von Oettingen, p. 500)

footnotes

Cain, H.D. 1980. Flint's Emergency Treatment and Management, 6th ed. Philadelphia: W.B. Saunders Company.

Duke, J.A. 1985. C.R.C. Handbook of Medicinal Herbs. Boca Raton, FL: The C.R.C. Press.

Morton, J.F. 1977. Major Medicinal Plants: Botany, Culture, Uses. Springfield, IL: Charles C. Thomas.

Thienes, C.H., Haley, T.J. 1975. Clinical Toxicology. 5th ed. Philadelphia: Lea and Febiger.

von Oettingen, W.F. 1958. Poisoning: A Guide to Clinical Diagnosis and Treatment. Philadelphia: W.B. Saunders and Company.

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Morton, J.F. 1977. Major Medicinal Plants: Botany, Culture, Uses. Springfield, IL: Charles C. Thomas.

Thienes, C.H., Haley, T.J. 1975. Clinical Toxicology. 5th ed. Philadelphia: Lea and Febiger.

von Oettingen, W.F. 1958. Poisoning: A Guide to Clinical Diagnosis and Treatment. Philadelphia: W.B. Saunders and Company.

adelphia: W.B. Saunders and Company.