-IBIS-1.5.0-
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toxidrome
Anticholinergic toxidrome
botanicals
definition
anticholinergic 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:
» Atropa belladonna
» Datura stramonium
treatment of overdose includes Physostigmine 2 mg I.V., cold water
hydrotherapy, cool drinks to reduce dryness of mouth, administration of
ophthalmic solution containing 1% or less Pilocarpine (Ellis, p. 65)
anticholinergic toxidrome: red as a beet, dry as a bone, blind as a bat, mad as a hatter. Causes drying of the mouth, with thirst and dysphagia, along with erythema especially on the neck, chest and face. Esophageal hyperemia and hemorrhagic gastritis can occur. Pupils dilate, react slowly to light; tachycardia, palpitations, tachypnea, urinary retention, fever, trembling, twitching. Mental changes can be seen including giddiness, restlessness, confusion, ataxia, delirium, mania, drowsiness, stupor. Paresthesias and anesthesias may occur; an illusionogenic hallucinatory stage (with both visual and auditory effects) can develop and last several days. Death occurs due to respiratory failure and circulatory collapse (AMA p. 36; Woodward, p. 64).
notable clinical and laboratory test results: dysuria, often with glycosuria accompanied by hypoxia and a change in body temperature (initially elevated, then depressed during or after the hallucinatory stage preceding death); elevated AST and LDH; EEG shows slow waves with rhythmic bursts (AMA, p. 36; Ellis, p. 79; Woodward, p. 64; von Oettingen, p. 249; Poisindex).
footnotes
Ellis, M.D. 1975. Dangerous Plants, Snakes, Arthropods, And Marine Life. Hamilton, IL: Drug Intelligence Publications, Inc.
Lampe, K.F., and McAnn, M.A. 1985. AMA Handbook of Poisonous and Injurious Plants. Chicago: American Medical Association.
von Oettingen, W.F. 1958. Poisoning: A Guide to Clinical Diagnosis and Treatment. Philadelphia: W.B. Saunders and Company.
Woodward, L. 1985. Poisonous Plants: A Color Field Guide. New York: Hippocrene Books, Inc.