Clinical Toxicology II Elective - Plants

Wild tobacco, golden chain, mescal bean, and poison hemlock have these types of effects

A) Anticholinergic
B) Cardiac glycoside
C) Cyanogenic glycoside
D) CNS stimulant
E) CNS hallucinogenic
F) Nicotinic
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Wild tobacco, golden chain, mescal bean, and poison hemlock have these types of effects

A) Anticholinergic
B) Cardiac glycoside
C) Cyanogenic glycoside
D) CNS stimulant
E) CNS hallucinogenic
F) Nicotinic
F) Nicotinic
Water hemlock, spice bush, and carolina moonseed have these types of effects

A) Anticholinergic
B) Cardiac glycoside
C) Cyanogenic glycoside
D) CNS stimulant
E) CNS hallucinogenic
F) Nicotinic
D) CNS stimulant
Morning glory, peyote, cannabinoids, and nutmeg have these types of effects

A) Anticholinergic
B) Cardiac glycoside
C) Cyanogenic glycoside
D) CNS stimulant
E) CNS hallucinogenic
F) Nicotinic
E) CNS hallucinogenic
Almond, apricot, plum, apple seeds, cherry laurel seeds, hydrangea buds, and elderberry have these types of effects

A) Anticholinergic
B) Cardiac glycoside
C) Cyanogenic glycoside
D) CNS stimulant
E) CNS hallucinogenic
F) Nicotinic
C) Cyanogenic glycoside
Deadly nightshade, angel trumpet, jimson weed, and thronapple have these types of effects

A) Anticholinergic
B) Cardiac glycoside
C) Cyanogenic glycoside
D) CNS stimulant
E) CNS hallucinogenic
F) Nicotinic
A) Anticholinergic
Lilly of the valley, foxglove, and oleander have these types of effects

A) Anticholinergic
B) Cardiac glycoside
C) Cyanogenic glycoside
D) CNS stimulant
E) CNS hallucinogenic
F) Nicotinic
B) Cardiac glycoside
The presentation of these types of plants can be remembered as "hot as hades, red as a beet, dry as a bone, blind as a bat, and mad as a hatter."

A) Anticholinergic
B) Cardiac glycoside
C) Cyanogenic glycoside
D) CNS stimulant
E) CNS hallucinogenic
F) Nicotinic
A) Anticholinergic

Typically presents with vasodilation, flshing, tacycardia, lethargy, hallucinations, agitation, seizures and coma 1-4 hours post-ingestion
The antidote for consuming plants with these types of properties is physostigmine.

A) Anticholinergic
B) Cardiac glycoside
C) Cyanogenic glycoside
D) CNS stimulant
E) CNS hallucinogenic
F) Nicotinic
A) Anticholinergic
These plants inhibit the Na-K-ATP-ase pump and produces primarily GI and cardiac symptoms

A) Anticholinergic
B) Cardiac glycoside
C) Cyanogenic glycoside
D) CNS stimulant
E) CNS hallucinogenic
F) Nicotinic
B) Cardiac glycoside

N/V occurs within 2-4 hours post ingestion followed by confusion, cardiac conduction issues, and increases in serum K and digoxin levels
True or false...

Any dysrhythmia can occur with cardiac glycoside poisoning.
True!
True or false... The pt's digoxin level can be used to determine cardiac glycoside toxicity.False! Can be useful to test for exposure as you will see an increase, but cannot determine toxicity itself.Digoxin immune fab is indicated for poisoning from which of these types of plants? A) Anticholinergic B) Cardiac glycoside C) Cyanogenic glycoside D) CNS stimulant E) CNS hallucinogenic F) NicotinicB) Cardiac glycosideHow many vials of digoxin immune fab are typically needed for cardiac glycoside toxicity?10-15 vialsWhat are the indications for digoxin immune fab? (hint: 4 indications)- Any 2nd or 3rd degree AV block - Hyperkalemia > 5 mEq/L - Any ventricular dysrhythmia - Hemodynamic instability despite atropineThese types of plants contain amygdalin which is hydrolzyed in the GI tract to hydrocyanic acid which prevent O2 utilization in the tissues. A) Anticholinergic B) Cardiac glycoside C) Cyanogenic glycoside D) CNS stimulant E) CNS hallucinogenic F) NicotinicC) Cyanogenic glycoside Typical onset is 30 mins - 2 hoursHydroxocobalamin is considered the antidote to this type of plant. A) Anticholinergic B) Cardiac glycoside C) Cyanogenic glycoside D) CNS stimulant E) CNS hallucinogenic F) NicotinicC) Cyanogenic glycoside Hydroxocobalamin = cyanokit Can also use BZDs and vasopressors for management of other manifestations (seizures, hypotension)