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1.
Clin Toxicol (Phila) ; 57(4): 246-253, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30522351

RESUMO

INTRODUCTION: Datura and Brugmansia plants, especially Datura species, have been used for their hallucinogenic effects in the United States and Europe; whereas Datura plants have been used as a traditional medicine in many Asian countries. This study was conducted to better understand the pattern and outcome of Datura/Brugmansia plant related poisoning in Taiwan. METHODS: This is a retrospective case series study of all cases with Datura/Brugmansia exposure reported to the Taiwan Poison Control Center between 1986 and 2015. Data for patients with relevant poisoning were reviewed and abstracted. Logistic regression analysis was used to identify potential predictors of the severity of poisoning; bivariate analysis was employed to assess the effectiveness of physostigmine in the treatment of Datura/Brugmansia poisoning. RESULTS: A total of 203 cases involving 114 Datura exposures and 89 Brugmansia suaveolens exposures were eligible for analysis. Using Datura/Brugmansia for a medicinal purpose by the patients without consulting Chinese medicine practitioners was the most common reason of poisoning (81.2%); whereas only 2% of the patients were poisoned after medicinal use associated with the prescription from Chinese medicine practitioners. None of the 203 patients had used Datura/Brugmansia plant for recreational purpose. Most frequently observed clinical effect was mydriasis (53.2%), followed by confusion (40%), tachycardia (35.5%), dry mouth (35.5%), dizziness (34%), dry skin (32.5%), and delirium (31%). Seventy-three cases (36%) had severe effects; none of them died. Misidentification of the plants and ingestion of plant parts other than flowers were positively associated with the severity of poisoning. Forty patients (19.7%) received physostigmine therapy and patients receiving physostigmine had an earlier resolution of central nervous system toxicity than those who did not. CONCLUSIONS: Medicinal use without consulting Chinese medicine practitioners is the main reason for Datura/Brugmansia poisoning in Taiwan. Consumption of parts other than flowers and misidentification of the plants predicted the severity of poisoning in this study. Patients who received physostigmine appear to have earlier improvement in the central nervous system effects. No adverse events were reported from physostigmine administration.


Assuntos
Brugmansia/envenenamento , Datura/envenenamento , Intoxicação por Plantas/epidemiologia , Adulto , Inibidores da Colinesterase/uso terapêutico , Feminino , Humanos , Masculino , Medicina Tradicional Chinesa , Pessoa de Meia-Idade , Antagonistas Muscarínicos/toxicidade , Fisostigmina/uso terapêutico , Intoxicação por Plantas/tratamento farmacológico , Intoxicação por Plantas/etiologia , Plantas Medicinais/efeitos adversos , Plantas Medicinais/envenenamento , Centros de Controle de Intoxicações/estatística & dados numéricos , Estudos Retrospectivos , Taiwan/epidemiologia
2.
Med J Malaysia ; 73(6): 453-454, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30647232

RESUMO

Datura plants contain anticholinergic properties. Consumers may present with a spectrum of anticholinergic symptoms, including hallucination, agitation, tachycardia, delirium, hyperthermia, and dilated pupils. Prompt identification of the symptoms with appropriate treatment can be life-saving. Some patients might not be able to provide history and therefore recognition of toxidromes is imperative. Awareness should be built among the public who may be exposed to such fruits or plants.


Assuntos
Datura/envenenamento , Frutas/envenenamento , Intoxicação por Plantas/diagnóstico , Adulto , Inibidores da Colinesterase/uso terapêutico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fisostigmina/uso terapêutico , Intoxicação por Plantas/tratamento farmacológico , Intoxicação por Plantas/etiologia
4.
Shokuhin Eiseigaku Zasshi ; 58(2): 86-95, 2017.
Artigo em Japonês | MEDLINE | ID: mdl-28484137

RESUMO

A food-poisoning case due to eating the roots of Datura occurred in Kawasaki City, Japan in 2014. The Datura plant was mistakenly collected instead of burdock in a domestic garden. The roots of these plants are quite similar to each other. We presumed that the specimen was the root of Datura, but it was difficult to classify it only from the morphology. Using LC-MS/MS, we detected atropine and scopolamine from the remaining plant specimen. Therefore, we applied the DNA barcoding method. The results showed that the specimen was classified into Solanaceae family, but not Asteraceae family. Thus, the specimen was confirmed to be Datura species based on both chemical and genetic analyses.


Assuntos
Cromatografia Líquida/métodos , Código de Barras de DNA Taxonômico/métodos , Datura/genética , Datura/envenenamento , Doenças Transmitidas por Alimentos/etiologia , Espectrometria de Massas em Tandem/métodos , Atropina/análise , Atropina/isolamento & purificação , Datura/química , Datura/classificação , Humanos , Escopolamina/análise , Escopolamina/isolamento & purificação , Solanaceae
5.
Forensic Sci Int ; 261: e17-21, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26952786

RESUMO

Datura poisonings have been previously described but remain rare in forensic practice. Here, we present a homicide case involving Datura poisoning, which occurred during a robbery. Toxicological results were obtained by second autopsy performed after one previous autopsy and full body embalmment. A 35-year-old man presented with severe stomach and digestive pain, became unconscious and ultimately died during a trip in Asia. A first autopsy conducted in Asia revealed no trauma, intoxication or pathology. The corpse was embalmed with methanol/formalin. A second autopsy was performed in France, and toxicology samples were collected. Scopolamine, atropine, and hyoscyamine were found in the vitreous humor, in addition to methanol. Police investigators questioned the local travel guide, who admitted to having added Datura to a drink to stun and rob his victim. The victim's death was attributed to disordered heart rhythm due to severe anticholinergic syndrome following fatal Datura intoxication. This is a recent case of a rare homicide involving Datura that highlights general information on Datura and discusses forensic interpretation after a previous autopsy and body embalmment.


Assuntos
Datura/envenenamento , Homicídio , Adulto , Síndrome Anticolinérgica/etiologia , Atropina/análise , Toxicologia Forense , Humanos , Hiosciamina/análise , Masculino , Escopolamina/análise , Corpo Vítreo/química
6.
Shokuhin Eiseigaku Zasshi ; 55(1): 55-63, 2014.
Artigo em Japonês | MEDLINE | ID: mdl-24598227

RESUMO

In the present study, we reviewed food poisoning data published by the Ministry of Health, Labour and Welfare of Japan from 1961 to 2010 in Japan to analyze the trends of plant toxin food poisonings (PTFPs). The annual number of incidents of PTFPs has gradually increased since 1995. PTFPs were predominantly caused by Datura spp., Veratrum spp. and Aconitum spp. Although PTFPs frequently occurred in April and May, poisonings caused by some plants occurred in all seasons, e.g. Datura spp. The major location of PTFPs was "at home", and most of the patients had accidentally harvested poisonous plants. During the past decade, the numbers of incidents of PTFPs caused by Veratrum spp., Narcissus spp., Solanum tuberosum and Alocasia odora were especially increased. Consumer advice to prevent PTFPs associated with certain plants that are cultivated in gardens and contain toxic substances is needed, because PTFPs caused by such plants are increasing. In addition, education of elementary school teachers and children about the potential risks of natural toxins in plants, particularly Solanum tuberosum, is desirable.


Assuntos
Intoxicação por Plantas/epidemiologia , Aconitum/envenenamento , Alocasia/envenenamento , Datura/envenenamento , Humanos , Japão/epidemiologia , Narcissus/envenenamento , Intoxicação por Plantas/mortalidade , Estações do Ano , Solanum tuberosum/envenenamento , Fatores de Tempo , Veratrum/envenenamento
11.
Przegl Lek ; 67(5): 438-9, 2010.
Artigo em Polonês | MEDLINE | ID: mdl-20684356

RESUMO

In recent months, more and more reports have appeared about datura seed poisoning. Datura is widespread and has hallucinogenic properties. It is part of the increase in drug use among the younger generation that is experimenting with intoxicants. The hallucinogenic and poisonous effects of datura involve the presence of tropine alkaloids: atropine and scopolamine. They both have similar effects, suppressing the parasympathetic peripheral nervous system. In large doses they lead to death as a result of respiratory paralysis. Treatment addresses the symptoms. In order to eliminate toxic effects of atropine, an antagonistic medication such as neostigmine is given.


Assuntos
Datura/envenenamento , Alucinógenos/envenenamento , Sementes/envenenamento , Adolescente , Antídotos/administração & dosagem , Inibidores da Colinesterase/administração & dosagem , Feminino , Humanos , Masculino , Neostigmina/administração & dosagem
13.
Clin Toxicol (Phila) ; 48(2): 143-5, 2010 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-20136480

RESUMO

BACKGROUND: Anticholinergic plants contain a variety of alkaloids that are toxic if ingested. Datura innoxia belongs to the family of Solanaceae and contains two main toxic alkaloids, atropine and scopolamine. CASE SERIES: In this study we report the case series of seven individuals who were admitted to two different hospitals of Athens with an anticholinergic syndrome. All symptoms manifested after consumption of cooked vegetables (blites). INVESTIGATION: The investigation of the cases revealed that among the vegetables there was also Datura innoxia, which has a similar appearance to blites. Urine and plasma samples of the seven patients, as well as a sample of cooked vegetables, were analyzed with gas chromatography-mass spectrometry. Atropine and scopolamine were confirmed in all urine and vegetable samples, but not in plasma probably because of the delay in sample collection. The urine samples of all patients contained atropine in concentrations between 67.1 and 691.7 ng/mL, while urine concentrations of scopolamine ranged from 32.4 to 186.4 ng/mL. The concentrations of atropine and scopolamine in the cooked vegetables were found to be 0.8 and 1.2 microg/g, respectively. CONCLUSION: All patients recovered completely, although some required mechanical ventilation. The investigation and the presentation of this case series illustrate not only mass intoxication with D. innoxia, but also the utility of analytical toxicology. It also illustrates the dangers of collection of vegetables in the wild.


Assuntos
Datura/envenenamento , Contaminação de Alimentos , Doenças Transmitidas por Alimentos/etiologia , Intoxicação por Plantas/etiologia , Atropina/farmacocinética , Atropina/envenenamento , Datura/química , Feminino , Doenças Transmitidas por Alimentos/fisiopatologia , Cromatografia Gasosa-Espectrometria de Massas , Grécia/epidemiologia , Humanos , Masculino , Intoxicação por Plantas/fisiopatologia , Escopolamina/farmacocinética , Escopolamina/envenenamento , Verduras/normas
14.
Artigo em Inglês | MEDLINE | ID: mdl-20578469

RESUMO

Traditional Malay herbal medicine is still used in Malaysia especially in rural areas, instead of using modern medicine. Datura or "kecubung" has been used to treat allergic rhinitis in certain places. Inaccurate doses can potentially cause severe or fatal neurologic anti-cholinergic toxidromes. A good knowledge of toxidromes with optimization of supportive care can prevent fatal complications and lead to a more speedy recovery. We present a case of kecubung poisoning.


Assuntos
Datura/envenenamento , Medicina Herbária , Medicina Tradicional do Leste Asiático , Humanos , Malásia , Masculino , Pessoa de Meia-Idade
15.
Chudoku Kenkyu ; 21(2): 177-81, 2008 Apr.
Artigo em Japonês | MEDLINE | ID: mdl-18516943

RESUMO

We saw 2 cases of datura poisoning, with the main complaint of impaired consciousness, which were brought to the emergency department of this hospital. The poisonous constituent of the datura is tropane alkaloid, which is said to have a short half-life period that makes it difficult to determine its quantity in the blood or urine. We stored the urine and blood specimens taken when the patients were brought in and sent them for analysis at a public health center a few days later. The determined amounts for both patients are as follows. Case 1: serum atropine, 70 ng/mL; scopolamine, 210 ng/mL; urine atropine, 0.34 mg/L; scopolamine, 0.11 mg/L. Case 2 : serum atropine, 60 ng/ mL ; scopolamine, 380 ng/mL ; urine atropine, 0.22 mg/L ; scopolamine, 0.14 mg/L. We attempted to compare these results with literature on the possible measurement of a determined amount in light of comparative considerations of the correlation between blood concentration and clinical conditions, but encountered some difficulties due to the lack of available reports. However, as our own experiment cases are retrospective we report them as valuable cases in which it is possible to obtain a determined amount of tropane alkaloid.


Assuntos
Datura/envenenamento , Envenenamento/diagnóstico , Envenenamento/etiologia , Tropanos/sangue , Doença Aguda , Idoso , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Envenenamento/terapia , Estudos Retrospectivos , Tropanos/urina
16.
Singapore Med J ; 49(5): e131-3, 2008 May.
Artigo em Inglês | MEDLINE | ID: mdl-18465037

RESUMO

Datura metel L. (Yangjinghua) is a toxic herb that contains anticholinergic compounds. Inappropriate consumption of this herb could result in anticholinergic poisoning. Clinical features of such poisoning have not been previously described. We report two such cases. Both patients had taken brews of Datura metel L., and developed poisoning soon afterwards. Prominent clinical features included confusion, dilated pupils, absence of sweating, and the absence of sluggish bowel sounds. No flushing of the face or skin was detected in either case. Both patients recovered fully within 12 hours with supportive measures, and no gastric elimination or antidote was used. The different names ascribed to Datura metel L. in chinese medicine can be confusing; this confusion resulted in the poisoning of one of our patients. The clinical features of Datura metel L. poisoning and concerns over inappropriate uses of herbal medicine are discussed.


Assuntos
Datura/envenenamento , Medicamentos de Ervas Chinesas/envenenamento , Adulto , Feminino , Humanos , Masculino , Erros de Medicação , Pessoa de Meia-Idade , Singapura
18.
J S Afr Vet Assoc ; 77(2): 86-9, 2006 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-17120625

RESUMO

Two out of a group of 23 mares exposed to tef hay contaminated with Datura ferox (and possibly D. stramonium) developed colic. The 1st animal was unresponsive to conservative treatment, underwent surgery for severe intestinal atony and had to be euthanased. The 2nd was less seriously affected, responded well to analgesics and made an uneventful recovery. This horse exhibited marked mydriasis on the first 2 days of being poisoned and showed protracted, milder mydriasis for a further 7 days. Scopolamine was chemically confirmed in urine from this horse for 3 days following the colic attack, while atropine could just be detected for 2 days. Scopolamine was also the main tropane alkaloid found in the contaminating plant material, confirming that this had most probably been a case of D. ferox poisoning. Although Datura intoxication of horses from contaminated hay was suspected previously, this is the 1st case where the intoxication could be confirmed by urine analysis for tropane alkaloids. Extraction and detection methods for atropine and scopolamine in urine are described employing enzymatic hydrolysis followed by liquid-liquid extraction and liquid chromatography tandem mass spectrometry (LC/MS/MS).


Assuntos
Datura/envenenamento , Doenças Transmitidas por Alimentos/veterinária , Doenças dos Cavalos/diagnóstico , Intoxicação por Plantas/veterinária , Animais , Atropina/urina , Cólica/etiologia , Cólica/veterinária , Evolução Fatal , Feminino , Contaminação de Alimentos , Doenças Transmitidas por Alimentos/diagnóstico , Doenças Transmitidas por Alimentos/patologia , Doenças Transmitidas por Alimentos/urina , Doenças dos Cavalos/patologia , Doenças dos Cavalos/urina , Cavalos , Midríase/etiologia , Midríase/veterinária , Intoxicação por Plantas/diagnóstico , Intoxicação por Plantas/patologia , Intoxicação por Plantas/urina , Escopolamina/urina
20.
J S Afr Vet Assoc ; 76(2): 107-12, 2005 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-16108531

RESUMO

Datura poisoning of horses is extensively reviewed. An outbreak of intractable impaction colic affecting 18 of 83 horses was stopped by withdrawing dried tef hay contaminated with young Datura plants. The dried, botanically identified Datura stramonium and D. ferox contained respectively 0.15% mass/mass (m/m) hyoscyamine as well as 0.16% m/m hyoscine (scopolamine) and only hyoscine at a concentration of 0.11% m/m. Immature, unidentifiable plants resembling D. stramonium, contained 0.14% m/m and 0.12% m/m of the 2 respective tropane alkaloids. The outbreak was characterised by protracted and repeated colic attacks due to impaction of the large colon and/or caecum without any other anti-muscarinic signs. Comparative analyses of single specimens of dried seed of the 2 species collected from both fertilised and waste areas revealed that young South African Datura spp. had levels of tropane alkaloids comparable to those in the well-known toxic seed and were, consequently, equally toxic. The inherent danger of tef hay being contaminated with Datura is emphasised. To our knowledge this is the 1st field case of poisoning in horses ascribed to the vegetative parts of Datura spp.


Assuntos
Cólica/veterinária , Datura/envenenamento , Surtos de Doenças/veterinária , Contaminação de Alimentos , Doenças Transmitidas por Alimentos/veterinária , Doenças dos Cavalos/etiologia , Animais , Cólica/epidemiologia , Cólica/etiologia , Datura stramonium/envenenamento , Doenças Transmitidas por Alimentos/epidemiologia , Doenças dos Cavalos/epidemiologia , Cavalos
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