Presumed Angel's trumpet (Brugmansia) poisoning: clinical effects and epidemiology.
Emerg Med (Fremantle)
; 15(4): 376-82, 2003 Aug.
Article
em En
| MEDLINE
| ID: mdl-14631706
ABSTRACT
OBJECTIVE:
To investigate the pattern and epidemiology of anticholinergic plant poisoning, and to characterize its time course and clinical features.METHODS:
We reviewed all anticholinergic plant poisonings using a prospective database of all poisonings admitted to a major toxicology unit in Australia. All patients that presented with anticholinergic plant poisoning between July 1990 and June 2000 were included. Patient demographics, details of poisoning, diagnostic clinical features, adverse effects (seizures, arrhythmias, hypotension, accidental injury), and treatments required were obtained. Important diagnostic features were analysed and compared to previous studies.RESULTS:
Thirty-three patients were presumed to have ingested Brugmansia spp. (Angel's trumpet) based on their description of the plant; median age 18 years (interquartile range 16-20); 82% males. Thirty-one ingested a brewed tea or parts of the plant (flower). Thirty-one used it recreationally. Common clinical features were mydriasis (100%), mean duration 29 h (SD 13) and delirium (88%) with a mean duration of 18 h (SD 12). Tachycardia only occurred in 11 of the 33 patients (33%). In 24 patients where the time of ingestion was certain, 7 of 8 (88%) patients presenting within 5 h had tachycardia and only 5 out of 16 (31%) presenting after 5 h had tachycardia. There were no deaths, seizures or arrhythmias (excepting tachycardia). One patient had hypotension and two sustained accidental traumatic injuries. Nineteen patients required sedation, mainly with benzodiazepines. Physostigmine was used diagnostically in eight cases.CONCLUSIONS:
Anticholinergic plant abuse is sporadic in nature. Most cases were moderate in severity, requiring sedation only, and severe toxicity was rare. Mydriasis and delirium were the commonest features, the later having important implications for management.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Solanaceae
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
/
Screening_studies
Limite:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
País/Região como assunto:
Oceania
Idioma:
En
Revista:
Emerg Med (Fremantle)
Assunto da revista:
MEDICINA DE EMERGENCIA
Ano de publicação:
2003
Tipo de documento:
Article
País de afiliação:
Austrália