Türkiye’den Şifalı Otlar İle İki Zehirlenme Olgusu; Hemoroid Ağrısını Hafifletmek İçin Datura, Afrodizyak Etki İçin Mandragora

Öz

Giriş: Bilinç durumunda değişiklik acil serviste sık rastlanan bir sağlık sorunudur. Bu durumun sebepleri arasında antikolinerjik ajanlara bağlı olarak gelişen intoksikasyonlar nadir değildir. Burada acil servisimize antikolinerjik sendrom nedeniyle getirilen iki hasta sunulmuştur. Olgu sunumu: Hastalar şifalı ot tedavisi için Datura stramonium (Olgu 1) ve Mandragora autumnalis (Olgu 2) tükettikten sonraki 4 saat içerisinde ajitasyon, konfüzyon, idrar retansiyonu ve dilate pupil ile acile başvurmuşlardır. Konservatif tedavi sonrası tam şifa ile taburcu olmuşlardır. Sonuç: Acil servis doktorları, hastaneye bilinç durumunda değişiklik nedeniyle başvuran hastalarda, şifalı ot tedavisine bağlı gelişebilen antikolinerjik sendrom tanısını akılda bulundurmalıdır.

Anahtar Kelimeler

• Mandragora autumnalis, Datura stramonium, Şifalı ot zehirlenmesi, Antikolinerjik Sendrom.

Two Herbal Poisoning Cases From Turkey; Datura For Haemorrhoidal Pain Relief, Mandragora For Aphrodisiac Effect

Öz

introduction: An altered state of mind is a common medical condition in emergency medicine. Among causes of this situation, toxic etiology due to an anticholinergic agent is not rare. We present two patients who were brought to our emergency department because of anticholinergic syndrome.case report: The patients displayed agitative behaviour, confusion, urinary retention, and dilated pupils within 4 h of ingesting of Datura stramonium (Case 1) and Mandragora autumnalis (Case 2) which have been used as herbal medicines. They were discharged with a complete recovery after receiving conservative therapy.conclusion: Emergency medicine physicians should be mindful of anticholinergic syndrome due to herbal medicine when the patient with a history of altered state of mind is presented to a hospital

Anahtar Kelimeler

• Mandragora autumnalis, Datura stramonium, Herbal poisoning, Anticholinergic Syndrome

Kaynakça

1. Furbee B, Wermuth M. Life-threatening plant poisoning. Crit Care Clin 1997;13:849-88.
2. Deng JF. Clinical and laboratory investigations in herbal poison- ings. Toxicology 2002;181-182: 571-6.
3. Hsu CK, Leo P, Shastry D. Anticholinergic poisoning associated with herbal tea. Arch Intern Med 1995;155:2245-8.
4. Kemmerer DA. Anticholinergic syndrome. J Emerg Nurs 2007;33:76-8.
5. Vanderhoff BT, Mosser KH. Jimsonweed toxicity: management of anticholinergic plant ingestion. Am Fam Physician 1992;46:526-30.
6. Coremans P, Lambrecht G, Schepens P, Vanwelden J, Verhaegen H. Anticholinergic intoxication with commercially available thorn apple tea. J Toxicol Clin Toxicol 1994;32:589-92.
7. Piccillo GA, Miele L, Mondati E, Moro PA, Musco A, et al. An- ticholinergic syndrome due to “Devil’s herb”: when risks come from the ancient time. Int J Clin Pract 2006;60:492-4.
8. Piccillo GA, Mondati EG, Moro PA. Six clinical cases of Man- dragora autumnalis poisoning: diagnosis and treatment. Eur J Emerg Med 2002;9:342-7.

9. Ernst E. Harmless Herbs? A review of the recent literature. Am J Med 1998;104:170-8.
10. Salen P, Shih R, Sierzenski P, Reed J. Effect of physostigmine and gastric lavage in a Datura stramonium-induced anticholinergic poisoning epidemic. Am J Emerg Med 2003;21:316-7.
11. Kose R, Sahin OO, Abay E. A case of delirium due to Datura stra- monium intoxication. Anatolian Journal of Psychiatry (Anadolu Psikiyatri Dergisi) 2008;9:54-7.
12. Aydın S, Bozkaya AO, Mazıcıoglu M, Gemalmaz A, Ozcakır A, et al. What influences herbal medicine use?-prevalence and related factors. Turk J Med Sci 2008;38:455-63.