Anticholinergic Toxicity Related to the Use of Datura Innoxia

Yıl 2017, Cilt: 8 Sayı: 2, 24 - 26, 01.04.2017

Mustafa Baştürk Mustafa İçer Cahfer Güloğlu Selçuk Ertekin Serkan Doğan

Öz

Introduction: The incorrect use of the flowers, leaves, and seeds of some plants by members of the general public can give rise to serious toxicities. Datura innoxia (DI), also known as pipe grass or weed wizard, is frequently used for the treatment of asthma and cough and to alleviate cramps. However, DI is also a hallucinogenic, with tremendous potential for abuse and can cause anticholinergic toxicity, and serious and fatal complications, such as coma, respiratory failure, and death, have been reported.Case Report: We present the cases of two women (21 years old and 41 years old) who were admitted to the emergency department with findings of anticholinergic toxicity, including mydriasis, agitation, and delirium, after taking DI. The patients’ pupils were widely dilated. Gastric decontamination and administration of activated charcoal, IV fluids, and midazolam/diazepam were performed. The patients’ general conditions were recovered except for mydriasis. However, after 1 week, the diameter of the patients’ pupils returned to normal. Conclusion: The unconscious misuse of some plants can cause fatal anticholinergic toxicity. Such toxicity though has rarely been reported with DI. When plants known to cause toxicity are usually endemic, clinicians should be alert to potential anticholinergic toxicity in patients who present with anticholinergic symptoms in these endemic areas

Anahtar Kelimeler

Anticholinergic toxicity, herbal therapy, Datura innoxia

Kaynakça

• Guven H. Environmental Toxins: Herbal Medicines and Poisonings. Tur- kiye Klinikleri J Pharmacol-Special Topics 2003; 1: 58-61.
• Celbek G, Gunes H, Gungor A, Cecen F, Basar C, Sarıtas A, et al. Anti- cholinergic syndrome after trial of datura stramonium: A Case Report. Konuralp Medical Journal 2010; 2: 35-7.
• Raman SV, Jacob J. Mydriasis due to datura inoxia. Emerg Med J 2005; 22: 310-1. [CrossRef]
• Marc B, Martis A, Moreau C, Arlie G, Kintz P, Leclerc J. Acute datura stra- monium poisoning in an emergency department. Presse Med 2007; 36: 1399-1403. [CrossRef]
• Wolf L. Anticholinergic toxicity Tintinalli J, Kelen G, Stapcznski JS (eds). Emergency medicine: a comprehensive study guide. New york: mc- graw-hill; 1999, pp 1182-1184.
• http://www.flowersinisrael.com/daturainnoxia_page.htm.
• Salen P, Shih R, Sierzenski P, Reed J. Effect of physostigmine and gastric lavage in a Datura stramonium-induced anticholinergic poisoning epi- demic. Am J Emerg Med 2003; 21: 316-7. [CrossRef]
• Kemmener DA. Anticholinergic syndrome. J Emerg Nurs 2007; 33: 76-8. [CrossRef]
• www.cdc.gov/mmwr/PDF/wk/mm4403.pdf Centers for disease control and prevention (cdc). Morbidity and mortality weekly report. Jimson weed poisoning--texas, New York, and California, 1994. MMWR Morb Mortal Wkly Rep 1995; 44: 41-4.