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Plant Toxicity PowerPoint Presentation

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Description : Check out this medical presentation on Poison Ivy / Poison Oak, which is titled "Plant Toxicity", to know about plant toxicity and management of a Plant poisoned patient.

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Published on : Jul 05, 2021 | Views : 3461 | Downloads : 7

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Slide 1-

Plant Toxicity
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Introduction
Slide 3-

Frequency of Plant Exposure by Plant Type Capsicum (pepper plant)(5374 exposures) Philodendron (4061) Holly (3441) Euphorbia sp. (poinsettia) (3296) Dieffenbachia (dumbcane) (2141)
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Non Toxic Plants African violet Begonia Boston fern Christmas cactus Coleus Corn plant Crab apple Daisies Dandelion Easter Lilly Hibiscus Jade plant Magnolia Marigold Petunia Prayer plant Snake plant Velvet plant
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Toxic Plants One of the most frequent poisonings reported to poison control centers 69% of plant exposures reported to poison control centers involved children > 6 yrs. 15,000 people a year poisoned by plants Account for 5-10% of calls to poison control center Incidence is increasing Toxicity's can also occur when plants have been treated with herbicides, insecticides or fertilizers
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Toxic Plants, cont. Almost any plant can cause nausea, vomiting and intestinal cramping Not all parts of a plant are always toxic and the toxic principle may be present only during certain times of the year
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General management of a Plant poisoned patient Treat all cases of plant ingestion as potentially toxic until shown otherwise First try and ID the plant, try to get actual plant if possible Time is on the side of the patient, determine when exposure happened. Determine how much was ingested. Call poison control center
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General management of a Plant poisoned patient Demulcent therapy - ice cream, milk, egg whites Observe patient for clinical signs If indicated induce vomiting - syrup of Ipecac Activated charcoal should be given Cathartics hasten removal of remaining material
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Common Poisonous Plants
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Arum family Most common toxic plant exposure reported in the US. And a very common plant in homes and public places Members of the Arum family: caladium dieffenbachia - dumbcane philodendron Contain calcium oxalate crystals Used for variety of purposes: punishing slaves, treating gout, impotence and frigidity
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Signs, Symptoms and Treatment Non soluble needle like Ca++ oxylate crystals are found in all parts of the plant, stalk produces most severe reaction Biting into the plant causes pain and irritation to the mucous membranes of the mouth and intense salivation edema when they contact lips, tongue, oral mucosa choking Treatment supportive care and demulcents (milk)
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Caladium
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Dumbcane
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Split leafed Philodendron
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Christmas plants American Holly Mistletoe Poinsettia
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American Holly Berries are toxic, contain Ilicin Clinical signs Nausea, severe vomiting, abdominal pain, diarrhea Treatment - Ipecac, activated charcoal
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Jerusalem Cherry
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Mistletoe Berries are toxic , contain B-phenylethylamine and tyramine Clinical signs acute gastroenteritis, cardiovascular collapse, nausea, vomiting, respiratory difficulty, delirium, hallucinations, death Treatment - Ipecac, activated charcoal, transport
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Poinsettia Non toxic contains a latex sap which can be slightly irritating to mucous membranes Treatment - give demulcents
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Poinsettia
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Cardiotoxic Plants Contain cardiac glycosides Oleander Azaleas Lilly of the valley
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Cardiotoxic plants First used by Egyptians as emetics and for heart aliments Toxicity occurs usually after consuming teas or consuming parts of the plant More than 200 naturally occurring cardiac glycosides have been Ided. Mech of Action - bind to cell membrane and inhibit the Na/K pump.
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Cardiotoxic plants Clinical signs: tachycardia V fib Toxic exposure is rare AAPCC reports in 1998 - 2,553 exposures (out of 2.24 million exposures to toxic substances) Mortality is rare - 1998 AAPCC reported one death Most common age of exposure is children under the age of 6 years (72.5% of exposures)
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Oleander Very toxic plant, common ornamental Clinical signs GIT irritation, vomiting, abdominal pain, diarrhea, hyperkalemia, AV block, cardiogenic shock Treatment - Ipecac, activated charcoal, transport
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Oleander
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Oleander
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Oleander
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Azaleas Rhododendron, Bird of paradise contain andromedotoxin Treatment - Ipecac, activated charcoal, transport
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Azaleas
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Azaleas
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Castor Bean
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Castor bean Contain phytotoxins - ricin - inactivated by heat during the production of castor oil seeds are the most toxic part of the plant, 2-4 seeds could be fatal in adult Clinical signs nausea, violent vomiting and diarrhea, burning sensation in the mouth, hemolysis, renal failure, death Treatment - Ipecac, activated charcoal, transport
Slide 35-

Castor bean
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Castor Bean
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Castor Bean
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Rhubarb
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Rhubarb Leaves are toxic, contain oxalic acid, heating does not destroy the toxic principle Stems are edible Clinical signs abdominal pain, vomiting, diarrhea, headache, muscle cramps, tetany, renal failure Treatment - Ipecac, activated charcoal, transport
Slide 40-

Rhubarb
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Rhubarb, stem
Slide 42-

Rhubarb
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Rhubarb, flowers
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Jimsonweed Datura stramonium
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Jimsonweed Toxicity Plant alkaloids are metabolites that have a nitrogen containing chemical ring This plant has a history of hallucinogenic use and has been connected to sorcery, witchcraft and native medicine dating back to 1500 BC Marc Anthony’s military troops were neutralized and defeated after ingesting this plant 318 cases reported to AAPCC with 2 deaths Toxicity manifests as classic anticholinergic posioning
Slide 46-

Jimsonweed Toxicity toxic agents - solanaceous alkaloids, atropine, hyoscyamine and scopolamine highest concentration of active agents is in the seeds (0.1 mg atropine per seed) As little as 1/2 tsp. of seeds has caused death from pulmonary arrest handling the seeds or leaves and rubbing the eyes can cause mydriasis Seeds can be made into a tea Reports of smoking the leaves of the plant
Slide 47-

Jimsonweed toxicity, cont. Clinical features: tachycardia, dry flushed skin, dry mucous membranes, mydriasis, blurred vision, hyperpyrexia, urinary retention, confusion, disorientation, loss of short term memory, ataxia, visual and auditory hallucinations, psychosis, death
Slide 48-

Jimsonweed toxicity, cont. “Mad as a hatter, red as a beet, dry as a bone, blind as a bat and hot as a hare” Treatment maintain airway transport do not induce vomiting and defer administration of activated charcoal unless prolonged transport time is anticipated
Slide 49-

Jimsonweed, thorn apple, angel’s trumpet
Slide 50-

Jimsonweed, flowers
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Jimsonweed, seed pod
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Pokeweed
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Pokeweed AKA Inkberry, pigeonberry Roots and leaves are the most toxic, fruit is mildly toxic Toxic principle is a resinous material and a water soluble saponin
Slide 54-

Poke weed Clinical signs produces a burning sensation in the mouth, GI cramps, vomiting, diarrhea, visual disturbances, diaphoresis, salivation, prostration, can be fatal To prepare pokeweed your must boil the leaves twice to remove the toxic principle Treatment - Ipecac, activated charcoal, transport
Slide 55-

Pokeweed, Ink berries
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Pokeweed, Ink berries
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Pokeweed
Slide 58-

Pokeweed
Slide 59-

Toxicodendron
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Poison Ivy All portions of the plant, even the smoke from burning leaves Toxic principle - an oily oleoresin called urushiol Urushiol can be transmitted from person to person or other vehicles by direct contact
Slide 61-

Poison Ivy 50-70% of US population is susceptible Poison ivy east of the Rockies, poison oak west and poison sumac in the south east. Clinical signs severe allergic contact dermatitis 12-24 hours post exposure, blistering, inflammation, and vesicle formation Urushiol penetrates skin and binds to membrane lipids within 10-20 minutes of exposure
Slide 62-

Poison Ivy, cont. Treatment: avoid contact, wash affected area with soap and rinse with alcohol, repeat 2 tbsp. Epsom’s salt/cup of water, sponge onto the affected area and allow to dry, 2-3 times/day Electronic itch stopper Tecnu cleanser corticosteroids, topically and orally histamine blockers
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Poison Ivy, cont. Treatment: cont. calamine lotion zinc oxide ointment baking soda paste (one tablespoon of baking soda to one teaspoon of water) baths in oatmeal soap or medicated oatmeal based products like Avenno. Zanfel - binds to urushiol Ivy Block - a pre-exposure preventative
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Poison Ivy, cont. Treatment: cont. If you were exposed to the smoke of burning poison ivy, oak or sumac and you believe you may have breathed in the fumes, you need to seek medical treatment immediately. Some people can have life threatening reactions from inhaling urushiol vapors into their lungs. In some states, it is illegal to burn poison ivy due to the health risks it represents.
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Slide 68-

Toxicodendron, Poison Ivy
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Poison Ivy “Leaflets of three, let it be”
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Poison Ivy
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Poison Ivy
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Slide 74-

Poison Ivy Other urushiol containing plants: cashew nut shells - exposure to unroasted cashew nut shells can cause a reaction, roasting inactivates the allergen. mango tree - mango fruit skin can cause reactions in sensitive individuals ginkgo tree
Slide 75-

Mushroom Toxicity
Slide 76-

Mushroom toxicity 1999 AAPCC reported 8996 mushroom exposures, 2930 treated in a hospital and 6 fatalities 5976 of these ingestions were in children > 6 years Amanitin phalloides accounts for 90-95% of all fatalities from mushroom poisoning in North America
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Mushroom toxicity Never eat any wild mushroom Etiology - consumption of raw or cooked mushrooms/toadstools Cooking, canning or freezing WILL NOT render toxic mushrooms non toxic Clinical Syndromes - usually acute onset of signs and symptoms
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Categories of Mushroom Toxicity I) Protoplasmic poisons - destruction of cells Signs and Symptoms Stage I - first 6-24 hrs., severe abdominal pain, severe diarrhea Stage II - 24-48 hrs., apparent recovery , cellular destruction is occurring in the kidney and liver Stage III - 3-5 days post ingestion, liver and kidney failure, death can occur 4-7 days post ingestion Treatment - induce vomiting, transport
Slide 79-

Examples of Mushrooms which cause protoplasmic poisoning
Slide 80-

Amanita phalloides Contain a mixture of heat stable cyclopeptides including: phalloidin phalloin amatoxin - accounts for the lethality
Slide 81-

Amanita phalloides
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Amanita phalloides
Slide 83-

Categories of Mushroom Toxicity, cont. II) Neurotoxins contain compounds which cause neurological signs and symptoms, convulsions, hallucinations, excitation, depression, spastic colon.
Slide 84-

Examples of Mushrooms which cause Neurologic signs and symptoms
Slide 85-

Amanita muscarina
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Inocybe sp.
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Inocybe sp.
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Inocybe sp.
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Inocybe sp.
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Psilocybe sp.
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Psilocybe sp.
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Categories of Mushroom Toxicity, cont. III) Gastrointestinal irritants cause nausea, vomiting, abdominal cramping, diarrhea Examples: green gill, gray pink gill, etc.
Slide 93-

Green gill These large, common mushrooms often appear in fairy rings on suburban lawns, commonly called toadstools. They cause violent gastrointestinal upset. Is parasol-shaped and has a cream or tan, scaly cap, a large ring on the stem and cream-colored gills which turn dingy green with age.
Slide 94-

Green gill, cont. As its name suggests, it is the only mushroom with a greenish spore print. Size 4" to 12" tall, 2" to 12" in diameter. This mushroom is found in summer and fall, on the ground in lawns, pastures and meadows.
Slide 95-

Green gill, green spored
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Categories of Mushroom Toxicity, cont. IV) Disulfiram-like compounds generally non toxic and produce no clinical signs unless alcohol is consumed within 72 hours of eating them. Example - inky cap mushroom
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Inky cap mushroom
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Diagnosis of Human toxicity Clinical testing History Outbreaks are not very common Usually isolated cases - seen in people who go out picking mushrooms Patient management - induce vomiting, give activated charcoal, seek medical help
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