Mushroom toxicity - Revision history

Danbot: Add MedicationDose entries (atropine, N-acetylcysteine) with SMW annotations

2026-03-20T18:59:50Z

Add MedicationDose entries (atropine, N-acetylcysteine) with SMW annotations

@@ Line 76: / Line 76: @@
 ===Delayed-Onset===
 *Admit
 ==References==

ClaireLewis at 19:11, 22 August 2019

2019-08-22T19:11:27Z

← Older revision		Revision as of 19:11, 22 August 2019
Line 16:		Line 16:
	''Depends on the type of mushroom ingested''		''Depends on the type of mushroom ingested''
	*GI		*GI
	**Nausea/vomiting/diarrhea		**[[Nausea/vomiting]], diarrhea
	**Resolves within 24hr		**Resolves within 24hr
	*CNS<ref>Rolston-Cregler L et al. Hallucinogenic Mushroom Toxicity. Apr 08, 2015. http://emedicine.medscape.com/article/817848-overview.</ref>		*CNS<ref>Rolston-Cregler L et al. Hallucinogenic Mushroom Toxicity. Apr 08, 2015. http://emedicine.medscape.com/article/817848-overview.</ref>
	**Isoxazoles (ibotenic acid and muscimol) - ~~dsyarthria~~, ataxia, muscle cramps		**Isoxazoles (ibotenic acid and muscimol) - [[dysarthria]], [[ataxia]], muscle cramps
	**Psilocybin - euphoria, visual hallucinations, agitation, sympathomimetic ~~Sxs~~		**Psilocybin - euphoria, visual [[hallucinations]], [[agitation]], [[sympathomimetic]] symptoms
	**Lasts 4-8hrs		**Lasts 4-8hrs
	*Muscarinic		*Muscarinic
	**SLUDGE symptoms		**SLUDGE symptoms
	**Diaphoresis, muscle fasciculations, miosis, bradycardia, bronchorrhea		**Diaphoresis, muscle fasciculations, miosis, [[bradycardia]], bronchorrhea
	**Resolves in 4-12hr		**Resolves in 4-12hr
	*Disulfiram-like effect		*Disulfiram-like effect
	**Usually when drinking alcohol		**Usually when drinking alcohol
	**Flushing, tachycardia, diaphoresis, hypotension		**Flushing, [[tachycardia]], diaphoresis, [[hypotension]]

	===Delayed-Onset===		===Delayed-Onset===
Line 46:		Line 46:

	===Delayed-Onset===		===Delayed-Onset===
	*Hypoglycemia is common cause of death and needs close monitoring		*[[Hypoglycemia]] is common cause of death and needs close monitoring

	==Management==		==Management==
	===Early-Onset===		===Early-Onset===
	*GI predominant symptoms:		*GI predominant symptoms:
	**Activated charcoal 0.5-1gm/kg		**[[Activated charcoal]] 0.5-1gm/kg
	**Do not give antidiarrheal meds		**Do ''not'' give antidiarrheal meds
	*CNS predominant symptoms:		*CNS predominant symptoms:
	**Place in dark, quiet room		**Place in dark, quiet room
	**Benzos may be given to patients who are agitated		**[[Benzos]] may be given to patients who are agitated
	**Consider [[pyridoxine]] for refractory seizures, especially if suspecting [[gyromitra]]<ref> Berger KJ, Guss DA. Mycotoxins revisited: Part II. J Emerg Med. 2005;28(2):175. </ref>		**Consider [[pyridoxine]] for refractory seizures, especially if suspecting [[gyromitra]]<ref> Berger KJ, Guss DA. Mycotoxins revisited: Part II. J Emerg Med. 2005;28(2):175. </ref>
	*Muscarinic predominant symptoms:		*Muscarinic predominant symptoms:
Line 65:		Line 65:
	*[[N-Acetylcysteine\|N-Acetylcysteine (NAC)]]: 150 mg/kg over one hour, 50 mg/kg over 4 hours, 100 mg/kg over 16 hours		*[[N-Acetylcysteine\|N-Acetylcysteine (NAC)]]: 150 mg/kg over one hour, 50 mg/kg over 4 hours, 100 mg/kg over 16 hours
	*Call poison control, consider:		*Call poison control, consider:
	**Penicillin G		**[[Penicillin G]]
	**Silibinin dihemisuccinate		**Silibinin dihemisuccinate
	**Cimetidine		**[[Cimetidine]]
	**Vitamin C		**Vitamin C

Rossdonaldson1: /* Differential Diagnosis */

2018-09-13T21:28:40Z

Differential Diagnosis

← Older revision		Revision as of 21:28, 13 September 2018
Line 39:		Line 39:
	==Differential Diagnosis==		==Differential Diagnosis==
	{{Mushroom toxicity DDX}}		{{Mushroom toxicity DDX}}
			{{SLUDGE DDX}}
	{{Acute hepatitis causes}}		{{Acute hepatitis causes}}

Rossdonaldson1 at 17:58, 13 September 2018

2018-09-13T17:58:50Z

← Older revision		Revision as of 17:58, 13 September 2018
Line 7:		Line 7:
	#*Clinical course is often serious/ possibly fatal		#*Clinical course is often serious/ possibly fatal
	#*Amanita species causes 95% of deaths		#*Amanita species causes 95% of deaths
	#**Most frequent species: ''A. phalloides, bisporigera, magnivelaris, ocreata, verna, virosa''<ref>Enjalbert F et al. Treatment of Amatoxin Poisoning: 20 year retrospective analysis. J tox Clin Tox 2002 40(6):715-767.</ref>		#**Most frequent species: ''[[A. phalloides]], bisporigera, magnivelaris, ocreata, verna, virosa''<ref>Enjalbert F et al. Treatment of Amatoxin Poisoning: 20 year retrospective analysis. J tox Clin Tox 2002 40(6):715-767.</ref>
	#**Toxin inhibits formation of mRNA and is heat stable		#**Toxin inhibits formation of mRNA and is heat stable

Rossdonaldson1 at 17:47, 13 September 2018

2018-09-13T17:47:56Z

← Older revision		Revision as of 17:47, 13 September 2018
Line 9:		Line 9:
	#**Most frequent species: ''A. phalloides, bisporigera, magnivelaris, ocreata, verna, virosa''<ref>Enjalbert F et al. Treatment of Amatoxin Poisoning: 20 year retrospective analysis. J tox Clin Tox 2002 40(6):715-767.</ref>		#**Most frequent species: ''A. phalloides, bisporigera, magnivelaris, ocreata, verna, virosa''<ref>Enjalbert F et al. Treatment of Amatoxin Poisoning: 20 year retrospective analysis. J tox Clin Tox 2002 40(6):715-767.</ref>
	#**Toxin inhibits formation of mRNA and is heat stable		#**Toxin inhibits formation of mRNA and is heat stable

	~~{{Mushroom toxicity DDX}}~~

	{{Mushroom identification images}}		{{Mushroom identification images}}
Line 40:		Line 38:

	==Differential Diagnosis==		==Differential Diagnosis==
			{{Mushroom toxicity DDX}}
	{{Acute hepatitis causes}}		{{Acute hepatitis causes}}

Rossdonaldson1 at 17:46, 13 September 2018

2018-09-13T17:46:20Z

← Older revision		Revision as of 17:46, 13 September 2018
Line 20:		Line 20:
	**Nausea/vomiting/diarrhea		**Nausea/vomiting/diarrhea
	**Resolves within 24hr		**Resolves within 24hr
	*CNS		*CNS<ref>Rolston-Cregler L et al. Hallucinogenic Mushroom Toxicity. Apr 08, 2015. http://emedicine.medscape.com/article/817848-overview.</ref>
	**~~Euphoria~~, hallucinations		**Isoxazoles (ibotenic acid and muscimol) - dsyarthria, ataxia, muscle cramps
	**Lasts 4-~~6hr~~		**Psilocybin - euphoria, visual hallucinations, agitation, sympathomimetic Sxs
			**Lasts 4-8hrs
	*Muscarinic		*Muscarinic
	**SLUDGE symptoms		**SLUDGE symptoms
Line 43:		Line 44:
	==Evaluation==		==Evaluation==
	===Early-Onset===		===Early-Onset===
	*Symptom onset 30-90 min with hallucinations, lasting 6-8 hrs<ref>Rolston-Cregler L et al. Hallucinogenic Mushroom Toxicity. Apr 08, 2015. http://emedicine.medscape.com/article/817848-overview.</ref>:
	**Isoxazoles (ibotenic acid and muscimol) - dsyarthria, ataxia, muscle cramps
	**Psilocybin - euphoria, visual hallucinations, agitation, sympathomimetic Sxs

	===Delayed-Onset===		===Delayed-Onset===

Rossdonaldson1: /* Early-Onset */

2018-09-13T17:43:33Z

Early-Onset

← Older revision		Revision as of 17:43, 13 September 2018
Line 60:		Line 60:
	**Consider [[pyridoxine]] for refractory seizures, especially if suspecting [[gyromitra]]<ref> Berger KJ, Guss DA. Mycotoxins revisited: Part II. J Emerg Med. 2005;28(2):175. </ref>		**Consider [[pyridoxine]] for refractory seizures, especially if suspecting [[gyromitra]]<ref> Berger KJ, Guss DA. Mycotoxins revisited: Part II. J Emerg Med. 2005;28(2):175. </ref>
	*Muscarinic predominant symptoms:		*Muscarinic predominant symptoms:
	**Consider atropine for severe symptoms; 0.5-1mg IV for adults; 0.01mg/kg IV for peds		**Consider [[atropine]] for severe symptoms; 0.5-1mg IV for adults; 0.01mg/kg IV for peds

	===Delayed-Onset===		===Delayed-Onset===

Rossdonaldson1: /* Background */

2018-09-13T17:43:01Z

Background

← Older revision		Revision as of 17:43, 13 September 2018
Line 3:		Line 3:
	#Early-Onset Poisoning (toxicity begins within 2hr of ingestion)		#Early-Onset Poisoning (toxicity begins within 2hr of ingestion)
	#*Clinical course is usually benign		#*Clinical course is usually benign
			#*Comprises majority of mushroom-induced intoxications
	#Late-Onset Poisoning (toxicity begins 6hr after ingestion)		#Late-Onset Poisoning (toxicity begins 6hr after ingestion)
	#*Clinical course is often serious/ possibly fatal		#*Clinical course is often serious/ possibly fatal

Rossdonaldson1: /* Evaluation */

2018-09-13T17:42:40Z

Evaluation

← Older revision		Revision as of 17:42, 13 September 2018
Line 42:		Line 42:
	==Evaluation==		==Evaluation==
	===Early-Onset===		===Early-Onset===
	*Comprises majority of mushroom-induced intoxications
	*Symptom onset 30-90 min with hallucinations, lasting 6-8 hrs<ref>Rolston-Cregler L et al. Hallucinogenic Mushroom Toxicity. Apr 08, 2015. http://emedicine.medscape.com/article/817848-overview.</ref>:		*Symptom onset 30-90 min with hallucinations, lasting 6-8 hrs<ref>Rolston-Cregler L et al. Hallucinogenic Mushroom Toxicity. Apr 08, 2015. http://emedicine.medscape.com/article/817848-overview.</ref>:
	**Isoxazoles (ibotenic acid and muscimol) - dsyarthria, ataxia, muscle cramps		**Isoxazoles (ibotenic acid and muscimol) - dsyarthria, ataxia, muscle cramps
Line 48:		Line 47:

	===Delayed-Onset===		===Delayed-Onset===
	*Hypoglycemia is common cause of death, needs close monitoring		*Hypoglycemia is common cause of death and needs close monitoring

	==Management==		==Management==

Rossdonaldson1 at 17:40, 13 September 2018

2018-09-13T17:40:41Z

← Older revision		Revision as of 17:40, 13 September 2018
Line 5:		Line 5:
	#Late-Onset Poisoning (toxicity begins 6hr after ingestion)		#Late-Onset Poisoning (toxicity begins 6hr after ingestion)
	#*Clinical course is often serious/ possibly fatal		#*Clinical course is often serious/ possibly fatal
			#*Amanita species causes 95% of deaths
			#**Most frequent species: ''A. phalloides, bisporigera, magnivelaris, ocreata, verna, virosa''<ref>Enjalbert F et al. Treatment of Amatoxin Poisoning: 20 year retrospective analysis. J tox Clin Tox 2002 40(6):715-767.</ref>
			#**Toxin inhibits formation of mRNA and is heat stable

	{{Mushroom toxicity DDX}}		{{Mushroom toxicity DDX}}