ENVIRONMENTAL EMERGENCIESMECHANISM OFTOXICITY
■ Ingestion or large skin exposure →stimulation of nicotinic receptors and
symptoms.
SYMPTOMS/EXAM
■ Characterized by early stimulation, followed by inhibition
■ Early stimulation
■ Abdominal pain, nausea/vomiting
■ Salivation, bronchorrhea
■ Hypertension, tachycardia
■ Fasciculations, seizures
■ Inhibition
■ Weakness
■ Respiratory muscle paralysis
■ Bradycardia and death
TREATMENT
■ GI decontamination with activated charcoal
■ Atropineas needed to control secretions
■ Benzodiazepinesto control agitation and seizures
■ Supportive care
POISONHEMLOCK(CONIUM MACULATUM)
Poison hemlock grows along roads, ditches, and pasture areas throughout the
United States. At first glance, its appearance is similar to water hemlock.
Toxin = coniine alkaloids,which are structurally similar to nicotine.
MECHANISM OFTOXICITY
■ Ingestion of plant →stimulation of nicotinic receptors and symptoms.
Presentation and treatment as with tobacco plant exposure, above
Anticholinergic Plants
JIMSONWEED(DATURA STRAMONIUM)
Also known as Jamestown weed and locoweed, jimsomweed is commonly
found along roadsides and in cornfields and pastures. It has broad green
leaves, light purple trumpetlike flowers, and large spiny seeds. It is used inten-
tionally for its hallucinogenic properties.
Toxin = atropinelike(belladonna) alkaloids.
MECHANISM OFTOXICITY
■ Ingestion→competitive inhibition of cholinergic receptors.