Comparative Treatment of α-Amanitin Poisoning With N-Acetylcysteine, Benzylpenicillin, Cimetidine, Thioctic Acid, and Silybin in a Murine Model

Amatoxin: A Review

“…In addition to silybin, NAC showed somewhat comparable results by reducing the average mortality to 6.8%; however, the sample size was significantly smaller with NAC [1]. This is in direct contrast to an earlier study, which showed no significant benefit [10].…”

“…Also, histological analysis showed no decrease in hepatic necrosis in the study groups when compared to the control groups. Thus, the researchers concluded that the five analyzed therapies were not effective in preventing hepatotoxicity after amatoxin poisoning [10].…”

Mycetism: A Review of the Recent Literature

“…Some recommend multiple-dose activated charcoal (20-40 g every 3-4 h for 24 h or 50 g every 6 h) and nasoduodenal suctioning to limit enterohepatic recirculation of amatoxin, because approximately 60 % of absorbed alpha-amanitin is excreted into the bile and is then returned to the liver via recirculation [29,38,73,84,85]. The antidotes benzylpenicillin, ceftazidime, Nacetyl-cysteine (NAC), rifamycin, and silibinin have been advocated by some [26,34,36,88,[110][111][112], and questioned by others [113,114]. Of these, silibinin and NAC show the most promise [32,34,111,115].…”

The role of oxidative stress in α-amanitin-induced hepatotoxicityin an experimental mouse model

“…Over many years, different treatment modalities, e.g., silibinin, penicillin, cimetidine, and N-acetyl cysteine, aimed at preventing the progressive hepatocyte and renal cell damage in α-amanitin poisoning have been evaluated. Despite those efforts, a clear and effective treatment option has yet to be identified (4)(5)(6)(7). Thus, in recent years, particular attention has been given to studies of the pathophysiology of α-amanitin poisoning (8)(9)(10)(11).…”