Use of Physostigmine for Hallucinogenic Plant Poisoning in a Teenager

Abstract

The objective of this study was to utilize a case report to review the use of physostigmine for jimsonweed intoxication. A 15-year-old girl was found at school hallucinating and incoherent. Upon presentation to the emergency department, she was found to be tachycardic and confused with dilated pupils and dry, flushed, hot skin. She was admitted to our institution. Hallucinations and symptoms resolved after the use of physostigmine. She subsequently admitted to ingesting 'moonflower seeds,' which are derived from Jimsonweed (Datura stramonium). She was discharged when she got well. Jimsonweed is known to contain high concentrations of anticholinergic substances; hence, ingestion can result in the anticholinergic toxidrome. Signs and symptoms include hallucinations, tachycardia, dilated pupils, and disorientation. In our patient, the use of the physostigmine as an antidote resulted in a favorable outcome without any complications. Ingestion of the Datura species can result in severe toxicity. Each plant varies in the concentrations of alkaloid substances. For this reason, it is very important for individuals to become educated on the toxicities and potential risks associated with recreational use of these plants. The use of physostigmine can help in both the diagnosis and management of patients intoxicated with these substances.

A neurological disorder presumably underlies painter Francis Bacon distorted world depiction

“…Cerebral hypoxic-ischemic lesions could have occurred during asthmatic attacks, which were reported to be “so severe that Bacon would lie in bed for days, blue in the face, struggling for each breath” (Peppiatt, 2008, p. 11). In addition, since Bacon has been prescribed morphine and stramonium to ease his bronchial spasms (Peppiatt, 2008), toxic factors (Vella-Brincat and Macleod, 2007; Glatstein et al, 2012) might be considered, although unlikely as not associated with pronounced systemic manifestations; in addition, distorted percepts upon sustained fixation consistently occurred over decades (Sylvester, 1980). …”

Belladonna Alkaloid Intoxication

“…14 Diagnosis can be difficult because of the wide range of signs and symptoms associated with anticholinergic toxicity and the difficulties associated with obtaining an accurate history in recreational drug ingestions. The estimated lethal dose of atropine in humans is .10 mg and that of scopolamine is .2-4 mg. 17 Toxicity usually occurs within 60 minutes of ingestion, and clinical symptoms may persist for 24-48 hours. 2 Clinical manifestations are caused by central or peripheral nervous system effects or both.…”

Intoxicación por uso recreativo de ‘floripondio’, reporte de caso.

“…Se recomienda una dosis de 0,02 mg / kg de fisostigmina (rango 0,5-2 mg) pasarlos en 2 minutos usando un acceso venoso periférico, reevaluando periódicamente el estado neurológico. Esto se puede repetir cada 10 minutos si es necesario, hasta un máximo de 4 mg. Los efectos adversos de la fisostigmina son de naturaleza colinérgica (diaforesis, emesis, diarrea, incontinencia urinaria, broncorrea, bradicardia) y aparecen 10-20 minutos después de la administración, o cuando se produce efecto pico en sistema nervioso central (14,15).…”