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Common toxic plant ingestions

Last reviewed: 1 Nov 2024
Last updated: 10 Apr 2024

Summary

Definition

History and exam

Key diagnostic factors

  • tachycardia
  • hypertension
  • hypotension
  • miosis
  • mydriasis
  • bradycardia
  • altered mental state
  • hallucinations
  • seizures
Full details

Other diagnostic factors

  • nausea
  • vomiting
  • abdominal pain
  • diarrhea
  • dyspnea
  • skin flushing
  • dermatitis
  • dermatologic/mucosal irritation
  • visible bleeding: epistaxis, melena, hematuria, hematemesis, hemoptysis
  • headache
  • chest pain
  • muscle pain/swelling
  • skin pallor
  • easy bruising
  • petechial spotting
  • jaundice
  • asterixis
  • ascites
  • palmar erythema
  • spider angiomata
  • diaphoresis
  • dry skin
  • fever
  • urinary retention
  • constipation
  • hyperventilation
  • fasciculations
  • neuromuscular weakness
  • altered sensation
Full details

Risk factors

  • foraging for wild plants to eat
  • brewing wild plants into tea
  • children found or suspected of ingesting plants
Full details

Diagnostic tests

1st tests to order

  • ECG
  • CBC
  • serum electrolytes
  • serum creatinine
  • serum lactate
  • serum BUN/creatinine ratio
  • liver function tests
  • INR
  • ABG
  • chest x-ray
Full details

Tests to consider

  • troponin
  • serum digoxin levels
  • response to physostigmine
Full details

Treatment algorithm

ACUTE

all patients

Contributors

Authors

Susan Smolinske, PharmD, DABAT, FAACT

Clinical Consultant

New Mexico Poison and Drug Information Center

Adjunct Professor

Pharmacy Practice and Administrative Sciences

University of New Mexico

Albuquerque

NM

Disclosures

SS is a member of the ToxED advisory board and consults with webPOISONCONTROL.

Cynthia K. Aaron, MD

Medical Director

Program Director Medical Toxicology

Regional Poison Center at Children's Hospital of Michigan

Professor of Emergency Medicine and Pediatrics

Wayne State University School of Medicine

Detroit

MI

Disclosures

CKA owns personal stock in Merck. CKA was on the State of Michigan Public Health Advisory Council for 3 years, and consults with RubiconMD.

Acknowledgements

Dr Susan Smolinske and Dr Cynthia K. Aaron would like to gratefully acknowledge Dr Gerald F. O'Malley and Dr Rika N. O'Malley, previous contributors to this topic.

Disclosures

GFOM and RNOM declare that they have no competing interests.

Peer reviewers

Jessamine Soderstrom, MD, MBBS, FACEM

Clinical Toxicologist

Emergency Consultant

Emergency Department

Royal Perth Hospital

Perth

Australia

Disclosures

JS declares that she has no competing interests.

Scott Phillips, MD

Clinical Faculty

Department of Toxicology

Rocky Mountain Poison & Drug Center

Denver

CO

Disclosures

SP declares that he has no competing interests.

Judith Alsop, PharmD, DABAT

Poison Center Director

California Poison Control System, Sacramento Division

University of California Davis Medical Center

Sacramento

Associate Clinical Professor of Pharmacy

University of California San Francisco School of Pharmacy

San Francisco

Clinical Professor of Medicine

Volunteer Clinical Faculty

University of California Davis School of Medicine

Sacramento

CA

Disclosures

JA declares that she has no competing interests.

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