Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- presença de fatores de risco
- taquicardia
- hipertensão
- hipotensão
- miose
- midríase
- bradicardia
- estado mental alterado
- alucinações
- convulsões
Outros fatores diagnósticos
- náuseas
- vômitos
- dor abdominal
- diarreia
- dispneia
- rubor cutâneo
- dermatite
- irritação dermatológica/da mucosa
- sangramento visível: epistaxe, melena, hematúria, hematêmese, hemoptise
- cefaleia
- dor torácica
- dor/inchaço muscular
- palidez cutânea
- hematomas frequentes
- sangramento petequial
- icterícia
- asterixis (flapping)
- ascite
- eritema palmar
- aranhas vasculares
- diaforese
- pele ressecada
- febre
- retenção urinária
- constipação
- hiperventilação
- fasciculações
- fraqueza neuromuscular
- alterações sensitivas
Fatores de risco
- forrageamento de plantas selvagens para comer
- preparação de chás com plantas selvagens
- suspeita ou confirmação de ingestão de plantas por crianças
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- eletrocardiograma (ECG)
- Hemograma completo
- eletrólitos séricos
- creatinina sérica
- lactato sérico
- ureia/creatinina sérica
- testes da função hepática
- razão normalizada internacional (INR)
- gasometria arterial
- radiografia torácica
Investigações a serem consideradas
- troponina
- níveis de digoxina sérica
- resposta à fisostigmina
Algoritmo de tratamento
todos os pacientes
Colaboradores
Autores
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
Declarações
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
Declarações
CKA owns personal stock in Merck. CKA was on the State of Michigan Public Health Advisory Council for 3 years, and consults with RubiconMD.
Agradecimentos
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. GFOM and RNOM declare that they have no competing interests.
Declarações
GFOM and RNOM declare that they have no competing interests.
Revisores
Jessamine Soderstrom, MD, MBBS, FACEM
Clinical Toxicologist
Emergency Consultant
Emergency Department
Royal Perth Hospital
Perth
Australia
Declarações
JS declares that she has no competing interests.
Scott Phillips, MD
Clinical Faculty
Department of Toxicology
Rocky Mountain Poison & Drug Center
Denver
CO
Declarações
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
Declarações
JA declares that she has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referências
Principais artigos
Froberg B, Ibrahim D, Furbee RB. Plant poisoning. Emerg Med Clin North Am. 2007 May;25(2):375-433. Resumo
Halpern JH. Hallucinogens and dissociative agents naturally growing in the United States. Pharmacol Ther. 2004 May;102(2):131-8. Resumo
Gowdy JM. Stramonium intoxication: review of symptomatology in 212 cases. JAMA. 1972 Aug 7;221(6):585-7. Resumo
Burkhard PR, Burkhardt K, Haenggeli CA, et al. Plant-induced seizures: reappearance of an old problem. J Neurol. 1999 Aug;246(8):667-70. Resumo
Gummin DD, Mowry JB, Beuhler MC, et al. 2022 Annual report of the National Poison Data System(®) (NPDS) from America's Poison Centers(®): 40th annual report. Clin Toxicol (Phila). 2023 Oct;61(10):717-939.Texto completo Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Gastroenterite viral
- Gastroenterite bacteriana
- Infarto agudo do miocárdio
Mais Diagnósticos diferenciais
Conectar-se ou assinar para acessar todo o BMJ Best Practice
O uso deste conteúdo está sujeito ao nosso aviso legal