mushroompoisoning-231022110323-ee1da2f1.pptx

Mushroom ppt

1. MUSHROOM POISONING

2. DEFINITION: Poisoning occurs when any substance interferes with normal body functions after it is swallowed, inhaled, injected or absorbed. The branch of medicine that deals with the detection and treatment of poison is known as toxicology. There are some 70 to 80 species of mushrooms that are poisonous to humans; many of them contain toxic alkaloids ( muscarine , agaricine , phalline ). MUSHROOM POISONING: Also known as ‘ mycetism ’ Refers to harmful effects from ingestion of toxic substance present in a mushroom. They are neither plant or animal and belong to the kingdom ‘ Fungi ’. Latin name of mushroom: Boletus edulis

3. EFFECTS OF MUSHROOM POISONING POSITIVE Mood lift and euphoria Increased giggling and laughing May interrupt cluster sequences in those suffering from cluster headaches. NEUTRAL Felling more emotionally sensitive General change in consciousness Sleepiness and lethargy Pupil dilation NEGATIVE Intense feeling of nausea, fear and confusion Mild to severe anxiety and dizziness.

4. CLASSIFICATION Cyclopeptide containing mushrooms- AMANITA SPECIES Mono methyl hydrazine- GYROMITRA SPECIES Muscarine containing mushrooms - INOCYBE SPECIES . Coprine – coprinus - ATRAMENTARIOUS Gastroenteritis including mushrooms- CHLOROPHYLLUM MOLYBDITES

5. Clinical manifestations, toxic syndrome, toxins, their sites and mortality rate found in different species of mushroom

6. AMATOXINS

7. Mode of action

8. Toxin Effects Alpha- Amanitin Causes often fatal liver damage 1–3 days after ingestion. The principal toxin in the  death cap . Phallotoxin Causes extreme gastrointestinal upset. Found in various mushrooms. Orellanine Redox cycler  similar to  paraquat . Causes kidney failure within three weeks after ingestion. Principal toxin in genus  Cortinarius . Muscarine Causes  SLUDGE syndrome . Found in various mushrooms. Antidote is  atropine Monomethylhydrazine  (MMH) Causes brain damage, seizures, gastrointestinal upset, and  hemolysis . Metabolic poison. Principal toxin in genus  Gyromitra . Antidote is large doses of intravenous  pyridoxine  hydrochloride [1] Coprine Causes illness when consumed with alcohol. Principal toxin in genus  Coprinus . Ibotenic acid Excitotoxin . Principal toxin in  Amanita muscaria ,  A. pantherina , and  A. gemmata . Muscimol Causes  CNS   depression  and  hallucinations . Principal toxin in  Amanita muscaria ,  A. pantherina , and  A. gemmata . Arabitol Causes diarrhea in some people. Bolesatine Causes gastrointestinal irritation, vomiting, nausea. Ergotamine Affects the vascular system and can lead to loss of limbs and/or cardiac arrest. Found in genus  Claviceps .

9. SYMPTOMS EARLY (6 hours) Hallucinations Convulsions Coma LATE (6-24 hours) Hepatotoxic Nephrotoxic DELAYED (after 24 hours) Jaundice Hypoglycemia MODS followed by death

10. COMPLICATIONS Kidney failure Kidny damage Death INDICATIONS Don’t believe that boiling, salting or drying the mushrooms will purify them. Don’t use alcohol. Some edible mushrooms can cause an abnormal response when taken with alcohol

11. DIAGNOSIS Arterial blood gas analysis may demonstrate hypoxia and acidosis. Electrolyte disturbances( hypokalemia) may occur in patients with severe gastroenteritis. LFT and RFT Monitoring BGL Detection of toxins in gastric aspirate, serum, urine, stool. Liver and kidney biopsies had to be done ELISA – Enzyme Linked Immunosorbent Assay analysis of urinary amanitin appears to be efficacious in diagnosing amatoxin poisoning. TLC GLC HPLC

12. TREATMENT The initial treatment is supportive Control the ABCs Hydration with intravenous fluid is essential to maintain a strong blood pressure. Transfusion a fresh frozen plasma, packed RBC is necessary Oxygen therapy and if necessary a breathing machine( mechanical ventilator) can be used Decontamination of GUT (A+ charcoal, emesis, catharsis. Forced diuresis, hemoperfusion ) Drugs include anticonvulsants, antiemetics , GI decontaminants, antidotes, and anticholinergic agents.

13. Drugs Anticonvulsants- lorazepam ( Ativan) Antiemetic agents- metoclopramide ( reglan ) Gastrointestinal agents – PEG Anticholinergic agents - atropine

14. ANTITODE BENZYL PENICILLIN Dose: 300000-1,000,000 units/day is effective M.O.A: by binding to specific penicillin binding protiens located inside the bacterial cell wall, penicillin G inhibits the third and last stage of bacterial cell wall synthesis. Cell lysis is then mediated by bacterial cell wall autolytic enzymes such as autolysis. ADR THIOCTIC ACID -hepatic damage SILYBINNIN - hepatic toxicity CIMETIDINE ( have hepato protector against alpha amanitin ) Dose- 4-6 gm /day