Belladona poisoning: History, Mechanism, Effects,Prevention

1. BELLADONA POISONING
By: Trishna Kisiju

3. Introduction
FAMILY: Solanaceae
GENUS: Atropa
SPECIES: belladonna
COMMON NAMES: Apples of Sodom, Deadly
Nightshade, Devil’s Herb ,Naughty man’s
cherries, Poison Black Cherry, Great morel, etc
Habitat: Grows in the mountain area in North
Europe, Africa and West Asia.
Morphology: The flowers are purple, the berries
are shiny black.

5. Nomenclature
• Takes its name from its lethal actions and use
in cosmetics.
• Atropos- greek goddess that cuts thread of
life.
• Belladona- in Italian means Beautiful lady,
used on cheeks for natural blush and to shine,
dilate the pupil.

6. Atropos belladona

7. Main chemical constituents
Hyoscyamine

8. % of tropane alkaloids in Belladona
• Roots have up to 1.3%
• Leaves 1.2%
• Ripe berries 0.7%
• Flowers 0.6%
• Seeds 0.4%

9. Pathophysiology
• Belladonna alkaloids : Muscarinic receptor
antagonists.
Competitive inhibition
Block actions of ACh on autonomic effectors and
CNS, exerted through muscarinic receptors.
Overdose causes toxic effects.

10. Mechanism Of Action

11. • Scopolamine :effects more on the CNS, eye,
and secretory glands .
• Atropine: exerts more activity on the heart,
muscle.
• Hyoscyamine : more potent central and
peripheral nervous system effects.

12. Sources of Intoxication
1. Deliberate: suicidal.
2. Infants and children mostly susceptible to toxic
doses of drugs like diphenoxylate-atropine
(Lomotil) used for treatment of diarrhoea.
4. Transdermal scopolamine: Used for motion
sickeness.
5. Conjunctival instillations in infants and young
children.
6. Poisoning from smoking and ingestion of
Jimson weed ( Datura stromanium)

13. Cause of Intoxication
• Poisoning caused by: atropine, hyoscine and
hyoscyamine. They are found in roots, leaves,
stems, fruits and flowers.
• The most toxic part is the root of the plant.
• Intoxication: 2-3 berries in children ,
15-20 berries in adult.
• Intoxication causes anticholinergic effects in
the body causing anticholinergic toxidrome.

14. Clinical Signs and Symptoms
• dryness, burning in the mouth and throat
• difficulty swallowing
• a hoarse voice until utter loss
• Stop perspiring
• Mydriasis, cycloplegia
• Photophobia,blurred vision
• thirst, nausea, vomiting
• urinary retention and constipation
• hyperthermia

16. • Tachycardia, about 150 beats per minute,
arrhythmia and palpitations
• severe shortness of breath
• flushed skin
• edema of the face, forearms, lower legs
• complete loss of orientation
• mental excitement, hallucinations , confusion
and delirium
• Coma and death

19. Diagnosis
• Injection Physostigmine i.v
• Confirmation: If typical salivation, sweating,
bradycardia, intestinal hyperactivity, etc don’t
occur with Physostigmine.

20. Treatment
• To limit intestinal absorption if poison is taken
orally- Gastric lavage with tannic acid.
• Physostigmine: 1-3 mg s/c or slow i.v. injection
rapidly abolishes coma and delirium.
• If marked excitement is present, Diazepam
(benzodiazipine) is the most suitable agent for
producing sedations and controlling
convulsions.

21. • Control of Hyperthermia: Ice bags and alcohol
sponges help to reduce fever especially in
children.
• Respiratory support
• Stop use of any other drugs with
anticholinergic property.
• Catheterization of urinary bladder.

22. THANK YOU!!!