This document summarizes information about Belladonna poisoning from the plant Atropa belladonna. It describes the plant's morphology, main chemical constituents including tropane alkaloids like hyoscyamine, and how these alkaloids act as muscarinic receptor antagonists. Symptoms of anticholinergic toxidrome from Belladonna poisoning include dry mouth, blurred vision, tachycardia, delirium and coma. Diagnosis involves injection of physostigmine and treatment focuses on gastric lavage, physostigmine administration, benzodiazepines, and supportive care.

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!!!