Mushroom poisoning

1. MUSHROOM
POISONING
Растоги Мускан

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

5. Clinical manifestations, toxicsyndrome,toxins,theirsites
andmortalityratefoundindifferent species ofmushroom

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