Tropane Alkaloid Poisoning Differential Diagnoses

  • Author: Richard A Wagner, MD; Chief Editor: Asim Tarabar, MD   more...
 
Updated: May 27, 2011
 
 

Differential Diagnoses

Proceed to Workup
 
 
Contributor Information and Disclosures
Author

Richard A Wagner, MD  PhD, FACEP, Staff Physician, EmCare, Inc.

Richard A Wagner, MD is a member of the following medical societies: American College of Emergency Physicians

Disclosure: Nothing to disclose.

Coauthor(s)

Samuel M Keim, MD  Associate Professor, Department of Emergency Medicine, University of Arizona College of Medicine

Samuel M Keim, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Public Health Association, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Michael S Beeson, MD, MBA, FACEP  Professor of Emergency Medicine, Northeastern Ohio Universities College of Medicine and Pharmacy; Attending Faculty, Akron General Medical Center

Michael S Beeson, MD, MBA, FACEP is a member of the following medical societies: American College of Emergency Physicians, Council of Emergency Medicine Residency Directors, National Association of EMS Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

John T VanDeVoort, PharmD  Regional Director of Pharmacy, Sacred Heart & St. Joseph's Hospitals

John T VanDeVoort, PharmD is a member of the following medical societies: American Society of Health-System Pharmacists

Disclosure: Nothing to disclose.

Michael Hodgman, MD  Assistant Clinical Professor of Medicine, Department of Emergency Medicine, Bassett Healthcare

Michael Hodgman, MD is a member of the following medical societies: American College of Medical Toxicology, American College of Physicians, Medical Society of the State of New York, and Wilderness Medical Society

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Asim Tarabar, MD  Assistant Professor, Director, Medical Toxicology, Department of Emergency Medicine, Yale University School of Medicine; Consulting Staff, Department of Emergency Medicine, Yale-New Haven Hospital

Disclosure: Nothing to disclose.

References

  1. Ramirez M, Rivera E, Ereu C. Fifteen cases of atropine poisoning after honey ingestion. Vet Hum Toxicol. Feb 1999;41(1):19-20. [Medline].

  2. Chang SS, Wu ML, Deng JF. Poisoning by Datura leaves used as edible wild vegetables. Vet Hum Toxicol. Aug 1999;41(4):242-5. [Medline].

  3. Pereira CA, Nishioka S de D. Poisoning by the use of Datura leaves in a homemade toothpaste. J Toxicol Clin Toxicol. 1994;32(3):329-31. [Medline].

  4. Hamilton RJ, Perrone J, Hoffman R. A descriptive study of an epidemic of poisoning caused by heroin adulterated with scopolamine. J Toxicol Clin Toxicol. 2000;38(6):597-608. [Medline].

  5. Lin CC, Chen JC. Medicinal herb Erycibe henri Prain ("Ting Kung Teng") resulting in acute cholinergic syndrome. J Toxicol Clin Toxicol. 2002;40(2):185-7. [Medline].

  6. Bronstein AC, Spyker DA, Cantilena LR Jr, Green JL, Rumack BH, Heard SE. 2007 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 25th Annual Report. Clin Toxicol (Phila). Dec 2008;46(10):927-1057. [Medline]. [Full Text].

  7. Lai MW, Klein-Schwartz W, Rodgers GC, Abrams JY, Haber DA, Bronstein AC. 2005 Annual Report of the American Association of Poison Control Centers' national poisoning and exposure database. Clin Toxicol (Phila). 2006;44(6-7):803-932. [Medline]. [Full Text].

  8. Forrester MB. Jimsonweed (Datura stramonium) exposures in Texas, 1998-2004. J Toxicol Environ Health A. Oct 2006;69(19):1757-62. [Medline].

  9. CDC. Anticholinergic poisoning associated with an herbal tea--New York City, 1994. MMWR Morb Mortal Wkly Rep. Mar 24 1995;44(11):193-5. [Medline].

  10. Al-Shaikh AM, Sablay ZM. Hallucinogenic plant poisoning in children. Saudi Med J. Jan 2005;26(1):118-21. [Medline].

  11. Balikova M. Collective poisoning with hallucinogenous herbal tea. Forensic Sci Int. Aug 14 2002;128(1-2):50-2. [Medline].

  12. Boumba VA, Mitselou A, Vougiouklakis T. Fatal poisoning from ingestion of Datura stramonium seeds. Vet Hum Toxicol. Apr 2004;46(2):81-2. [Medline].

  13. CDC. From the Centers for Disease Control and Prevention. Scopolamine poisoning among heroin users--New York City, Newark, Philadelphia, and Baltimore, 1995 and 1996. JAMA. Jul 10 1996;276(2):92-3. [Medline].

  14. CDC. Jimson weed poisoning--Texas, New York, and California, 1994. MMWR Morb Mortal Wkly Rep. Jan 27 1995;44(3):41-4. [Medline].

  15. Chan TY. Anticholinergic poisoning due to Chinese herbal medicines. Vet Hum Toxicol. Apr 1995;37(2):156-7. [Medline].

  16. DeFrates LJ, Hoehns JD, Sakornbut EL, Glascock DG, Tew AR. Antimuscarinic intoxication resulting from the ingestion of moonflower seeds. Ann Pharmacother. Jan 2005;39(1):173-6. [Medline]. [Full Text].

  17. Dewitt MS, Swain R, Gibson LB Jr. The dangers of jimson weed and its abuse by teenagers in the Kanawha Valley of West Virginia. W V Med J. Jul-Aug 1997;93(4):182-5. [Medline].

  18. Drager B. Analysis of tropane and related alkaloids. J Chromatogr A. Nov 29 2002;978(1-2):1-35. [Medline].

  19. Dyer S. Plant exposures: wilderness medicine. Emerg Med Clin North Am. May 2004;22(2):299-313, vii. [Medline]. [Full Text].

  20. Francis PD, Clarke CF. Angel trumpet lily poisoning in five adolescents: clinical findings and management. J Paediatr Child Health. Feb 1999;35(1):93-5. [Medline].

  21. Froberg B, Ibrahim D, Furbee RB. Plant poisoning. Emerg Med Clin North Am. May 2007;25(2):375-433; abstract ix. [Medline].

  22. Greene GS, Patterson SG, Warner E. Ingestion of angel's trumpet: an increasingly common source of toxicity. South Med J. Apr 1996;89(4):365-9. [Medline].

  23. Hayman J. Datura poisoning--the Angel's Trumpet. Pathology. Jul 1985;17(3):465-6. [Medline].

  24. Hung OL, Lewin NA, Howland MA. Herbal preparations. In: Goldfrank's Toxicologic Emergencies. 6th ed. 1998.

  25. Huxtable RJ. The toxicity of alkaloids in foods and herbs. In: Food Poisoning: Handbook of Natural Toxins. Vol 7. Marcel Dekker; 1992:237-62.

  26. Isbister GK, Oakley P, Dawson AH. Presumed Angel's trumpet (Brugmansia) poisoning: clinical effects and epidemiology. Emerg Med (Fremantle). Aug 2003;15(4):376-82. [Medline].

  27. Micke MM. The case of hallucinogenic plants and the Internet. J Sch Health. Oct 1996;66(8):277-80. [Medline].

  28. Miraldi E, Masti A, Ferri S. Distribution of hyoscyamine and scopolamine in Datura stramonium. Fitoterapia. Aug 2001;72(6):644-8. [Medline].

  29. Mobus U, Demmler G, Schulz K. [Accidental drowning due to tropane alkaloid abuse]. Arch Kriminol. Jul-Aug 2002;210(1-2):16-21. [Medline].

  30. Munoz O, Casale JF. Tropane alkaloids from Latua pubiflora. Z Naturforsch [C]. Sep-Oct 2003;58(9-10):626-8. [Medline].

  31. Olson KR. Poisoning and Drug Overdose. 3rd ed. Simon & Schuster Trade; 1998.

  32. Plaitakis A, Duvoisin RC. Homer's moly identified as Galanthus nivalis L.: physiologic antidote to stramonium poisoning. Clin Neuropharmacol. Mar 1983;6(1):1-5. [Medline].

  33. Rodgers GC Jr, Von Kanel RL. Conservative treatment of jimsonweed ingestion. Vet Hum Toxicol. Feb 1993;35(1):32-3. [Medline].

  34. Rwiza HT. Jimson weed food poisoning. An epidemic at Usangi rural government hospital. Trop Geogr Med. Jan-Apr 1991;43(1-2):85-90. [Medline].

  35. Schultes RE, Hoffmann A. Holy flower of the North Star: Datura. In: Plants of the Gods: Their Sacred, Healing, and Hallucinogenic Powers. 1992:106-11.

  36. Smith EA, Meloan CE, Pickell JA, Oehme FW. Scopolamine poisoning from homemade 'moon flower' wine. J Anal Toxicol. Jul-Aug 1991;15(4):216-9. [Medline].

  37. Steenkamp PA, Harding NM, van Heerden FR. Fatal Datura poisoning: identification of atropine and scopolamine by high performance liquid chromatography/photodiode array/mass spectrometry. Forensic Sci Int. Oct 4 2004;145(1):31-9. [Medline].

  38. Tiongson J, Salen P. Mass ingestion of Jimson Weed by eleven teenagers. Del Med J. Nov 1998;70(11):471-6. [Medline].

  39. Urich RW, Bowerman DL, Levisky JA. Datura stramonium: a fatal poisoning. J Forensic Sci. Oct 1982;27(4):948-54. [Medline].

  40. Vanderhoff BT, Mosser KH. Jimson weed toxicity: management of anticholinergic plant ingestion. Am Fam Physician. Aug 1992;46(2):526-30. [Medline].

  41. Wiebe TH, Sigurdson ES, Katz LY. Angel's Trumpet (Datura stramonium) poisoning and delirium in adolescents in Winnipeg, Manitoba: Summer 2006. Paediatr Child Health. Mar 2008;13(3):193-6. [Medline]. [Full Text].

 
Previous
Next
 
Datura stramonium (jimson weed). Note 4-5 inch long white flowers.© 2000 Richard Wagner
Datura stramonium flower. Note the trumpetlike shape.© 2000 Richard Wagner
Datura stramonium (close-up of unripe seed pods). Note spiny appearance of pods.© 2000 Richard Wagner
Datura stramonium is the plant shown. © 2000 Richard Wagner
The plant shown is foxglove (Digitalis purpura), which contains cardiac glycosides, not tropane alkaloids. © 2000 Richard Wagner
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.