Laboratory Studies
No specific diagnostic studies for tropane alkaloid poisonings exist. Tropane alkaloids are not included in standard drugs of abuse or comprehensive toxicology panels; serum drug concentrations are neither helpful nor readily available to aid in initial management.
Since acetaminophen and salicylate are common co-ingestants in many poisonings, consider assays for acetaminophen and salicylate levels. In febrile patients, consider blood and urine cultures. Serum electrolyte levels may provide insight into other intoxicating agents and co-ingestants.
Consider a pregnancy test for all female patients of childbearing age.
Imaging Studies
Consider CT scan of the head for patients with altered mental status that is inadequately explained by toxicity from ingested agent or is unresponsive to appropriate intervention.
Other Tests
Obtain an electrocardiogram (ECG) at presentation for all patients with suspected toxic ingestions.
Procedures
Consider lumbar puncture (LP) for patients with fever and altered mental status.
Consider invasive monitoring for hemodynamically unstable patients.
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Datura stramonium (jimson weed). Note 4-5 inch long white flowers.© 2000 Richard Wagner
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Datura stramonium flower. Note the trumpetlike shape.© 2000 Richard Wagner
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Datura stramonium (close-up of unripe seed pods). Note spiny appearance of pods.© 2000 Richard Wagner
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Datura stramonium is the plant shown. © 2000 Richard Wagner
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The plant shown is foxglove (Digitalis purpura), which contains cardiac glycosides, not tropane alkaloids. © 2000 Richard Wagner
