Spina Sean P, Taddei Anthony
Division of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
CJEM. 2007 Nov;9(6):467-8. doi: 10.1017/s1481803500015530.
We report 2 cases of teenagers who were poisoned with Jimson weed (Datura stramonium) and presented to the emergency department with a severe acute anticholinergic toxidrome after ingestion of several hundred seeds. The patients presented with visual hallucinations, disorientation, incomprehensible and nonsensical speech, and dilated sluggish pupils. Both patients required restraints for combativeness until adequate sedation with lorazepam and haloperidol was achieved. Jimson weed is found in southern Canada and the United States and can cause acute anticholinergic poisoning and death in humans and animals. The treatment of choice for anticholinergic poisoning is mainly supportive care and gastrointestinal decontamination with activated charcoal. Jimson weed intoxication should be considered in cases of patients presenting with unexplained peripheral and central anticholinergic symptoms including delirium, agitation and seizures, especially among younger patients and partygoers. It is important that health care professionals recognize that Jimson weed is a toxic, indigenous, "wild" growing plant, subject to misuse and potentially serious intoxication requiring hospitalization.
我们报告了2例青少年曼陀罗中毒病例,他们在摄入数百颗种子后因严重急性抗胆碱能中毒综合征被送往急诊科。患者出现视幻觉、定向障碍、言语不清且无意义,以及瞳孔散大、反应迟钝。两名患者均因好斗而需要约束,直到使用劳拉西泮和氟哌啶醇达到充分镇静。曼陀罗在加拿大南部和美国均有发现,可导致人和动物急性抗胆碱能中毒及死亡。抗胆碱能中毒的首选治疗方法主要是支持治疗和用活性炭进行胃肠道去污。对于出现不明原因的外周和中枢抗胆碱能症状(包括谵妄、躁动和癫痫发作)的患者,尤其是年轻患者和参加派对者,应考虑曼陀罗中毒。医护人员必须认识到曼陀罗是一种有毒的本土“野生”生长植物,可能被滥用并导致需要住院治疗的潜在严重中毒,这一点很重要。