MusHroom - poisoning

G.Rohini 4th Pharm D Sri Venkateswara College of Pharmacy

Contents: Introduction Definition Effects of Mushroom Poisoning Classification Toxic group of mushroom Poisoning classification Various species of poisonous mushrooms >>>>>>Clinical manifestations and toxicity of poisonous mushroom species,

Contents: Treatment for species of mushroom Poisoning Diagnosis Treatment for mushroom poisoning Antidote Adverse effects Preventive care Uses......

Introduction: Mushroom poisoning (also known as mycetism) Refers to harmful effects from ingestion of toxic substances present in a mushroom. They are unique. >>>> They are neither animal or plant. • The Kingdom of “ Fungi”

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 poisons is known as toxicology. Nearly above 100 plants are toxic to humans.PoisoningPoisoning Examples : AloeAloe: • Latin name -Vera , Cannabis • Latin name - Cannabis Sativaarly

Effects of Mushroom poisoning: Mushroom’s poisoning : There are three types of effects;: POSITIVE Effects: It includes Mood lift, Euphoria , Increased giggling and laughing , May interrupt cluster sequences in those suffering from cluster headaches.

NEUTRAL Effects: Feeling more emotionally sensitive General change in consciousness , Sleepiness, lethargy , Pupil dilation. NEGATIVE Effects : Intense feelings of fear, Nausea, confusion , Mild to severe anxiety, Dizziness.

Classification: Mono methyl hydrazine - Gyromitra species, Cyclopeptide – containing mushrooms - AMANITA SPECIES, Mono methyl hydrazine - Gyromitra species, Muscarine containing mushrooms – Inocybe species , Coprine – coprinus – Atramentarius , Gastroenteritis including mushrooms – Chlorophyllum molybdites.

Toxic Group of mushroom Classification:

Clinical manifestations,, Site of toxicity,, Mortality Rate,, Toxic Syndrome,, Found in various species of Mushrooms: ,

AmanTia Species: AMANITA SPECIES : DESCRIPTION: Fly agaric or fly amanita. Poisonous and psychoactive basidiomycete fungus, one of many in the genus Amanita. DESCRIPTION: A large conspicuous mushroom . Fly agaric fruiting bodies emerge from the soil looking like a white egg, covered in the white warty material of the universal veil.

Poisonous Mushrooms Amanita Clitocybe Cortinarius Gyromitra Psilocybe Well known for the presence of mainly amatoxins. Some species also contain phalloin, phalloidin, phallisin, phallacidin, phallacin and phallisacin, virotoxin . Fig: Amanita phalloids

Toxic Effects of Amentia species: Phallotoxin causes alternations of enterocytes cellular membrane. Amatoxin inhibits protein synthesis at transcriptional level within enterocytes, hepatocytes and proximal renal tubular cells. After the ingestion of this mushroom, >>>>>it causes necrosis of liver cells with mortality rates ranging from about 10-20%. Some reports have shown that this mushroom causes hallucinogenic effect due to the presence of ibotenic acid. (sleepy) Muscle twitching.

Symptoms: Symptoms : Motor depression , Ataxia (incoordination of muscular movement), Changes in mood Precipitation and feelings Dizziness Gastrointestinal disturbances Drowsiness.

Treatment For species of Amantia mushroom poisoning: Cholinesterase inhibitors as they counteract the effects of poisoning. Includes detoxification, careful monitoring and liver transplantation in severe case. Saline solution should be given to control thirst. Nitroglycerine and strychnia frequently given upto the limit of tolerance are of great value. Milk is mild antidote. Atropin may be of use as a stimulant.

Clitocybe Species: Clitocybe species: Toxic effects : Cused by acromelic acid (ACRO) which has two isomers- ACRO-A and ACRO-B. ACRO-A has very powerful excitatory action on rat. Some of the species are poisonous due to the presence of muscarine in their chemical composition.

Symptoms of intoxication And it's treatment: Symptoms of intoxifications : The patients show paresthesia (abnormal sensation) of the toes and finger followed by paroxysmal (time to time) burning pain notably at night. A sensation of heat, numbness, odema and local erythema (abnormal awareness of feeling) are associated with cries. Approximately after 15 minutes to 2 hours of ingestion of this mushroom, Patient can present gastrointestinal problems, miosis, hypersecretion and bradycardia (slower heart beat) in severe cases. Treatment: >>>>>>Aropine can be administered.

Cortinarius species: Cortimarius smithii : Toxic effects : Nephrotoxic due to the presence of the cyclopeptide orellanine. Also the oxidation of orellanine in renal tissue may accumulate quinone compounds which bind covalently with biological structures leading to cell damage

Symptoms of intoxication And it's treatment: Symptoms of intoxification : The symptoms of this species appear will between 2-20 days after ingestion. Delayed acute Tubulopathy (damage kindney tubules) that can progress to chronic renal insufficiency. Initially people experience nausea, vomiting Abdominal pain followed by intense thirst, chills etc., Polyuria or Oliguria and possibly Anuria. Treatment : Emodialysis (blood purification) can be done for recreational purposes. Saline solution can be given for thirst.

Clinincal manifestations For mushroom poisoning: Early symptoms: Category for within 6hours- Allergic, and neurologic syndromes (Hallucinations, Convulsions,coma ) , Late symptom category – 6 and 24 hours • Hepatotoxic, nephrotoxic. Delayed symptom category – After 24 hours , Jaundice, hypoglycemia, MODS followed by death.

Other symptoms : Diarrhea, Fever, Headache, Weakness, Drowsiness, Dizziness, sweating, Confusion, and hallucination.

Complications For Mushroom poisoning: • Kidney damage, Kidney failure & Death Indications: Don't believe that boiling, salting, or drying mushrooms will purified ones . Don't use alcohol. Some edible mushrooms can cause an abnormal reaction when taken with alcohol.

Diagnosis: DIAGNOSIS : Arterial blood gas analysis may demonstrate hypoxia and acidosis. Electrolyte disturbances (eg, hypokalemia) may occur in patients with severe gastroenteritis. LFT & RFT

Monitoring BGL , Detection of toxins in gastric aspirate, serum, urine, stool. Liver & kidney biopsies has to done. Enzyme-linked immunosorbent assay (ELISA) analysis of urinary amanitin appears to be efficacious in diagnosing amatoxin poisoning. TLC, GLC and HPLC.

Treatment For Mushroom Poisoning: The initial treatment is supportive: Control the ABCs , Hydration with intravenous fluid is essential to maintain a strong blood pressure. Transfusion of 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 For treatment of mushroom Poisoning Drugs used for treating Mushroom Poisoning: Anticonvulsants, Antiemetics, Gastrointestinal (GI) decontaminants, Antidotes, Anticholinergic agents.

Drug classification: Anticholinergics: Anti convulsants: carbamazepine (Tegretol) divalproex sodium, valproic acid, or valproate sodium ( Depakote, Depakene ) lamotrigine Anticholinergics: atropine (Atropen) belladonna alkaloids. benztropine mesylate (Cogentin) clidinium.

Anti emitics: ondansetron, Granisetron and tropisetron, Dexamethasone, droperidol and cyclizine

Antidote: Mechanism of action: Antidote : BENZYL PENICLLIN DOSE : 300000 – 1,000,000units/day is effective. Mechanism of action: Binding to specific penicillin-binding proteins (PBPs) which are 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.

ADVerse effects: Hypersensitivity, Rashes, Neurotoxicity , Erythema, Dermatitis , Angioedema ,

Seizures. Thioctic acid – hepatic damage , Silybinnin – hepatic toxicity Cimetidine (have hepato protector against alpha amanitin) Dose – 4-6gm/day

.......? How to get infect from mushrooms......? IF…. Eat poisonous mushroom. Eat rotten mushroom. Eat mushrooms sprayed with pesticides. Eat mushrooms if the person is allergic too. Eat safe mushrooms but have a panic reaction.

Suggestions To prevent mushroom poisoning: Tips For Identifying Poisonous Mushrooms : Should never pick little brown mushrooms or umbrella- capped ones with white gills. Always leave out the mushroom that has a bulbous cap or sac around its base. This ring or ‘annulus’ is a clear indication of the toxicity of a mushroom. Just bite into its fleshy cap and wait for 24 hours to see any possible signs of poisoning. Also, avoid eating wild mushrooms in raw form or in large quantities as these are difficult to digest.

Uses of Mushrooms: Production of foodstuffs like wine and cheese. Mushrooms has immune system enhancement properties. Used for dyeing wool and other natural fibers. Used as a antioxidant.

References: https://www.slideshare.poisoning overdose -24520752 Modern Toxicology 4th edition By V V pillay https://www.slideshare.net/Nageshb11/poisonous-mushroom https://www.slideshare.net/VELSPHARMD/mushroom-poisoning-24520752