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- Plant exposure is 1 of the most common reasons to contact the poison center
- Majority of cases involve unintentional ingestion in children <6 yr old.
EtiologyIdentification of ingested plant species should be attempted whenever possible.
Plants with Anticholinergic Properties
- Genera include Atropa, Datura, Hyoscyamus, Solandra, and Solanum.
- Common names of anticholinergic plants include Jimson weed, deadly nightshade, henbane, and angel trumpet.
- Competitive antagonists of acetylcholine at the muscarinic acetylcholine receptor
Plants with Cardiac Glycosides
- Genera include Digitalis, Nerium, Thevetia, and Helleborus.
- Common names of cardiac glycoside plants include foxglove, oleander, yellow oleander, lily of the valley, and hellebore/Christmas rose
- Inhibit Na+/K+-ATPase:
- See separate chapter on Digoxin Poisoning
Plants with Nicotine-like Alkaloids
- Genera include Nicotiana, Caulophyllum, and Conium
- Common names of plants containing nicotine include tobacco, blue cohosh, and poison hemlock.
- Direct-acting agonists at the nicotinic acetylcholine receptor
Plants with Cyanogenic Compounds
- Genera include Hydrangea, Malus, Prunus, Sambucus
- Common names of plants containing cyanogenic compounds (in some part of the plant) include apricot, cherry, peach, plum, apple, cassava, and elderberry
- Metabolized to cyanide, which interferes with electron transport chain and leads to cellular poisoning
Plants with Calcium Oxalate Crystals
- Genera include Alocasia, Dieffenbachia, and Philodendron as well as many others
- Common names for calcium oxalate–containing plants include elephant's ear, dumb cane, and mother-in-law's tongue
- Clinical manifestations occur after release of intracellular calcium oxalate crystals:
- Local tissue exposure to calcium oxalate crystals leads to inflammatory response.
Plants with Pyrrolizidine Alkaloids
- Genera include Crotalaria, Heliotropium, Senecio, and Sesbania
- Common names of plants with pyrrolizidine alkaloids include scorpion's tail, ragwort, groundsel, and rattlebox
- Metabolized to highly reactive pyrroles, which are directly hepatotoxic acutely and lead to hepatic vascular proliferation and veno-occlusive disease chronically.
Plants with Sodium Channel Activity
- Genera include Aconitum, Delphinium, Leucothoe, Lyonia, Pernettya, Pieris, Rhododendron, Schoenocaulon, Veratrum, and Zigadenus
- Common names of plants with aconitine, veratrum alkaloids, and zygacine, all sodium channel openers, include: Aconite (monkshood, wolfsbane, delphinium), veratrum (false hellebore), and zygacine (death camas)
- Common names of plants with grayanotoxins, which have variable effects on sodium channels, include sweet bells, rhododendron, azalea, and lily-of-the-valley bush
- Variable sodium channel effects depending on toxin, although most lead to prolonged sodium channel influx.
Plants with Toxalbumins
- Genera include Abrus, Jatropha, Phoradendron, Ricinus, Robinia, Wisteria
- Common names of plants with toxalbumins include rosary pea, mistletoe, and castor bean
- Cause direct cellular toxicity by interfering with ribosomal function