Plant Poisoning

Basics

Identification 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 “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

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