In this edition, the Pain and Pain Management section is now at the front of the book, since a large percentage of emergency department patients present with pain-related complaints. [books.google.de]

Because of the competitive nature of the immunoassay as well as the complexity of the mixture of cross-reacting cardiac glycosides present in the plant material, the measured apparent digoxin concentration is not linearly related to the cardiac glycoside [ncbi.nlm.nih.gov]

We compared two immunoassays (LOCI digoxin assay and iDigoxin assay) for rapid detection of convallatoxin if present in human serum. [readbyqxmd.com]

Acute yellow oleander (Thevetia peruviana) poisoning: cardiac arrhythmias, electrolyte disturbances, and serum cardiac glycoside concentrations on presentation to hospital. Heart. 2000 Mar. 83(3):301-6. [QxMD MEDLINE Link]. [emedicine.medscape.com]

• Pain

  In this edition, the Pain and Pain Management section is now at the front of the book, since a large percentage of emergency department patients present with pain-related complaints. [books.google.de]

  Symptoms: Nausea, vomiting, salivation, drowsiness, abdominal pain, diarrhea, weakness, and respiratory depression. [people.uwec.edu]

  In acute toxicity, the following may be present: GI symptoms - Usually evolve within minutes to hours, are nonspecific, and include nausea, vomiting, and abdominal pain Neurologic symptoms - Often are nonspecific and include weakness and altered mental [emedicine.medscape.com]

  Signs and Symptoms: In children cardiac glycoside ingestion causes severe abdominal pain, diarrhea, nausea and vomiting. Additional symptoms include lethargy, circumoral flush, dialated pupils, drooling, sweating, shaking, and ashy coloring. [sites.google.com]

• Congestive Heart Failure

  It is used in modern medicine to increase the force of the systolic contractions and prolong duration of the diastolic phase in congestive heart failure. [poisonousplants.ansci.cornell.edu]

  Description of the problem Digoxin is commonly used for the treatment of atrial fibrillation, especially with co-existing congestive heart failure. [clinicaladvisor.com]

  Foxglove was originally used for congestive heart failure and atrial fibrillation (chaotic contractions across the atrium of the heart). [encyclopedia.com]

  Class identifiers Use Congestive heart failure ATC code C01A Biological target Na+ /K+ -ATPase External links MeSH D002301 In Wikidata Cardiac glycosides are a class of organic compounds that increase the output force of the heart and decrease its rate [en.wikipedia.org]

  References: [1] [3] [7] [5] [6] Indications Congestive heart failure (symptomatic patients with NYHA ≥ II despite pharmacotherapy) Atrial fibrillation Supraventricular tachycardia References: [4] [8] Contraindications References: [7] [8] We list the most [amboss.com]

• Gastric Lavage

  Gastric lavage Weak solution of iodine, in KI, or tannic acid to precipitate alkaloid Animal charcoal Cathartic Atropine Eliminated mainly by urine [slideshare.net]

  lavage for elimination of the compound from the stomach (irrigation using special solutions) Administer suitable medication to counter the effects of the toxin Administer activated charcoal to avoid absorbance of the compound in the body Administer laxatives [dovemed.com]

  After conducting all the routine investigations, gastric lavage was done with activated charcoal in the ICU. The patient was given one dose of 0.6 mg atropine intravenously, which did not resolve his bradycardia. [roaic.eg.net]

• Vomiting

  In acute toxicity, the following may be present: GI symptoms - Usually evolve within minutes to hours, are nonspecific, and include nausea, vomiting, and abdominal pain Neurologic symptoms - Often are nonspecific and include weakness and altered mental [emedicine.medscape.com]

  Two to three hours later, other signs of poisoning may occur, including nausea, vomiting, sweating, confusion, and slowing of the heart rate. There have been reports of seizures with severe overdoses. [chop.edu]

  Case report A 26-year-old male patient presented to the emergency room with vomiting, disorientation, and increased tone of muscles (spasticity) in lower limbs. [roaic.eg.net]

  Symptoms: Nausea, vomiting, salivation, drowsiness, abdominal pain, diarrhea, weakness, and respiratory depression. [people.uwec.edu]

• Nausea

  Symptoms: Nausea, vomiting, salivation, drowsiness, abdominal pain, diarrhea, weakness, and respiratory depression. [people.uwec.edu]

  In acute toxicity, the following may be present: GI symptoms - Usually evolve within minutes to hours, are nonspecific, and include nausea, vomiting, and abdominal pain Neurologic symptoms - Often are nonspecific and include weakness and altered mental [emedicine.medscape.com]

  Two to three hours later, other signs of poisoning may occur, including nausea, vomiting, sweating, confusion, and slowing of the heart rate. There have been reports of seizures with severe overdoses. [chop.edu]

  Signs and Symptoms: In children cardiac glycoside ingestion causes severe abdominal pain, diarrhea, nausea and vomiting. Additional symptoms include lethargy, circumoral flush, dialated pupils, drooling, sweating, shaking, and ashy coloring. [sites.google.com]

• Abdominal Pain

  In acute toxicity, the following may be present: GI symptoms - Usually evolve within minutes to hours, are nonspecific, and include nausea, vomiting, and abdominal pain Neurologic symptoms - Often are nonspecific and include weakness and altered mental [emedicine.medscape.com]

  Symptoms: Nausea, vomiting, salivation, drowsiness, abdominal pain, diarrhea, weakness, and respiratory depression. [people.uwec.edu]

  Signs and Symptoms: In children cardiac glycoside ingestion causes severe abdominal pain, diarrhea, nausea and vomiting. Additional symptoms include lethargy, circumoral flush, dialated pupils, drooling, sweating, shaking, and ashy coloring. [sites.google.com]

  The signs and symptoms of Lily-of-the-Valley Plant Poisoning may include: Headaches and weaknesses Nausea, vomiting, and diarrhea Abdominal pain Increased urination frequency at night Skin rashes and hives (red weals on the body) Vision abnormalities, [dovemed.com]

• Loss of Appetite

  Symptoms such as depression, loss of appetite, and halos in the vision are typically only present in cases of chronic or severe poisonings. [homeguides.sfgate.com]

  An overdose of foxglove may also cause diarrhea, headache, loss of appetite, and vomiting. More serious and potentially deadly reactions to an overdose affect the heart and the central nervous system. [encyclopedia.com]

  […] of appetite* Nausea and vomiting Stomach pain HEART AND BLOOD Irregular heartbeat (or slow heartbeat) Shock (extremely low blood pressure) Weakness NERVOUS SYSTEM Confusion Depression* Drowsiness Fainting Hallucinations* Headache Lethargy or weakness [medlineplus.gov]

• Abdominal Cramps

  Acontium spp and Delphinum spp, may be in Asian herbal medicines sodium channel activator GI symptoms: N&V, abdominal cramps, diarrhoea tachycardia, dysrhythmia, shock CNS effects: paresthesiae, paralysis, coma, seizures MODS, lactic acidosis Belladona [lifeinthefastlane.com]

• Confusion

  GI symptoms are nonspecific and include the following: Anorexia Nausea Vomiting Diarrhea Abdominal pain Weight loss Neurologic symptoms include the following: Confusion Drowsiness Disorientation Delirium Headache Hallucinations Seizures Visual disturbances [emedicine.medscape.com]

  Two to three hours later, other signs of poisoning may occur, including nausea, vomiting, sweating, confusion, and slowing of the heart rate. There have been reports of seizures with severe overdoses. [chop.edu]

  Poison hemlock (Conium maculatum) Poison hemlock ( Conium maculatum ) Hemlock is sometimes confused with other species in the Apiaceae family such as cow parsley. It’s a large plant up to 2m tall, with hollow, purple-blotched stems. [woodlandtrust.org.uk]

  […] vomiting, diarrhea, salivation Oleander ( Nerium oleander, Thevetia peruviana ) Toxins: oleandrin, folinerin, digitoxigenin, nerium Signs and symptoms: Abdominal pain, visual disturbances, hypotension, bradycardia and heart block, tachydysrhythmias, confusion [sites.google.com]

• Insomnia

  She had no previous medical or cardiac history, with the patient stating that she tried a herbal remedy of boiled comfrey leaves for insomnia 18 hours before arrival to the department. [readbyqxmd.com]

Digoxin Fab fragment treatment should be given if indicated. Fab Fragment Treatment Sheep-derived digoxin antibody Fab fragments reportedly are effective for some plant cardiac glycosides. [emedicine.medscape.com]

The treatment of oleander poisoning is empirically based on the treatment of digitalis glycoside toxicity and consists of supporting the patient hemodynamically. [roaic.eg.net]

Overdose can quickly become life-threatening and swift treatment is vital. The first-line treatment for cardiac glycoside poisoning is administration of digoxin-specific antibodies. [amboss.com]

Because cardenolides from these plants are structurally similar, acute poisonings are managed using similar treatments. [cochrane.org]

Specific Treatment The first priority in treatment is ensuring the patient has an adequate airway and breathing. Patients who are bradycardic can receive atropine 0.5 mg IV, although any response is likely to be transient and minimal. [clinicaladvisor.com]

In such cases, the prognosis may be adversely affected. However, fatalities have generally not been reported from Lily-of-the-Valley Plant Poisoning In general, toxicities are common situations in the emergency departments. [dovemed.com]

Prognosis The prognosis for acute digoxin toxicity directly correlates with the mortality. [clinicaladvisor.com]

Age-related differences in incidence AAPCC data from 2019 show the following age breakdowns for plant cardiac glycoside exposure [4] : Infants and children younger than 6 years - 52% Children aged 6-19 years - 18% Adults older than 19 years - 30% Prognosis [emedicine.medscape.com]

Cardiac glycoside poisoning Etiology Digoxin overdose ( iatrogenic, by nonadherence to prescribed dosages or by ingestion of plants containing cardiac glycosides) Hypokalemia Renal failure Treatment with verapamil, diltiazem, amiodarone, and/or quinidine [amboss.com]

Etiology Exposure to plants containing glycosides can occur through ingestion of sap, berries, leaves, blossoms, or seeds, or of teas brewed from plant parts. Plant extracts also have been intentionally injected. [emedicine.medscape.com]

Alternative diagnosis If an adequate dose of digoxin immune Fab fragments has been administered and there is no change in the hemodynamics, one should consider searching for alternative etiologies. [clinicaladvisor.com]

^ a b c "Cardiac Glycoside Plant Poisoning: Practice Essentials, Pathophysiology, Etiology". 2017-05-05. ^ a b "Pharmacognosy 2|Digital Textbook Library". www.tankonyvtar.hu. [en.wikipedia.org]

[…] foxglove ( Digitalis purpurea) Woolly foxglove ( Digitalis lanata) Ouabain ( Strophanthus gratus) Lily-of-the-valley ( Convallaria majalis) Common oleander ( Nerium oleander) Yellow oleander ( Thevetia peruviana) Squill or sea onion ( Urginea maritima) Epidemiology [emedicine.medscape.com]

Epidemiology In the 1780s, the foxglove plant (from which digoxin is derived) was used in the treatment of congestive heart failure. [clinicaladvisor.com]

Pathophysiology More than 200 naturally occurring cardiac glycosides have been identified. These bind to a site on the cell membrane, producing reversible inhibition of the sodium (Na+)-potassium (K+)-adenosine triphosphatase (ATPase) pump. [emedicine.medscape.com]

Pathophysiology Ingested cardioactive steroids (CAS) are approximately 80% bioavailable. However, toxicokinetics depends on multiple factors,... References 1. [link.springer.com]

Pathophysiology Digoxin, like other cardiac glycosides, inhibits the sodium-potassium-ATPase. This inhibition results in a rise in extracellular potassium and a rise in intracellular sodium. [clinicaladvisor.com]

^ a b c "Cardiac Glycoside Plant Poisoning: Practice Essentials, Pathophysiology, Etiology". 2017-05-05. ^ a b "Pharmacognosy 2|Digital Textbook Library". www.tankonyvtar.hu. [en.wikipedia.org]

Centers for Disease Control and Prevention Poisoning Prevention is a resource offering tips for preventing poisonings at home, including those by pesticides and plants. [redfin.com]

Understand the common characteristics and methods of transmission for each disease, and learn all the applicable diagnosis, treatment, control, and prevention techniques. [books.google.de]

To prevent further absorption, oral administration of activated charcoal is recommended if no contraindications exist. [emedicine.medscape.com]

Cardiac glycosides function by inhibiting the intercellular sodium-potassium pumps to prevent the extrusion of sodium. Raised sodium levels derange the action of the sodium-calcium pump leading to an increased intracellular calcium concentration. [sites.google.com]