close encounters of the botanical kind donna lotzer, rph certified specialist in poison information...

CLOSE ENCOUNTERS OF THE BOTANICAL

KIND

Donna Lotzer, RPhCertified Specialist

in Poison InformationUW Hospital Poison Prevention

& Education Center

February 2007

MonkshoodAconitum napellus

• Whole plant toxic, esp. roots and leaves

• Leaves like parsley, roots mistaken for horseradish/celery

• Ingestion causes local tingling, burning, numbness, thirst

• Vomiting, diarrhea, visual changes follow

• Irregular heart beats, low blood pressure lead to fatalities

• Fatal cases resulted 1½ to 8 hours after eating

• Management in intensive care if person can get there

Monkshood

Alternate names include friar’s cap, old wife’s hood, helmet flower (easy to see why!)

Poison IvyToxicodendron radicans

• One of most UNpopular plants• Reaction is dual with allergic rxn

too• Sap is culprit, found in entire

plant• Skin contact causes symptoms

of redness, itching, blisters “progressing” over time

• Management:• Wash affected area well• Domeboro®, rubbing alcohol,

steroid cream, jewel weed (?)• Protect blisters, keep clean• Oral antihistamines/steroids• Launder clothing separately

Poison Ivy

Poison SumacToxicodendron

vernix

•

Water HemlockCicuta maculata

• Very highly toxic to fatal plant• Mistaken for other edible

plants (smells like parsnip)• Symptoms occur in 15-60

min. and include vomiting, diarrhea, severe abdominal pain, dilated pupils, violent muscle spasms, seizures, breathing paralysis

• Person may not survive till medical care can be provided

• Folk antidote of salmon oil skimmed off salmonhead soup!!

ROOT SECTION

Water Hemlock

Folk names of beaver poison, death-of-man, children’s bane (HINT!)

Poison HemlockConium maculatum

• Highly toxic plant, common in WI marshes, ditches

• Mistaken for carrot, parsnip• Roots and seeds esp. toxic• Symptoms (1-3 hours out)

include irritation, salivation, tremors, dilated pupils, muscle spasm, seizures, paralysis

• Death due to breathing failure

• Management is supportive, observe 4 hours if no symptoms.

• Fatal peds cases mistook ID• Socrates killed with this

plant in liquid prep at 70 !

• Dermal contact causes a dermatitis reaction

Poison HemlockAlso known as kill cow, poison parsley, spotted hemlock

Wild ParsnipPastinaca sativa

• Ditch weed, fields, RR tracks• Dermal toxicity dominates• No sun – irritation and rash• Sun-induced burns

• Psoralens are culprit• Mild: red, sunburn look• Moderate: blisters form, area

looks scalded (Day 1-3)• Sweat enhances reaction• Delayed: Blisters rupture, red-

brown hyperpigmentation lasting up to 2 years!

• Burns appear streaky from sap

• Mistaken for poison ivy• Management:

• Cover up skin• Domeboro®, steroid

cream• Protect blisters, keep

clean

Wild Parsnip

Queen Anne’s LaceDaucus carota

• Commonly referred to as wild carrot

• Compare look to hemlock!!

• Toxic because of skin irritation from sap, combined with sunlight (like parsnip).

• Some parts are potentially edible so must be sure of ID.

• Management for dermal exposure is repeated washing and sun avoidance

Wild Plant Guessing Game

IS THIS PLANT…

Wild Carrot ?

Wild Parsnip ?

Poison Hemlock ?

WOULD YOU EAT IT TO FIND OUT THE RESULTS?

The Poison Center phone number is 1-800-222-1222 !!!!

FoxgloveDigitalis purpurea

• Active principle is digitalis, used since 1700’s in medical practice

• “Mistaken ID” leads to ingestion and some poisonings

• Symptoms include vomiting, diarrhea, visual changes, slow irregular pulse, tremors, seizures

• Management includes medical observation for 12 hours, with intensive care if problems develop, using pacemaker, special drugs

FoxgloveCommon names include fairy bells, witches’ thimble, rabbit flower, lion’s mouth

Lily of the ValleyConvallaria majalis

• Plant contains convallarin, convallotoxin, convallamarin (digitalis-like compounds)

• Multiple reasons to eat by kids/adults

• Symptoms like foxglove (affects the heart)

• Management like foxglove

Lily of the Valley

Castor Bean PlantRicinus communis

• Grown as an ornamental in WI

• Beans common in imported jewelry

• Ricin – poison for spy stories and bioterrorism concerns

• One of most potent natural toxins (also contains ricinus)

• If chewed, expect burning mouth and throat, vomiting, sweats, seizures and death

• Management in intensive care for kidney, breathing and heart failure from ingestion or injection

Castor Bean Plant

JimsonweedDatura stramonium

• Good-looking, ill-smelling weed• Poisoning from honey, making

tea, eating seeds or leaves• Abusable by eating, smoking• “Good” symptom=hallucinations• “Bad” symptoms=flushed & dry

skin/mouth, dilated pupils, high pulse, fever, delirium, seizures

• Symptoms may last 12-48 hours• Management is to monitor body

temp and mental status, antidote drug for severe cases

Jimsonweed

(Close relative is Angel’s trumpet)

Also called mad apple, Devil’s trumpet, stink weed

LupineLupinus spp.

• Member of the legume family• Forms seed pods like peas• Contains multiple toxins

under variable growing conditions

• Seed pods and leaves/stems most toxic in spring

• Symptoms include nausea, vomiting, abdominal pain, slowed breathing, death (rare)

• Management is supportive care

TobaccoNicotiana tabacum

• Garden ornamental, grown for smoking tobacco in WI

• Whole plant is toxic, usually eating or skin exposures cause problems

• Harvest time leads to occupational exposures

• Symptoms include salivation, vomiting, diarrhea, pulse and blood pressure changes, seizures, breathing failure

• Management is washing, supportive care (ICU ?), possibly antidote drug in severe cases

Indian TobaccoLobelia inflata

• Common names include pukeweed, gagroot, vomitroot, asthma weed

• Has breathing stimulant, muscle relaxant properties

• Native Americans smoked or chewed for lung diseases (asthma, bronchitis)

• Toxicity includes vomiting, seizures, breathing failure from muscle paralysis (like curare!) and death

• Management is supportive in intensive care

• May find in stop-smoking products to help with nicotine withdrawal sxs

Thomas G. Barnes @ USDA-NRCS PLANTS Database Barnes, T.G. & S.W. Francis. 2004.

Indian Tobacco Cardinal

FlowerFound along WI river banks

YewTaxus spp.

• Several varieties, all toxic• Foliage will kill cows, horses• Seeds commonly ingested

by children• Symptoms include vomiting,

diarrhea, dizziness, dilated pupils, slow pulse, seizures, coma and rarely death

• Management ranges from observation to support in an intensive care setting (rare)

MilkweedAsclepius spp.

• Food source for Monarch butterflies

• Selected varieties edible young

• Toxic part is white latex (sap) found inside entire plant

• Mixed toxic chemicals found• Topical exposure can cause

skin irritation• Management is washing • Folk medicines use milkweed• Animals poisoned by ingestion

Milkweed

Skunk CabbageSymplocarpus foetidus

• Called polecat weed because of odor

• Toxic chemical is calcium oxalate

• Symptoms are mouth pain and swelling if eaten

• Management is supportive care (ice cream works well)

• Claims for edibility, but…

William S. Justice @ USDA-NRCS PLANTS Database

Jack-in-the-pulpitArisaema spp.

• Cultivated or wild woodland plant, attractive fruits

• Toxic chemical is calcium oxalate

• Symptoms are localized painful burning, and swelling of mouth, throat and tongue

• Management includes ice cream, milk or any cool liquid

• Seeds mistaken for pomegranate!

Jack-in-the-pulpitFruiting bodies (seed head)

MayapplePodophyllum peltatum

• Common woodland plant• Ripe fruit possibly edible but

stay away from the rest !• Symptoms after eating

include explosive diarrhea• Liver and kidney damage

possible, mutagen• Management is antiemetics

and supportive care

• NOT “DEADLY” plant• Vine, related to tomatoes• Attractive but inedible weed• Several common variations, bad

reputation exaggerated• Symptoms potentially could

include vomiting, weakness• Management is generally not

needed, but would be supportive care

Nightshade

Solanum spp.

Climbing Nightshade

Nightshade

Black Nightshade

BaneberryActea rubra

• Toxic woodland plant with unidentified chemicals

• Symptoms include mouth burning and swelling, headache, abdominal pain, salivation

• Management is supportive care

• Used historically in Native American medicine

BaneberryCommonly known as doll’s

eyes or snakeberry

BloodrootSanguinaria canadensis

• Member of the poppy family• Named for red-orange juice

in roots and stems• Most toxic part is roots• Multiple toxic compounds• Symptoms might include

vomiting, diarrhea, dizziness, fainting, dilated pupils

• Management is supportive care

Stinging NettleUrtica dioica

• Weed found in open areas• Some sources say edible,

BUT…• Toxicity: painful burning

skin irritation upon contact• Management is supportive,

with hot water to wash skin, steroid cream and oral antihistamines

• Common cultivated woody vine on buildings or a weed in woods wrapped around trees

• Toxic chemical is calcium oxalate in fruit, sap

• Symptoms of local irritation expected on skin and in mouth

• Management is washing skin, ice cream, milk or any cool liquid

Virginia Creeper

Parthenocissus quinquefolia

BurdockArctium minus

• Commonly mistaken for rhubarb when young

• Leaves are “fuzzy” and stems inedible but not toxic

• Burs cause mechanical injury

• Management not required unless for stuck burs

• Very popular herbal preps from root, seeds

ElderberrySambucus spp.

• Flowers and fruits used to make wine, jelly

• Potential toxicity of fruit, leaves, bark, roots

• Symptoms potentially vomiting, diarrhea

• Native Americans used stems and roots as emetic and cathartic agents

• Management is supportive care

Oak acornsQuercus spp.

• Essential food for wild critters, not humans

• Contains bitter tannins• Symptoms not expected• Management usually not

needed• Foliage can be toxic to

animals

Bracken FernPteridium aquilinum

• Reputation as edible but numerous toxic compounds including cyanide, carcinogens

• Linked to stomach cancer in Japan

• Fiddleheads most likely to be consumed by humans, animals

• Acute toxic effects not generally expected

• Recipes say to cook 20 minutes (unknown if this eliminates toxins)

For More Information…• This presentation is on

the web at www.uwhealth.org/poison– Look under

educational programs• Common Plants book

also on my website or call 608-265-8160

• http://plants.usda.gov/index.html is an excellent reference and used for selected pictures in this presentation

Call the Wisconsin Poison Center for

questions andexposuresanytime!!