1 / 44

MUSHROOMS

MUSHROOMS. 5000 SPECIES (2%). Cyclopeptide Toxin. Amanita phalloides (death cap) A. verna A.virosa Galerina marginata. 1-Amatoxins Α - amanitin β - amanitin 2-Phallotoxin Phalloidin. Amatoxin : high oral absorb , entrohepatic circulation, renal reabsorption Phallotoxin :

elvin
Download Presentation

MUSHROOMS

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. MUSHROOMS 5000 SPECIES (2%)

  2. Cyclopeptide Toxin • Amanita phalloides (death cap) • A. verna • A.virosa • Galerinamarginata

  3. 1-Amatoxins • Α-amanitin • β-amanitin • 2-Phallotoxin • Phalloidin

  4. Amatoxin: high oral absorb, entrohepatic circulation, renal reabsorption Phallotoxin: very low oral absorption (no oral toxicity) Both: heat stable

  5. Amatoxin • Inhibit RNA polymerase ║ • Interfere DNA Transcription Protein Synthesis Necrosis

  6. Amatoxin target • Liver • KIDNEY • PANCREAS • INTESTINE

  7. phallotoxin • Bind to actin • Disrupt cell membrane liver • protein synthesis

  8. Clinical • 1-- GI effect (6-24h) • Abdominal pain • nausea • vomiting • Diarrhea • Fever • Hypoglycemia • elecrolyte imbalance

  9. CLINICAL • 2- Temporary clinical remission (24-72h) • Toxin induce cell injury (misdiagnose)

  10. CLINICAL • 3--Hepatorenal phase (3-6 days) • Hepatic-renal failure • Pancreatitis • Coagulophaty • Seizure • Coma

  11. Treatment • Lavage • Charcoal • Diuresis • Electrolyte balance • Vit K • FFP • Glucose

  12. Penicillin G • 300,000-One million IU/Kg (seizure) • Displace toxin from protein binding renal excretion

  13. Silymarin • 140 mg TID • Inhibit toxin uptake by cells • NAC– thioctic acid– hyperbaric(oxygen) regenerate • Hemodialysis- hemopefusionlate

  14. Gyromitrin toxin (heat labile) • GyromitraesculentagyromitrinGI methyl formyl hydrazine GI Methyl Hydrazine

  15. metabolites toxicity • Inhibit Pyridoxal Phosphate GABA seizure • liver Nitrosamide Liver Toxicity • Inhibit histaminase His GI effect • Inhibit DihydrofolateReductaseAnemia • Induce oxidative Stress Hemolysis , Methemoglobinemia

  16. Clinical (after 6h) • GI: nausea-vomit-abdo pain-diarrhea • CNS: dizziness-headache-seizure-coma • Liver: ALT and AST-coagulopathy-jaundice • Blood: hemolysis-metHb-anemia- • others: hypotension-rhabdomyolysis

  17. treatment • metHb > 30% ---- methylene blue + o2 supp • Folinic acid : 5-15 mg/day for 7 day • Pyridoxine: up to 25 mg/kg +diazepam seizure • Vit K – fluid (ringer-lactat) alkaline urine prevent myoglobin deposition

  18. MUSCARINE • Heat stable • Low oral absorbtion • Clitocybe • Inocybe • No effect on nicotinic receptor • No CNS effect

  19. CLINICAL (0.5 – 1h) • Cholinergic: • salivation • lacrimation • Diarrhea • Bradycardia • Hypotension • perspiration

  20. Treatment • Lavage • Charcoal • Ipratropium (inhalation) • Atropine • Glycopyrolate (0.5 to 1 mg ) IV No CNS effect

  21. AMANITA MUSCARIA AND AMANITA PANTHERINA

  22. ISOXAZOLE COMPOUND • Ibotenic acid NMDA activation excitation • muscimol GABA agonist depression • serotonin , dopamine

  23. CLINICAL (0.5 TO 2 h) • Ephoria depression • Agitation somnolence • Amnestic to event during intoxication • GI effect – tremor –ataxia – hallucination-salivation-perspiration-bradycardia • no effect on muscarinic receptors

  24. Treatment • Charcoal • Quiet, dark room • Diazepam in agitation • No role for atropine • Poison exctract by water (discard water)

  25. INDOLE ALKALOID Psilocybin (heat stable) psilocin body

  26. Psilocybe • Gymnopilus • panaeolus

  27. Stimulate (5HT 2 A) receptor LSD like effect

  28. Clinical ( 0.5-2 h) • Mydriasis • Blurred vision • Hypotension • Tachycardia • Euphoria • Agitation • Hallucination • Hyperthermia • seizure

  29. treatment • Charcoal • Quiet and dark room • Diazepam • Antipsychotic worsen hyperthermia Or induce seizure)

  30. GI IRRITANT CHLOROPHYLLUM MOLYBDITES OMPHALOTUS OLEARIUS

  31. Toxin not isolated • Cooking decrease toxicity

  32. Clinical ( 0.5-2 h) • Nausea • Vomiting • Abdominal pain • Bloody diarrhea • Bradycardia • Diaphoresis • Chills • dizziness

  33. GI effect + muscarinic like effect without salivation and lacrimation

  34. treatment • Fluid • Electrolyte • Ondansetron • Charcoal (low effect)

  35. NEPHROTOXIC MUSHROOM • AMANITA SMITHIANA

  36. TOXIN • Cortinarius: • Orellanine (heat stable) Disruption of actin and inhibit protein synthesis • Cortinarin A , cortinarin B • A.smithiana: • Aminohexadienoic acid

  37. Clinical effect • 36h post ingestion! Nausea – vomiting – headache – polydipsia • 7-10 day : renal failure (tubulin necrosis) oliguria - anuria

  38. Treatment • Hemodialysis for a long time is a supportive care ( 50-70 % improve after several weeks)

  39. MUSHROOM WITH DISULFIRAM EFFECT • COPRINUS ATRAMENTARIOUS • COPRINE (HEAT STABLE) AMINOCYCLOPROPANOL BODY

  40. INHIBIT ALDEHYDE DEHYDROGENASE If ethanol ingestion within 48 h after mushroom Flushing-vomiting-tachycardia-arrhythmia

  41. Treatment • Hemodialysis ethanol acetaldehyde • Fomepizole: inhibit alcohol dehydrogenase

  42. MUSHROOM INDUCE RHABDOMYOLYSIS RUSSULA SUBNIGRICANS TRICHOLOMA EQUESTER

  43. CLINICAL • GI effect + myalgia (myoglobinuria) • Treatment: • Fluid, alkaline urine

More Related