CLOSE ENCOUNTERS OF THE BOTANICAL KIND

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CLOSE ENCOUNTERS OF THE BOTANICAL KIND

• Donna Lotzer, RPh
• Certified Specialist in Poison Information
• UW Hospital Poison Prevention
• Education Center

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MonkshoodAconitum napellus

• Whole plant toxic, esp. roots and leaves
• Leaves like parsley, roots mistaken for
  horseradish/celery
• Ingestion causes local tingling, burning,
  numbness, thirst
• N, V, D, visual changes follow
• Circulatory failure, cardiac arrhythmias lead to
  fatalities
• Fatal cases resulted 1½ to 8 hours post
  ingestion, most with cardiac cause of death
• Management in ICU if get there

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Monkshood

• Alternate names include friars cap, old wifes
  hood, helmet flower (easy to see why!)

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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
• Protect blisters, keep clean
• Oral antihistamines/steroids
• Launder clothing separately

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Poison Ivy
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Poison SumacToxicodendron vernix

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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 N, V, D,
  severe abdominal pain, dilated pupils, violent
  muscle spasms, seizures, respiratory paralysis
• Person may not survive till medical care can be
  provided
• Folk antidote of salmon oil skimmed off
  salmonhead soup!!

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Water Hemlock
Folk names of beaver poison, death-of-man,
childrens bane (HINT!)
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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) like nicotine, and
  include irritation, salivation, tremors, dilated
  pupils, muscle spasm, seizures, paralysis
• Death due to respiratory failure
• Management is seizure and respiratory support,
  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

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Poison Hemlock
Also known as kill cow, poison parsley, spotted
hemlock
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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

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Wild Parsnip
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Queen Annes LaceDaucus carota

• Commonly referred to as wild carrot
• Compare look to hemlock!!
• Toxic because of dermal 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

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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 !!!!
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FoxgloveDigitalis purpurea

• Active principle is digitalis, used since 1700s
  in medical practice
• Mistaken ID leads to ingestion and some
  poisonings
• Symptoms include N, V, D, visual changes, slow
  irregular pulse, tremors, seizures
• Management includes medical observation for 12
  hours, with ICU if sxs develop, with pacer,
  atropine, ?Fab fragments?

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Foxglove
Common names include fairy bells, witches
thimble, rabbit flower, lions mouth
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Lily of the ValleyConvallaria majalis

• Plant contains convallarin, convallotoxin,
  convallamarin (digitalis-like compounds)
• Multiple options for ingestion by kids/adults
• Symptoms like foxglove
• Management like foxglove

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Lily of the Valley
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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, N,
  V, D, sweats, seizures and death
• Management in ICU for renal, resp. and
  circulatory failure from ingestion or injection

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Castor Bean Plant
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JimsonweedDatura stramonium

• Good-looking, ill-smelling weed
• Poisoning from honey, making tea, eating seeds or
  leaves
• Abusable by ingestion, smoking
• Good symptomhallucinations
• Bad symptomsflushed 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, physostigmine for severe cases

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Jimsonweed
Also called mad apple, Devils trumpet, stink weed

• (Close relative is
• Angels trumpet)

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LupineLupinus spp.

• Member of the legume family
• Forms seed pods like peas
• Contains multiple toxins under variable
  conditions
• Seed pods and leaves/stems most toxic in spring
• Symptoms include N, V, abdominal pain, slowed
  breathing, death (rare)
• Management is S S care

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TobaccoNicotiana tabacum

• Garden ornamental, grown for smoking tobacco in
  WI
• Whole plant is toxic, usually ingestion or dermal
  exposures cause problems
• Harvest time leads to occupational exposures
• Symptoms include salivation, N, V, D, pulse and
  BP changes, seizures, respiratory failure
• Management is topical decontamination, S S care
  (ICU ?), possibly atropine in severe cases

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Indian TobaccoLobelia inflata

• Common names include pukeweed, gagroot,
  vomitroot, asthma weed
• Has respiratory stimulant, antispasmodic and
  relaxant properties
• Native Americans smoked or chewed for lung
  diseases (asthma, bronchitis)
• Toxicity includes N,V, seizures, respiratory
  failure from muscular paralysis (like curare!)
  and death
• Management is S S in ICU
• May find in stop-smoking products to help with
  nicotine withdrawal sxs

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Indian Tobacco Cardinal Flower
Found along WI river banks
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Yew Taxus spp.

• Several varieties, all toxic
• Foliage will kill cows, horses
• Seeds commonly ingested by children
• Symptoms include N, V, D, dizziness, dilated
  pupils, slow pulse, seizures, coma and rarely
  death
• Management ranges from observation to support in
  an ICU setting (rare)

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

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Milkweed
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Skunk CabbageSymplocarpus foetidus

• Called polecat weed because of odor
• Toxic chemical is calcium oxalate
• Symptoms are oral pain and swelling if ingested
• Management is S S care (ice cream works well)
• Claims for edibility, but

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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
• Mistaken for pomegranate!

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

• Common woodland plant
• Ripe fruit possibly edible but stay away from the
  rest !
• Symptoms of ingestion are GI (explosive diarrhea)
• Systemic liver and kidney damage possible,
  mutagen
• Management is antiemetics and supportive care

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NightshadeSolanum spp.
Climbing Nightshade

• NOT DEADLY plant
• Vine, relative of tomatoes
• Attractive but inedible weed
• Several common variations, bad reputation
  exaggerated
• Symptoms potentially could include N, V, D,
  weakness
• Management is generally not needed, but would be
  S S care

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Nightshade
Black Nightshade
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BaneberryActea rubra

• Toxic woodland plant with unidentified chemicals
• Symptoms include mouth burning and swelling,
  headache, abdominal pain, salivation
• Management is S S care
• Used historically in Native American medicine

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Baneberry Commonly known as dolls eyes or
snakeberry
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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 include N, V, D, dizziness, fainting,
  dilated pupils (in theory)
• Management is S S care

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Stinging NettleUrtica dioica

• Weed found in open areas
• Some sources say edible, BUT
• Toxicity painful burning dermatitis upon contact
• Management is S S with hot water to wash skin,
  steroid cream and oral antihistamines

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Virginia CreeperParthenocissus quinquefolia

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

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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

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ElderberrySambucus spp.

• Flowers and fruits used to make wine, jelly
• Potential toxicity of fruit, leaves, bark, roots
• Symptoms potentially N, V, D
• Native Americans used stems and roots as emetic
  and cathartic agents
• Management is S S care

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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

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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)