Symptoms
The possible symptoms and consequences of datura poisoning include:
- Dry mouth, dry skin and mucous membranes, thirst, difficulty speaking and swallowing.
- Dilation of the pupils
- Visual disturbances, sensitivity to light
- Urinary retention, constipation, nausea and vomiting.
- Feeling of heat, increased temperature, flush
- Rapid pulse, palpitations, low blood pressure.
- Movement disorders, rapid breathing rate
- Hallucinations that can not be distinguished from reality.
- Delirium, agitation, psychosis, aggressiveness, belligerence, convulsions.
- Coma, rhabdomyolysis, fulminant hepatitis, cardiac arrest, respiratory arrest, death.
Symptoms are also summarized with the following mnemonic phrase: “Blind as a bat, mad as a hatter, red as a beet, hot as a hare, dry as a bone, bowel and bladder lose their tone, and the heart runs alone”. The symptoms begin about 5-60 minutes after ingestion and can last up to two days due to slowed intestinal movements and delayed release. Intoxication is complicated by concurrent abuse of other intoxicants such as alcohol.
Causes
The cause of poisoning is accidental and, more commonly, intentional ingestion of datura leaves, herb, or seeds. Datura L. of the nightshade family is a popular intoxicant and hallucinogen, especially among young people, and is experimented with worldwide. The plant parts are taken directly or prepared as tea or smokes. The drug is easy and legal to obtain, as the plant is kept in gardens as an ornamental plant and the seeds can be ordered from online stores on the Internet. The intoxication is due to the tropane alkaloids it contains, such as atropine, hyoscyamine and scopolamine, which have anticholinergic properties. They cancel the effects of the parasympathetic nervous system, a part of the autonomic nervous system, and thus trigger intoxication depending on the dose. In any case, the use of datura as an intoxicant is strongly discouraged due to its high toxicity and poor controllability.
Treatment
Upon recognition of datura poisoning, immediate intensive medical care in a hospital is required because of the danger to life. Possible measures include gastric lavage, administration of activated charcoal, benzodiazepines, neuroleptics, and intravenous fluids. According to the literature, the antidote physostigmine, a cholinesterase inhibitor, should only be used as a 2nd-line agent. Sedatives with anticholinergic components of action, such as the phenothiazines or tricyclic antidepressants, are not recommended.
