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Poisoning due to water hemlock.
Leo J Schep1, Robin J Slaughter, Gordon Becket
1Department of Preventive and Social Medicine, National Poisons Centre, University of Otago, Dunedin, New Zealand. leo.schep@otago.ac.nz
Water hemlock poisoning, caused by cicutoxin and oenanthotoxin, can lead to severe CNS effects and death. Prompt supportive care, including airway management and seizure control, improves prognosis.
Area of Science:
- Toxicology
- Pharmacology
- Botany
Background:
- Water hemlock (Cicuta and Oenanthe genera) is among North America's and the UK's most poisonous plants.
- Existing literature is primarily composed of case reports.
Purpose of the Study:
- To review water hemlock's taxonomy, botanical characteristics, toxins, pharmacology, and clinical management.
- To consolidate information on water hemlock poisoning.
Main Methods:
- Literature review summarizing existing case reports and scientific data.
- Analysis of toxicity mechanisms, clinical presentation, and treatment strategies.
Main Results:
- Principal toxins, cicutoxin and oenanthotoxin, are C17 conjugated polyacetylenes acting as GABA antagonists.
- Ingestion causes CNS stimulation, seizures, and potentially fatal complications like rhabdomyolysis and cardiac dysrhythmias.
- Hemodialysis has been used successfully for renal failure.
Conclusions:
- Water hemlock ingestion can cause severe, fatal complications.
- Prompt and aggressive supportive care significantly improves patient outcomes.
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