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U.S. Department of Health and Human Services

FDA Poisonous Plant Database

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AUTHOR(S): Barajas, M.; Guharoy, S.
TITLE: Atropine intoxication secondary to the ingestion of jimson weed (Datura stramonium).
YEAR: 1990 CITATION: ASHP Annu Meeting, 47(), P-44D [English]
ABSTRACT: Anticholinergic effects due to jimson weed (Datura stramonium) intoxication have been reported in the literature. We report four cases of jimson weed poisoning that were successfully managed. Four cases of atropine/atropine alkaloid toxicity in adolescents due to the ingestion and inhalation (smoking) of jimson weed with their subsequent management are discussed. Three of the youths* aged 14 to 15 years* became toxic by boiling various portions of the plant and placing the extract on cigarettes which were then smoked. The fourth youth* age 16 years* ingested several jimson weed seeds derived from plants found in a rural desert area. Jimson weed* also known as stinkweed* locoweed* green dragon* devil's apple and datura among others* is a common annual weed that grows up to 6 feet high and emits a foul-smelling odor. It is found throughout the United States as well as in many parts of the world. Its toxic* mind-altering properties have been known since ancient times with examples referenced in writings by Homer and Shakespeare. The most common intoxication now involves teenagers desiring the mind-altering properties of the plant.The typical patient is 17 years of age and ingests seeds* drinks the tea or smokes various portions of the plant* all of which contain atropine alkaloids. The toxins in Datura species are tropane belladonna alkaloids (atropine* scopolamine)* which possess strong anticholinergic properties. The alkaloids are easily absorbed from the mucous membranes* respiratory tract and gastrointestinal tract. The alkaloids are metabolized in the liver and excreted unchanged in the urine. Three youths obtained a jimson weed plant from a local rural area and extracted resin by boiling. The resin was then placed on cigarettes and smoked. Upon inhalation of the burning resins the youths became lethargic* confused* disoriented and reported hallucinations. At this time* they were found roaming the streets by the local police and were brought to the hospital. Upon admission the patients were found to have atropine-like toxicity consisting of tachycardia* mydriasis* blurred vision and warm* dry skin. Additionally* the patients were combative and unable to answer questions. The patients were treated with 0.4 mg physostigmine I.V. push along with intravenous fluids. Twenty four hours post admission the patients were found to be markedly improved* and they were discharged from the hospital. The fourth youth ingested several jimson weed seeds after which he became agitated* experienced respiratory distress and was seeing things. Upon admission to the hospital* the patient was found to have similar atropine-like toxicities as listed in the previous cases. Treatment consisted of 30 ml of ipecac*which did not return any particulate matter (ingestion occurred 12 hours prior to admission)* intravenous fluids and 5 mg I.V. diazepam for agitation. Twenty four hours post admission the patient was discharged due to satisfactory improvement. The classical presentation of jimson weed toxicity is the anticholinergic poisoning syndrome i.e.* blind as a bat* hot as a hare* dry as a bone* red as a beet and mad as a wet hen. Symptoms begin within hours after ingestion or within minutes within smoking or drinking tea. Symptoms usually subside within 1 to 2 days; however* mydriasis may continue for as long as 7 days. Fatalities from the actual atropine-like toxicity are rare. Clinicians should be aware in these times of increasing illicit drug abuse that substances (botanicals) such as jimson weed are legal* available and have the potential for abuse.