Kolisini (Autumn Crocus) ni kungo kɔnɔ alikama balo ɲinini bagaji ani ji Hemlock (Cicutoxin) ni Poyi Hemlock (Coniine) Triage¶

Ka fili kungo kɔnɔ jiri fagalen dɔ ma ka kɛ foroba nakɔfɛn ye min bɛ se ka dun walima ka kɛ jirisunba ye, o ye furakɛli kɔrɔtɔlen dɔ ye min bɛ taa teliya la kɛnɛma ɲɛnajɛw ni so tobili la. Ni mɔgɔ o mɔgɔ ye kɔnɔboli, da jeni, ɲɛnamini, dusukun tantanni dɔɔni, farikolo fanga dɔgɔya, walima kirinni kungo kɔnɔ alikama balolen dunni kɔfɛ (ramps), kungo karɔti, walima kungo kɔnɔ parsnips, aw bɛ aw ka sigida kɔrɔtɔko nimɔrɔ wele (911 Ameriki ani Kanada, 112 Erɔpu tɔnba bɛɛ kɔnɔ, 999 Angletɛri) walima aw ye an ka diɲɛ kɔnɔ kɔrɔtɔko nimɔrɔw ɲɛbilasɛbɛn o yɔrɔnin bɛɛ. K’aw to kɛnɛyabaarakɛlaw makɔnɔni na, aw ka segin an ka gafew kan minnu ka bon kosɛbɛ kungo ɲɛgɛnw ni jiri bagalenw dunni protocole, aw ka aw labɛn status epilepticus kirinni kuntaalajanw ni Ji Hemlock tun dunna, ani ka labɛn ka daminɛ dusukun ni fogonfogon lakununni (CPR) . ni Poison Hemlock walima Autumn Crocus bɛ ninakili walima dusukun tantanni bila mɔgɔ la.

Erɔpu, Ameriki Woroduguyanfan ani Azi jamana funtenimanw bɛɛ la, jaan fila minnu tɔgɔ bɔra kosɛbɛ, minnu bɛ i n’a fɔ jiriw, olu de bɛ kungo kɔnɔ jiriw baga fagalenw fanba la: 1. The Broad-Leaf "Wild Garlic" Trap: Balo ɲinibagaw bɛ dumunifɛnw lajɛ Kungo kɔnɔ alikama / Ramsons (Allium ursinum) walima Ameriki Woroduguyanfan Ramps (Allium tricoccum) kaban kungo nɔgɔlenw na, u bɛ Autumn Crocus / Meadow Saffron (Colchicum autumnale) walima Hɛlɛbore nkalonma (Veratrum album / . Veratrum viride), minnu bɛ falen kɛrɛfɛ dugukolo kelen tigitigi la. K’a sɔrɔ Veratrum bɛ fɔɔnɔ teliya, dusukun tantanni jugumanba, ani tansiyɔn jiginni bila mɔgɔ kɔnɔ 30 to 120 minutes min bɛ jaabiba di atropine ma, Colchicum autumnale kɔnɔ, mitotic spindle poison colchicine bɛ sɔrɔ, o min bɛ kɔnɔboli jugumanba ladege a kama 24 hours sani a ka farikolo yɔrɔ caman dɛsɛ min bɛ mɔgɔ faga, dusukun tantanni, ani kolotugudaw sɔgɔsɔgɔli labɔ, fura tɛ min na min bɛ jɛnsɛn jagokɛyɔrɔw la. 2. Umbellifer "Wild Carrot / Parsnip" Jaan: Balo ɲinibagaw bɛ karɔti/peresi denbaya kɔnɔmɔgɔw tigɛ (Apiaceae) fili Ji Hemlock ( .Cicuta maculata, . Cicuta virosa, walima Oenanthe crocata) walima Poyi Hemlock (Conium maculatum) kungo karɔti (Queen Anne ka dancɛ), kungo kɔnɔ parsnip, angelica, walima kungo seleri kama. Hali ni u fila bɛɛ tɔgɔ bɛ "hemlock" la, u ka bagaw ye kɛnɛyaso kɔkanna ye: Ji Hemlock bɛ sɔrɔ cicutoxin (walima oenanthotoxin) la, o ye GABA-A cɛmancɛ kɛlɛbaga fariman ye min bɛ status epilepticus refractory lawuli miniti 15 fo 60 kɔnɔ, k’a sɔrɔ Poison Hemlock bɛ nicotinic alkaloid sɔrɔ coniine, o bɛ kɛ sababu ye ka ninakilidegun min bɛ i n’a fɔ kurare jiginni ka sɔrɔ a tigi bɛ to a kunun pewu fo oksizɛni dɔgɔyali ka don.

+-------------------------------------------------------------------------+
|        CRITICAL WILD FORAGING POISONING IDENTIFICATION MATRIX           |
+-------------------------------------------------------------------------+
|  GROUP A: SPRING BROAD-LEAF LOOKALIKES (MISTAKEN FOR WILD GARLIC/RAMPS) |
|  1. AUTUMN CROCUS (Colchicum autumnale) -> Toxin: COLCHICINE            |
|     * Onset: Delayed 2 to 24 hours (cholera-like vomiting & diarrhea)   |
|     * Day 2-7: Cardiogenic shock, ARDS, DIC, Bone Marrow Aplasia        |
|     * Treatment: Early Multi-Dose Activated Charcoal + ICU + G-CSF      |
|  2. FALSE HELLEBORE (Veratrum album / viride) -> Toxin: VERATRUM ALK.   |
|     * Onset: Rapid 30 minutes to 3 hours (violent vomiting & paresthesia|
|     * Hallmark: Bezold-Jarisch Triad (Severe Bradycardia + Hypotension) |
|     * Treatment: IV Atropine (0.5-1.0 mg) + IV Fluids + Charcoal        |
+-------------------------------------------------------------------------+
|  GROUP B: APIACEAE CARROT-FAMILY LOOKALIKES (HOLLOW STEMS, WHITE UMBLES)|
|  3. WATER HEMLOCK (Cicuta maculata / virosa) -> Toxin: CICUTOXIN        |
|     * Onset: Ultra-rapid 15 to 60 minutes after chewing root or stem    |
|     * Hallmark: Explosive, continuous Tonic-Clonic Status Epilepticus   |
|     * Treatment: IV Benzodiazepines -> Phenobarbital / Propofol         |
|  4. POISON HEMLOCK (Conium maculatum) -> Toxin: CONIINE                 |
|     * Onset: 30 minutes to 2 hours (burning mouth, salivation, tremors) |
|     * Hallmark: Ascending Flaccid Respiratory Paralysis (Clear Mind)    |
|     * Treatment: Mechanical Ventilation for 24-72 hours (100% recovery) |
+-------------------------------------------------------------------------+

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Aw bɛ o kɛ sisan¶

1. Aw bɛ kɔrɔtɔko baarakɛlaw ni Poyi kunbɛnni wele joona. Aw bɛ telefɔni 911 (Amerika ni Kanada), 112 (Erɔpu jamana), 999 (Royaume-Uni), 000 (Ɔsitarali), walima 111 (Nouvelle-Zélande) wele. Aw kana a jira ko bana taamasiɲɛw ka daminɛ ni mɔgɔ dɔ y’a ye ko a ye Autumn Crocus, Water Hemlock, Poison Hemlock, walima False Hellebore munumunu dɔrɔn: colchicine bɛ ni nanbarafɛn ye 2 to 12 hour silent phase min kɔnɔ dɔgɔtɔrɔso kɔnɔbara nɔgɔlen bɔli daminɛ na, o dɔrɔn de ye sababu ye ka selilɛriw tali bali ka mɔgɔ faga.
2. Aw bɛ jiri min ma tiɲɛ, aw bɛ o lajɛ ani ka a foto ta, ka fara a bulɔgu/juru, a jiribolo da, ani a buluw kan. Aw bɛ a buluw, a buluw, a buluw, walima a buluw (ka fara suman, pesto, walima salati tolenw kan) ta papiye foroko walima minɛn kɔnɔ ka na n’a ye ni banabagatɔ ye kɛnɛyaso la. Kɔrɔtɔko baga dɔnbagaw ni baga furakɛli yɔrɔ minnu bɛ weleli la, olu bɛ baara kɛ ni jirisunw yɔrɔw ye, jirisunw sɔgɔsɔgɔninjɛw, furabuluw bɔyɔrɔw, ani alikama kasa walasa ka baga tigitigi dɔn miniti damadɔ kɔnɔ.
3. Aw kana fɔɔnɔ bila so kɔnɔ abada. Aw kana siro ipecac, kɔgɔji, walima bolokɔni daji di a ma. Ni jiri in tun ye Ji Hemlock (Cicuta), farigan generalized seizures bɛ se ka kɛ kɔnɔna na 15 minutes ka a minɛ, o bɛ kɛ sababu ye ka fogonfogon lafiɲɛ faga ni a tigi bɛ fɔɔnɔ.
4. Aw bɛ banabagatɔ bila a da la a kɛrɛ fɛ ani ka aw labɛn kirinni walima ninakilidegun kama.
5. Ni a tigi ye jirisun/tubered chambered dun kɔji walima kɔji da la (Water Hemlock), aw bɛ fɛn nɔgɔlenw labɔ ka u kunkolo sɔgɔ walasa ka tonic-clonic convulsions barikamaw labɛn.
6. Ni a tigi ye jiribolo dɔ dun min kɔnɔna ye bulama ye walima a buluw bɛ i n’a fɔ fern (Poison Hemlock), aw bɛ a disi wulicogo kɔlɔsi kosɛbɛ: ni a senw bɛ girinya ani ni a ninakili bɛ dɔgɔya walima ni a ninakili bɛ jɔ, aw bɛ a daminɛ ninakili kisi / bag-valve-mask ventilation (walima CPR dafalen ni a tɛ ni tansiyɔn ye) o yɔrɔnin bɛɛ.
7. Ni a tigi ɲɛnamini bɛ kɛ ni dusukun tantanni ye dɔɔni dɔɔni a duguma 45 beats per minute aw kɛlen kɔ ka bulu jɛmanw dun (False Hellebore), aw bɛ u da kɛnɛ kan ka u senw kɔrɔta 30 centimeters (12 inches) walasa ka joli seginni dɛmɛ dusukun na fo dɔgɔtɔrɔw ka atropine pikiri kɛ joli la.
8. Aw ye mɔgɔ tɔw bɛɛ lasɔmi minnu ye dumuni kɛ ɲɔgɔn fɛ joona. Kungo kɔnɔ alikama pesto, ramp soup, ani foraged salads bɛ to ka tila denbaya kɔnɔmɔgɔw, sufɛdumuni dunanw walima kanpaɲi mɔgɔw cɛ. Mɔgɔ o mɔgɔ ye hali tobilikɛminɛn bulu kelen walima kuyɛri kelen dun (kɔlisisini ni veratrum alkaloïdes bɛ funteni sabati pewu ani u bɛ wuli ka kɛ sumanji ye) o tigi ka kan ka taa dɔgɔtɔrɔso la joona hali ni a bɛ kɛnɛya.

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Desizɔn jiri : Fɛnɲɛnɛmaw dɔnni ani kɛnɛyaso toxicdrome triage¶

flowchart TD
    A["Bana jugumanba walima dumuni dunni kungo kɔnɔ jiriw balo ɲinini kɔfɛ"] --> B{"Fɛnɲɛnɛma sugu jumɛn de Sunna?"}
    B -->|"Furu jɛman nɔgɔlenw (A fililen don kungo kɔnɔ alikama / Ramps) ."| C{"Aw bɛ taamasiɲɛw daminɛcogo & dusukun tantanni lajɛ"}
    B -->|"Furaw minnu bɛ i n’a fɔ Fern walima Parasol finman Fulaw / Juw (A filila ka kɛ kungo karɔti / Parsnip ye) ."| D{"Aw ye Dominant Neurological Sign lajɛ"}
    C -->|"A daminɛ teliya la (miniti 30-120) + Dusukunnabana jugumanba (HR < 45) + Tansiyɔn jiginni"| E["HELLEBORE KA NKALO (Albamu Veratrum / viride) - Bezold-Jarisch Reflex"]
    C -->|"A daminɛ kɔfɛ (lɛrɛ 2-24) + Kɔnɔboli cayalenba min bɛ i n’a fɔ kolera + Kɔnɔboli"| F["OUTUMN CROCUS (Colchicum autumnale) - Kolikisini baga mitotiki"]
    E --> G["Aw bɛ Charbon Activé (< 1-2h) di; IV 0,9% Saline + IV Atropine (0,5-1,0 mg q3-5m) -> Dopamine/Fhenylephrine ni a mago bɛ a la"]
    F --> H["Charbon activé multi-dose aggressif (MDAC q4-6h) + ICU hakɛ lakununni joona + G-CSF ka ɲɛsin Pancytopenia ma"]
    D -->|"Violent Generalized Status Epilepticus min bɛ kɛ miniti 15-60 kɔnɔ"| I["JI HEMLOCK (Cicuta maculata / virosa / Oenanthe crocata) - Sikutosini"]
    D -->|"Ascending Flaccid Muscle & Respiratory Paralysis ni hakili jɛlen ye"| J["POISON HEMLOCK (Conium maculatum) - Komini nikotini balili"]
    I --> K["Fiɲɛbɔyɔrɔ lakanani; Benzodiazepines IV hakɛ caman -> Fenobarbital walima Propofol + Active Cooling + Bicarbonate for Rhabdomyolyse"]
    J --> L["Endotracheal Intubation teliya la & Mechanical Ventilation fo Lɛrɛ 24-72 (Aw kana Succinylcholine kɛ) + Charbon activé"]

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Balo ɲinini bana 4 minnu bɛ mɔgɔ faga, olu sangali jiriw ni kɛnɛyaso la¶

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Yɔrɔ fɔlɔ: Kungo kɔnɔ alikama cogoya: Otomɛ Crocus (Colchicine) ni Hɛlɛbore nkalonma (Veratrum) .¶

Kaban o samiyɛ Erɔpu, Angletɛri ani Ameriki Woroduguyanfan bɛɛ la, mɔgɔ ba caman bɛ balo ɲini kungo nɔgɔlenw kɔnɔ minnu falen bɛ Kungosogo la (Allium ursinum) walima Ramps (Allium tricoccum) ka kungo kɔnɔ alikama pesto, suman, walima jiribulu tobilen dilan. Sabula kungo kɔnɔ alikama bɛ falen tapi densew kɔnɔ Autumn Crocus (Colchicum autumnale) ani Hɛlɛbore nkalontigɛlen (Veratrum album Erɔpu jamanaw na; Veratrum viride Ameriki Woroduguyanfan na), furabulu minɛlen bolo kelen kɔnɔ, a ka c’a la, suguya saba bɛɛ bɛ sɔrɔ. Ka fara o kan, ni baloɲinikɛla bolokɔnincininw datugulen don kungo kɔnɔ alikamamugu mugulen na, u bolow kasa bɛ bɔ i n'a fɔ alikama, o bɛ "sniff test" lafili n'u bɛ furabulu nataw sɛgɛsɛgɛ.

Sindrome 1A: Kɔrɔsili (Colchicum autumnale) ani Glory Lily (Gloriosa superba): Kolisini (Colchicine Poison) (banakisɛfagalan).¶

Colchicum autumnale (buluw, corm/bulb, kisɛw, ani sɛnɛfɛnw) ani yɔrɔ minnu ka timi Gloriosa superba jirisunw yɔrɔ bɛɛ la, u hakɛ ka ca (0.1% to 0.6%) ka alkaloyi kolisisini. A minɛni ka tɛmɛ 0.5 mg/kg ka kolikisini (roughly 2 to 5 fresh leaves of Autumn Crocus baliku dɔ kama, walima 1 leaf den ta la) ka teli ka mɔgɔ faga, wa a tata hakɛ bɛ tɛmɛ 0.8 mg/kg sababu bɛ se ka kɛ 100% saya sɔrɔli dusukun tantanni fɛ ani farikolo yɔrɔ caman dɛsɛ fɛ.

Banakisɛfagalanw ni Kɔlisini baga furakɛli taabolo 3¶

Kolisini bɛ siri farikolo kɔnɔ alfa- ni beta-tubulin dimɛriw la cogo la min tɛ se ka segin kɔ, o bɛ u bali ka polimɛri kɛ ka kɛ mikɔrɔtubules ye. Ni mikrotubulu baarakɛtaw tɛ, farikolokisɛw tɛ se ka mitotiki sɔgɔli kɛ walasa ka tila (ka selilu bɛɛ minɛ minnu bɛ tila teliya la metaphase kɔnɔ), ani farikolokisɛ minnu tɛ tila (i n’a fɔ dusukun mikorositɛriw ni farikolo laminiw) bɛ bɔnɛ selilu kɔnɔ fɛnɲɛnamafagalanw tali ni u ka sɔgɔsɔgɔli la.

+-------------------------------------------------------------------------+
|            THE 3 CLINICAL STAGES OF COLCHICINE POISONING                |
+-------------------------------------------------------------------------+
|  STAGE 1 (2 TO 24 HOURS POST-INGESTION): GASTROINTESTINAL / CHOLERAIC   |
|  * Mucosal crypt cells of the small intestine divide faster than any    |
|    other tissue; mitotic arrest causes massive mucosal sloughing        |
|  * Profuse, intractable vomiting, fiery abdominal pain, and liters of   |
|    watery/bloody cholera-like diarrhea -> Severe hypovolemic shock      |
|  * Marked initial leukocytosis (white blood cell count > 20,000/mm3)    |
+-------------------------------------------------------------------------+
|  STAGE 2 (DAYS 2 TO 7): MULTI-ORGAN FAILURE & BONE MARROW APLASIA       |
|  * Direct myocardial microtubule poisoning -> Refractory Cardiogenic    |
|    Shock, malignant arrhythmias, and sudden cardiac arrest (Days 2-4)   |
|  * ARDS (non-cardiogenic pulmonary edema), rhabdomyolysis, acute renal  |
|    failure, hepatic necrosis, DIC, and ascending metabolic neuropathy   |
|  * Bone marrow collapse (Days 4-8): Profound Pancytopenia / Agranulo-   |
|    cytosis (WBC < 500/mm3, Platelets < 10,000/mm3) -> Fulminant Sepsis  |
+-------------------------------------------------------------------------+
|  STAGE 3 (DAYS 7 TO 21+): MARROW RECOVERY & ANAGEN ALOPECIA             |
|  * If the patient survives Stage 2, rebound leukocytosis occurs along   |
|    with sudden, complete, reversible scalp hair loss (Alopecia)         |
+-------------------------------------------------------------------------+

Kɔlɔsili baga furakɛli dɔgɔtɔrɔso la senfɛ-senfɛ¶

1. Kɔnɔbaralabana teliya ani segin-ka-bɔnye (Even if Presenting Late): Ikomi kolisini bɛ sɔgɔsɔgɔninjɛ segin-segin caman kɛ (a bɛ bɔ bile la ka segin ka don banakɔtaa fitini na) ani ka kɔnɔbara lamagacogo sumaya, aw bɛ kɔnɔnatumu daminɛ joona/lavage kɛ (ni a bɛ a kɔnɔ 1 to 2 hours ka furabuluw dun) ani ka Multi-Dose Activated Charcoal (MDAC: 1 . 50 grams a daminɛ na, o tuma na 25 grams bɛɛ 4 to 6 hours sabu 24 to 48 hours). Jaba min bɛ baara kɛ, o bɛ kolisini siri kosɛbɛ kɔnɔbara la, wa o ye fɛɛrɛ kelen ye min bɛ se ka kɛ sababu ye ka farikolo fagali dɔgɔya.
2. Aggressive Hemodynamique et ICU Resuscitation: Aw bɛ kristali balannen hakɛ caman don a la Etape 1 kɔnɔ walasa ka u bila u nɔ na 5 to 10 liters ka GI ji bɔli min bɛ i n’a fɔ kolera. Aw bɛ echocardiographie kɛ dilan kɛrɛfɛ joona: ni Stage 1 hypovolémic shock bɛ wuli ka kɛ Stage 2 direct cardiogenic shock ye (typically at 24 to 72 hours), ka bɔ ji hakɛ caman na ka taa inotropew la (norepinephrine + dobutamine walima epinephrine) ani ka jateminɛ kɛ joona Veno-Arterial Extracorporeal Membrane Oxygenation (V-A ECMO) sani asistole refractaire ka kɛ.
3. Granulocyte Koloni-Stimulateur Facteur (G-CSF / . Filgrastim): Aw bɛ joli jate dafalen kɔlɔsi siɲɛ fila tile kɔnɔ. O waati la, joli kuru finman (WBC) jate bɛ daminɛ a jigin teliya la ( .typically Day 3 to 4), a daminɛ farikolo jukɔrɔ Filgrastim ( .G-CSF, . 5 micrograms/kg/day) ani ka banabagatɔ bila farikolojidɛsɛbanakisɛ lakanani yɔrɔ la ni banakisɛfagalanw ye minnu bɛ kɛ joli la ani joli segin furakisɛw tali walasa ka kisi kolotugudaw aplasia nadir ma.
4. Why Dialysis Fails & Fab Fragments: Sabula kolisini bɛ don farikolokisɛw la joona ani a jɛnsɛnni hakɛ ka bon kosɛbɛ (2 to 12 L/kg), joli-sira-funu ni joli-sira-funu aw kana kolisini bɔ (hali ni CRRT bɛ kɛ sugunɛbilenni jugumanba ni asidɔni na). Kɔrɔbɔli colchicine-specifique ovine Fab anticorps fragments bɛ baga kɔsegin kosɛbɛ kɛnɛyaso kalanw na, hali ni jagokɛlaw ka sɔrɔ dan ye kosɛbɛ diɲɛ kɔnɔ; aw bɛ Poyi Kɔlɔsilikɛla lajɛ joona walasa ka ɲininiw sɔrɔli lajɛ.

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Sindrome 1B: Hɛlɛbore nkalonma (Veratrum album, . Veratrum viride, . Veratrum californicum): Bezold-Jarisch ka dusukun tantanni bana¶

A tɛ i n’a fɔ Autumn Crocus ka fagali kɔfɛ, False Hellebore buluw dunni (walima ka so kɔnɔ gentian liqueur min min filila ka dila ni Veratrum album juw ye) o bɛ taamasiɲɛ kabakomaw lawuli ** kɔnɔ.30 minutes to 3 hours**.

• Fɛɛrɛ: Veratrum suguyaw la, stéroïde veratrum alkaloïdes (veratridine, . protoveratrine A and B, . germerine, ani jervine). Nin baga minnu bɛ sɔrɔ tulumafɛnw na, olu bɛ siri da wulilen na voltage-gated sodium (Na+) kanali minnu bɛ vagus nerve la, carotid sinus barorecepteurs, ani numanbolo ventriculaire mechanorecepteurs, o bɛ sodium kanali baarakɛbaliya bali. Dusukun dusukunnataw fiyɛriw cili segin-seginlen bɛ Bezold-Jarisch reflex baara: kunsɛmɛnasumaya b’a ye ko dusukun bɛ sɛgɛn kojugu farati la, wa a bɛ jaabi di ni parasympathetic vagal tone belebeleba bɔli ye ka sɔrɔ ka sympathetic vascular tone datugu.
• Dɔgɔtɔrɔso jiracogo: Kɔnɔna na 30 to 120 minutes, banabagatɔ bɛ kɔkolo jeni jugumanba sɔrɔ, fɔɔnɔ jugumanba bɛ kɛ a la, a bɛ sɔgɔsɔgɔ ani ka kirinni kɛ a da ni a bolokɔniw lamini na (paresthesia), ɲɛnayeli gɛlɛyaw (xanthopsia), sinus bradycardie profonde (heart rate 30 to 45 beats per minute), ɲɛgɛnɛsiralabanaw (AV) dusukun tantanni, ani tansiyɔn jiginni jugumanba (systolic BP < 60 to 70 mmHg).
• Furakɛcogo laɲinilen:
• Faraba min bɛ kɛ ni a tata hakɛ kelen ye (50 grams da la ni a kɔnɔ 1 to 2 hours ani fiɲɛbɔyɔrɔw tɛ farati ye) + kɔnɔboli furaw (ondansetron).
• Fɔli teliya la jolisira fɛ: Aw bɛ a di 1 to 2 liters ka 0.9% saline normale.
• Atropini min bɛ don joli la (The Specific Physiologic Antagonist): Aw bɛ Atropine (Atropine) di a ma 0.5 to 1.0 mg IV push bɛɛ 3 to 5 minutes (up to 3 mg total balikuw la; 0.02 mg/kg denmisɛnw na). Atropini bɛ muscarinic vagal receptors bali sinoatrial ni atrioventricular nodes kan, ka bradycardie ni dusukun balili kɔsegin o yɔrɔnin bɛɛ.
• Tansiyɔn jiginni basigilen: Ikomi Bezold-Jarisch reflex fana bɛ kɛ sababu ye ka dusukunnataw bɔli cɛmancɛ la (joli-sira-funu-kɛnɛya) ka fara dusukun tantanni kan, tansiyɔn bɛ se ka to ka dɔgɔya dɔɔni hali ni atropine ye dusukun tantanni kɛcogo ɲuman segin a cogo kɔrɔ la aw bɛ fenilefirini, dopamine, walima norepinefirini pikiri hakɛ dɔgɔman fara a kan 12 to 24 hours fo ka se a kɛnɛyali ma pewu (virtually 100% of Veratrum patients recover fully within 24 to 48 hours with supportive care).

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Yɔrɔ 2nan: Karɔti-denbaya (Apiaceae) A ɲɛda cogoya: Ji Hemlock (Cicutoxin) ni Poyi Hemlock ( ) ni ɲɔgɔn cɛ (Coniine) .¶

Fɛnɲɛnɛma-ko denbaya Apiaceae (Umbelliferae) dumunifɛn dumanw bɛ sɔrɔ a la (karɔti, pɔmutɛri, seleri, peresidan, fenɛn, dili, kɔri) ka fara jiri fila kan minnu bɛ mɔgɔ faga kosɛbɛ farikolojidɛsɛ la Woroduguyanfan fɛ: Ji Hemlock (Cicuta suguyaw ni Oenanthe crocata) ani Poyi Hemlock (Conium maculatum). U fila bɛɛ bɛ ni flen finmanw ye minnu bɛ i n’a fɔ parasol (compound umbels), jiribolo minnu bɛ ɲɔgɔn na ni dingɛ ye, ani furabuluw faralen ɲɔgɔn kan minnu tilalen don ka ɲɛ.

+-------------------------------------------------------------------------+
|     HOW TO TELL WATER HEMLOCK vs. POISON HEMLOCK AT THE BEDSIDE         |
+-------------------------------------------------------------------------+
|  WATER HEMLOCK (Cicuta maculata / Cicuta virosa / Oenanthe crocata):    |
|  * Habitat: Grows IN or right along stream banks, marshes, wet ditches  |
|  * Root Cut Open: Chambered bamboo-like compartments leaking yellow oil |
|  * Toxin: CICUTOXIN (Polyacetylenic alcohol -> GABA-A receptor blocker) |
|  * Clinical Effect: CENTRAL EXCITATORY -> Violent Status Epilepticus    |
|    within 15 to 60 minutes; patient is unconscious and convulsing       |
+-------------------------------------------------------------------------+
|  POISON HEMLOCK (Conium maculatum - The Plant That Killed Socrates):    |
|  * Habitat: Dry roadsides, waste ground, field edges, disturbed soil    |
|  * Stem & Odor: Smooth hairless stem with PURPLE BLOTCHES; mousey odor  |
|  * Toxin: CONIINE (Piperidine alkaloid -> Nicotinic AChR blocker)       |
|  * Clinical Effect: PERIPHERAL PARALYTIC -> Ascending curare-like       |
|    flaccid respiratory paralysis; patient is AWAKE until hypoxia hits   |
+-------------------------------------------------------------------------+

Sindrome 2A: Ji la Hemlock (Cicuta maculata, . Cicuta virosa) ani Hemlock Ji Dropwort (Oenanthe crocata): Sikutɔsini cogoya Epilepticus¶

Ji Hemlock bɛ jate kosɛbɛ ko a ye jiri ye min bɛ baga kosɛbɛ Ameriki Woroduguyanfan na ani Erɔpu woroduguyanfan fɛ. Tubabukan duman, parsnip kasa bɛ min na ani a jiribolo dugumalanw na, ji gɛlɛn, jɛman, tulu bɛ sɔrɔ a la, min falen bɛ sikutosini (walima oenanthotoxin la Oenanthe crocata la, min bɛ sɔrɔ Angletɛri ni Erɔpu Tlebi fan bɛɛ la), alifatiki min tɛ fa C17 alikɔli poliasetilɛni ye. Kisɛ kelen (2 to 3 centimeters) min bɛ Ji Hemlock ju la, walima hali denmisɛn min bɛ baara kɛ ni a jiribolo kɔnɔna ye i n’a fɔ sɛnɛfɛnw walima fiyɛlilan, o bɛ se ka a tata hakɛ faga.

• Fɛɛrɛ: Sikutɔsini bɛ joli-sɔgɔsɔgɔninjɛ barika tigɛ joona ani a bɛ siri pikɔrɔtɔkisini yɔrɔ la cogo la min tɛ ɲɔgɔndan ye cɛmancɛ-sɔgɔsɔgɔninjɛ GABA-A receptor-ionophore complexes kan, ka kuloridi kanal conductance bali pewu. Ni GABA balili tɛ, kɔri ni kunsɛmɛnasumaya senfagabana bɛ depolarize tuma bɛɛ.
• Dɔgɔtɔrɔso ka ɲɛfɔli (15 to 60 minutes): Kɔnɔna na 15 minutes ka a ju munumunu, a tigi bɛ kɔnɔboli sɔrɔ, ka daji caman bɔ, kɔnɔbara basigilen dimi, ɲɛnamini, ani ɲɛkisɛw bɛ bonya (mydriasis), o kɔfɛ yɔrɔnin kelen banakisɛfagalanw, minnu bɛ segin-ka-bɔ ɲɔgɔn na (status epilepticus). Kɔnɔnatumuw fanga ka bon fo banabagatɔw bɛ to ka kan tigɛli, opisthotonos, vertebral compression fractures, hyperthermie extreme (> 41 degrees Celsius), rabdomyolyse ( ) belebeleba (creatine kinase > 50,000 U/L), aniyoni-yɔrɔba jugumanba asidɔni laktiki (pH < 6.9), sugunɛbaralabana mikolobinuriki, ani dusukun tantanni min tɛ oksizɛni sɔrɔ.
• Dɔgɔtɔrɔso kɔrɔtɔlenw ɲɛnabɔli:
• Fiɲɛbɔyɔrɔ ni GABA-Agonist Seizure Control teliya la: Aw kana waati tiɲɛ ni fenitoyini ye (ineffective against GABA-A blockade). Aw bɛ bɛnzodiazepiniw hakɛ caman di jolisira fɛ (lorazepam 4 mg IV walima diazepam 10 mg IV), a bɛ wuli o yɔrɔnin bɛɛ ka se fenobarbital ( ) jolisira fɛ (15 to 20 mg/kg) walima pikiri teliya la ni poropofoli walima midazolam pikiri ye min bɛ to sen na.
• Nuromuscular Blockade and Active Cooling for Rhabdomyolysis: Ni farikolo gɛlɛya ni farigan caya bɛ to sen na hali ni GABA-agoniste lafiɲɛ jugumanba bɛ a la, aw bɛ neurmuscular blocker min tɛ depolarize (rocuronium walima vecuronium; aw bɛ aw yɛrɛ tanga sukisinilikolini ma ka a sababu kɛ kalisiyɔmu caya farati ye) EEG kɔlɔsili basigilen kɔnɔ walasa ka kolotugudaw funteni bɔli ni miyɔglobini bɔli dabila joona.
• Bicarbonate de sodium ni Sugunɛbilenni jugumanba: Aw bɛ kirisitaloyi isotropew don joli la ani bikarbonati sodiyɔmu joli la walasa ka farikolojidɛsɛ jugumanba latilen ani ka sugunɛ kɛ alkalini ye (target urine pH > 6.5), ka miyoglobine cast sanji bali sugunɛbaralabanaw la. Aw bɛ joli segin furakɛli kɛ joona ni kalisiyɔmu camanba, asidɔzi walima sugunɛbaralabana min tɛ se ka furakɛ.

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Sindrome 2B: Poyi Hemlock (Conium maculatum): Coniine ninakilidegun min bɛ wuli¶

Poyi Hemlock (Conium maculatum), min tɔgɔ bɔra klasiki tariku kɔnɔ iko fagali baga min ye filozofi Socrate ye san 399 BCE, piperidini alkaloyi 8 bɛ sɔrɔ a la minnu bɛ wuli, olu fanba ye konini ani gama-konisini ye. Ikomi a bulu minnu bɛ i n’a fɔ fern, olu ni peresidan bulu fla, chervil walima kungo karɔti buluw bɛ Taa ɲɔgɔn fɛ (wa a bulu finman bɛ i n’a fɔ parsnip), taamakɛlaw ni so nakɔbaarakɛlaw bɛ to k’a min fili la.

• Fɛɛrɛ (Biphasic Nicotinic Blockade): Coniine ka kemikaliya kɛcogo ni a furakɛcogo bɛ tali kɛ nicotine ni curare la kosɛbɛ. A bɛ baara kɛ cogo fila la minnu tɛ kelen ye otonomi ganglia ani kolo fasa neuromuscular junction (nicotinic acetylcholine receptors [nAChR]):
• Fase 1 (Nikotini lawulili fɔlɔ, 15 to 60 minutes): Da ni galaka jeninida, daji caman bɔli, kɔnɔboli, fɔɔnɔ, kɔnɔdimi, dusukun tantanni, tansiyɔn jiginni, ɲɛkisɛw ka bonya, ani farikolojidɛsɛ/yɛrɛyɛrɛli.
• Fase 2 (Blockade neuromusculaire dépolarisation/non-dépolarisation, 1 to 4 hours): Recepteur sirili basigilen bɛ nikotini asetilikolini minɛbagaw bali ka u bali motɛri labanyɔrɔ la, ka klasiki ascending curare-like flaccid paralysis lase.
• "Socrates Taamaʃyɛn" (Ascending Paralysis with Clear Consciousness): Paralizi bɛ daminɛ senw ni senw na (o bɛ kɛ sababu ye ka ataxia (ataxie) sennasumaya ni jɔlibaliya lase mɔgɔ ma), a bɛ wuli ka taa a fɛ ka tɛmɛ cɛya, kɔkolo ani bolokɔniw fɛ, ka laban ka farikolo cɛmancɛ farikolo ni diaphragm paralize, ka sɔrɔ a bɛ cɛmancɛ-sɔgɔsɔgɔninjɛ kisi. Fo ka se kunsɛmɛ na oksizɛni jugumanba ma ka bɔ ninakilidegun na, banabagatɔ bɛ to a ɲɛna pewu, a ɲɛ bɛ jɛya, ani a bɛ siran, a tɛ se ka lamaga walima ka ninakili. Konini bɛ se ka kɛ sababu ye fana ka rabdomyolyse directe ni tubular necrosis acute lase mɔgɔ ma.
• Dɔgɔtɔrɔso kɔrɔtɔlenw ɲɛnabɔli:
• Endotracheal Intubation daminɛ na ani fiɲɛ bilali masin na (The Definitive Cure): Furakɛlan kemikali tɛ konini na (ani antikolinɛsitɛriw i n’a fɔ neostigmine walima physostigmine man kan ka di, barisa u bɛ se ka nikotini balili depolarize juguya ani ka kolinɛriji gɛlɛya bila mɔgɔ la). O nɔ na, fiɲɛ bilali masin fɛ, o bɛ mɔgɔ kisi 100%. Aw bɛ tubabufura don banabagatɔ la joona ni ninakili fanga fanga dɔgɔyara walima ni ninakili fanga jugumanba fanga dɔgɔyara dɔrɔn (avoid succinylcholine), aw bɛ hakiliɲagamifura ɲuman di (propofol/ .midazolam o la, banabagatɔ min hakili bɛ farikolo la, o tɛ kunun fiɲɛbɔlan kan), ka ** charbon activé** di a ma nasogastric tube fɛ, ka fiɲɛbɔ kɛ fo 24 to 72 hours. Ni sugunɛ ni fogonfogonw ye koni fɛnɲɛnamafagalanw falen ka bɔ a la, farikolojidɛsɛ fanga bɛ segin pewu ni hakiliɲagami kɔlɔlɔ banbali tɛ a la.

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Sigidaw ka kɔrɔtɔko ni baga kɛlɛli sariyaw¶

• Amerika ani Kanada: Aw bɛ 911 wele joona ani ka 1-800-222-1222 (US Poison Help) walima 1-844-POISON-X (1-844-764-7669 Kanada jamana na). Ameriki Woroduguyanfan fɛ, Ji Hemlock (Cicuta maculata ani Cicuta douglasii), Poyi Hemlock (Conium maculatum), ani Hɛlɛbore nkalontigɛlen / Mangoro Lili (Veratrum viride ani Veratrum californicum) bɛ jɛnsɛn jisigiyɔrɔw la, kuluw kɔnɔ, ani sirada la; marabolow ka Poyi Santiriw bɛ ja nizɛri lajɛ rezow mara tile 24/7 ni baga dɔnnikɛlaw ni jiriw dɔnbagaw ye minnu bɛ ladilikan di walasa ka jiriw ja talenw dɔn minnu cilen don ka bɔ kɛnɛyaso kɔrɔtɔlenw na.
• Royaume-Uni ani Erɔpu Kelenyatɔnba: Aw bɛ telefɔni 999 (UK) walima 112 (UE) wele. Alimanjamana, Ɔtirisi, Suwisi, Faransi, Itali, Slovini, ani Angletɛri jamana bɛɛ kɔnɔ, foroba balo ɲinini ɲagami bɛ Bärlauch / Ramsons (Allium ursinum) ani Hɛrɛbstzeitlose (Colchicum autumnale) walima Weißer Germer (Veratrum album) bɛ kɛ sababu ye ka mɔgɔ tan ni caman don ICU la ani ka u faga awirilikalo ni mɛkalo o mɛkalo. Angletɛri ani Erɔpu tilebin yanfan kɔgɔjida la, Hemlock Water Dropwort (Oenanthe crocata, "Mɔgɔ salen bolokɔnincininw") tubabukan minnu kolen don bajida la ani kɔgɔjida la, olu bɛ kɛ sababu ye ka oenanthotoxin status teliya la epilepticus min ni Cicuta bɛ kelen ye. Dɔgɔtɔrɔw ka kan ka taa NPIS / TOXBASE (UK) walima jamana ka UE baga furakɛli yɔrɔw la (Giftnotruf / . Tox Info Suisse / . CAPTV) o yɔrɔnin bɛɛ.
• Ɔsitarali ni Zelande kura: Aw bɛ se ka 000 (Ɔsitarali) walima 111 (New Zealand) wele, ani ka Poyiw kunnafonidiyɔrɔ (13 11 26 Ɔsitarali jamana na; 0800 764 766 Nuwɛlika jamana na). A jirala ko Poison Hemlock (Conium maculatum) ani finidoncogo Gloriosa Lily (Gloriosa superba, minnu falen don kolisini la) ye jiriw baga sababuba ye jamana fila bɛɛ kɔnɔ.
• Azi ani yɔrɔw minnu ka timi: Ɛndujamana, Sri Lanka, ani Azi Saheli-Kɔrɔn fan bɛɛ la, Flame Lily / Glory Lily (Gloriosa superba) ye kolisisini baga jugumanba sababuba ye (a kɛra kasaara ye ani ni laɲini ye), u bɛ ɲɛnabɔ ni Multi-Dose Activated Charcoal, ICU hemodynamic, ani G-CSF protocole kelen ye min bɛ kɛ Colchicum autumnale la.

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Ɲininkali minnu bɛ kɛ tuma caman na¶

Mɔgɔw ​​bɛ Autumn Crocus walima False Hellebore fagalen ɲagami cogo di ni Wild Garlic dunta ye?¶

Samiya daminɛ na sani falenfɛnw ka bɔ, kungo kɔnɔ alikama duntaw (Allium ursinum) ani Ramps (Allium tricoccum) bɛ furabulu janw ci ka taa sanfɛ kungo dugukolo ɲiginnenw na, ka kɛɲɛ ni Autumn Crocus (Colchicum autumnale) ani False Hellebore (Veratrum album walima viride) bulu jɛmanw ye minnu bɛ bɔ kɛnɛ kan. Ni baloɲinikɛla ye kungo kɔnɔ alikama bulu bolo kelen minɛ siɲɛ kelen, u bɛ Autumn Crocus walima False Hellebore bulu dɔ tigɛ nɔgɔya la min bɛ falen o yɔrɔ cɛmancɛ la, wa k’a sababu kɛ u bolow datugulen don ni alikama tulu ye kaban, a bɛ i n’a fɔ a bulu baga kasa tɛ minnu na, olu fana kasa bɛ i n’a fɔ alikama.

Dɔgɔtɔrɔ bɛ se k’a dɔn cogo di ni kungo kɔnɔ alikama balo ɲininikɛla banabagatɔ dɔ ye Autumn Crocus walima False Hellebore dun?¶

Waati ni dusukun tantanni bɛ u fila fara ɲɔgɔn kan o yɔrɔnin bɛɛ: Hɛlɛbore nkalonma (Veratrum) bɛ mɔgɔ minɛ joona miniti 30 fo lɛri 3 kɔnɔ, o bɛ fɔɔnɔ jugumanba bila mɔgɔ la ka fara dusukun tantanni jugumanba kan (sinus bradycardie juguman min bɛ 45 bpm duguma) ani tansiyɔn dɔgɔyali min bɛ kɔsegin joona ni atropine ye jolisira fɛ. Otumn Crocus (colchicine) bɛ latɛmɛ lɛri 2 fo lɛri 24 kɔnɔ min bɛ mɔgɔ lafili sani a ka kɔnɔboli joli la min bɛ i n’a fɔ kolera ani dusukun tantanni teliya (tachycardie), o bɛ taa ɲɛ tile 2 fo tile 7 kɔnɔ fo ka se dusukun tantanni ma min bɛ mɔgɔ faga ani kolotugudaw ka dɛsɛ.

Danfara jumɛn bɛ Ji Hemlock (Cicuta) ni Poison Hemlock (Conium) cɛ?¶

Hali n’u fila bɛɛ ye karɔti denbaya kɔnɔmɔgɔw ye minnu falen bɛ parasol finmanw na ani u buluw ye dingɛ ye, u bɛ bin farikoloɲɛnajɛ kan cogoya wɛrɛw la. Ji Hemlock (Cicuta suguya) bɛ falen kɔji ɲiginnenw na, a ju bɛ kɛ so kɔnɔ, tulu jɛman bɛ bɔ a la, wa cicutoxin bɛ a la, o min bɛ GABA-A minɛbagaw kunkolo bali walasa ka kirinni kɛ min bɛ se ka bɔn, min bɛ to senna miniti 15 fo miniti 60 kɔnɔ. Poyi Hemlock (Conium maculatum) bɛ falen dugukolo jalen kan, a buluw ye bulama ye, wa coniine bɛ a la, o bɛ farikolo lamini farikolo yɔrɔw bali walasa ka ninakilidegun wulilen bila ka a sɔrɔ banabagatɔ tora a ɲɛ na.

Mun na Multi-Dose Activated Charcoal fɔlɔ nafa ka bon kosɛbɛ ni mɔgɔ dɔ ye Autumn Crocus dun?¶

Ni kolisini donna dusukun fasa ni kolotugudaw la ka a datugu selilɛri kɔnɔ tubuline la, joli seginni tɛ se k’a bɔ ani furafura jɔnjɔn si tɛ sɔrɔ yɔrɔ bɛɛ. Nka, kolisini bɛ to ka bɔ sugunɛ fɛ ka don bile kɔnɔ ka segin ka don banakɔtaa fitini na; ni aw ye Charbon Activé tata hakɛ segin-segin di lɛri 4 fo lɛri 6 o lɛri 6, o bɛ kolisisini minɛ kɔnɔbara la, ka bilisi seginni tigɛ, wa a bɛ se ka dusukun tantanni taamasiɲɛ 2nan bali min bɛ mɔgɔ faga.

Yala mɔgɔ bɛ se ka kisi Poison Hemlock (Conium maculatum) ma ni a ninakili jɔra wa?¶

Ɔwɔ, ni bi kɔrɔtɔko ladonni ye, mɔgɔ kisi ka bɔ Poyi Hemlock la, o bɛ se ka kɛ 100% ye ni kisi ninakili ni dɔgɔtɔrɔso masin fiɲɛbɔli daminɛna sani oksizɛni dɔgɔyali ka kɛ kunsɛmɛ na. Ikomi konini tɛ kunsɛmɛ walima farikolojidɛsɛ tiɲɛ kudayi, ni aw ye banabagatɔ bila fiɲɛbɔlan masin kan ni lafiyalan ye fo lɛri 24 fo lɛri 72, o bɛ a to farikolo bɛ se ka baga in falen ka bɔ a la fo ka se farikolo fanga dafalen seginni ma.

Yala kungo kɔnɔ jiriw tobili walima u tobi bɛ bagaw tiɲɛ minnu bɛ sɔrɔ Autumn Crocus walima Hemlock kɔnɔ wa?¶

Ayi, tobili, tobili, tobi walima jalen tɛ kolisini, veratrum alkaloïdes walima cicutoxin tiɲɛ. Tiɲɛ na, ni aw ye Autumn Crocus walima False Hellebore buluw tobi suman walima pasta ji la, o bɛ bagaw bɔ ji la ka taa tobilikɛji la, ka baga don mɔgɔ o mɔgɔ la min bɛ o shɔ dun.

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Walasa ka to lakana la kɛnɛma ɲɛnajɛw ni kungo kɔnɔ kɔrɔtɔko waatiw la, aw bɛ a lajɛ ka bololabaarakɛlaw ka dɛmɛ fɔlɔ ni CPR kalan kɛ ka bɔ Croix Rouge fɛ, St John Ambulance fɛ, walima kungo furakɛlikɛla dɔ fɛ min ka lakɔliso sɛbɛn bɛ a bolo.

Gafe minnu bɛ tali kɛ o ko la¶

• Kungo kɔnɔ ɲɛgɛnw baloli (Amatoxin) ani jiri bagalenw dunni
• Status Epilepticus, Kɔnɔboli kuntaalajan, ani Kisili furaw
• CPR: Dusukun ni fogonfogon lakununni senfɛ-senfɛ
• Dumuni baga, kɔnɔboli jugumanba, ani farikolojidɛsɛ
• Baga caman sɔrɔli Dɛmɛ fɔlɔ ni nɔgɔ bɔli

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Sosow ani ɲɛmɔgɔyaso ka bilasiralikan¶

• U.S. ka baarakɛyɔrɔ la. Banaw kɛlɛli ni u kunbɛnni baaradaw (CDC): Banaw ni sayaw dɔgɔkun o dɔgɔkun kunnafoni (MMWR): Jilaji (Cicuta maculata), Poyi Hemlock (Conium maculatum), ani False Hellebore (Veratrum viride) baga minnu bɛ tali kɛ balo ɲinini na (Amerika).
• Alemaɲi Fɛdɛrali Institut for Risk Assessment (BfR) & Swiss Toxicological Information Center (Tox Info Suisse): Mɔgɔw ​​ka lasɔmini ni kɛnɛyaso laadilikanw ka ɲɛsin kungo kɔnɔ alikama (Allium ursinum) ni Autumn Crocus (Colchicum autumnale) ani White Hellebore (Veratrum album) ɲagamini ma (Erɔpu tɔnba ni Suwisi).
• UK National Poisons Information Service (NPIS) / TOXBASE: Kɔlchicum autumnale (Kolchicine), Oenanthe crocata (Hemlock ji jiginɛ), ani Conium maculatum Ingestion (Angletɛri) furakɛli kɛnɛyaso la.
• Finkelstein Y, Aks SE, Hutson JR, Juurlink DN, et al.: Kolchicine baga: fura kɔrɔ dɔ dibi fan (Clinical Toxicology).
• Schep LJ, Slaughter RJ, Becket G, Beasley DM: Baga bɛ sɔrɔ ji la (Cicuta suguya) ani baga hemlock (Conium maculatum) (Clinical Toxicology / New Zealand National Poisons Centre).