Kolkisiin (Krocus d'automne) e Tooke ngam ñaamde laay ladde e ƴiiƴam ndiyam (Cicutoxin) e ƴiiƴam tooke (Coniine) Triage¶

Juumtude lekki ladde maayki e leɗɗe ñaameteeɗe walla leɗɗe ɗaɗol ina jeyaa e ko ɓuri yaawde e caɗeele safaara e nder wellitaare yaajnde e defde galle. So tawii won mo heɓi ɓuuɓri, ɓuuɓri hunduko, ɓuuɓri ƴiiƴam, ɓuuɓri ɓernde, ɓuuɓri ɓalndu, walla ɓuuɓri caggal nde ñaami laay ladde (ramps), karaŋ ladde, walla parsnip ladde, noddu limoore emergency nokku maa (911 to Amerik e Kanadaa, 112 e nder Dental Orop, 999 to Angalteer) walla jokkondir e men regginorde limooje emergency hakkunde leyɗeele ɗoon e ɗoon. Nde o fadi safrooɓe, ƴeewto men yaajde porotokol ñaamde mboros ladde e leɗɗe tooke, peewnitde ngam status epilepsi ko ɓuuɓri juutndi so Water Hemlock ñaamaama, kadi aɗa hesɗitina fuɗɗoraade wuurtinde ɓernde e ɓuuɓri (CPR) so tawii Tooke Hemlock walla Autumn Crocus ina addana fooftere walla ɓernde ɓuuɓde.

E nder Orop, Amerik worgo, e Asii ɓuuɓɗo, ko mborosaaji ɗiɗi nannduɗi e leɗɗe, ina kaala ko ɓuri heewde e tookeeji leɗɗe ladde: 1. Fannde "Laay ladde" nde leɗɗe jaajɗe: Ñaamooɓe ina moofta ko ñaametee Laay ladde / Ramsons (Allium ursinum) walla Amerik worgo Raamuuji (Allium tricoccum) e nder leɗɗe ɓuuɓɗe e ndunngu, ina njuppa e aksidaa leɗɗe daneeje ummotooɗe e Crocus Autumn / Meadow Saffron (Colchicum autumnale) walla Hellebor fenaande (Veratrum album / Veratrum viride), ɗe mawnata bannge-bannge e nder leydi ngootiri tigi. Nde Veratrum ina addana ɓuuɓri jaawndi, bradikardiya tiiɗɗo, e hipotension nder 30 to 120 minutes ko jaabotoo e atropine no feewi, Colchicum autumnale ina waɗi tooke ƴiiƴam mitotik kolkisiin, ko nanndi e ñawu nguu, ngu alaa ko bonnata ɗum 24 hours hade mum yaltinde ŋakkeende terɗe keewɗe baawɗe warde, sokla kardiyogenik, e aplasia ƴiiƴam mo alaa ko bonnata ɗum e njulaagu. 2. Umbellifer "Karot ladde / Parsnip" Trap: Ƴeewooɓe nguura ina njuppa terɗe galle karot/persiil (Apiaceae) majjere Hemlock ndiyam (Cicuta maculata, Cicuta virosa, walla Oenanthe crocata) walla Tooke Hemlok (Conium maculatum) ngam karaŋ ladde (lace laamɗo Anne), parsel ladde, angelica, walla seleri ladde. Hay so tawii kamɓe ɗiɗo fof ɓe njogii ko innde « hemlock », tooke maɓɓe ko luurondirɗe e kilinik : Hemlock ndiyam ina waɗi cikutoksin (walla oenanthotoksin), ko ɗum antagonist GABA-A caɗtuɗo doolnuɗo, baawɗo saabaade **status epilepticus refractaire e nder hojomaaji 15 haa 60 ɗo Hemlock ina waawi heɓtaade neɗɗo e nder hojomaaji 15 haa 60 alkaloid coniine, ko kañum addata paralisis respiratoire flaccide ascendant comme curare tawa ñawɗo oo ina heddii e ŋoŋɗi haa laaɓa cer haa hipoksiya naata.

+-------------------------------------------------------------------------+
|        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) |
+-------------------------------------------------------------------------+

Waɗde ɗum jooni¶

1. Noddu sarwisaaji toppitiiɗi ko fayti e tooke ɗoon e ɗoon. Noddu 911 (Amerik e Kanadaa), 112 (Dental Orop), 999 (Dental Dowlaaji Amerik), 000 (Ostarali), walla 111 (New Selannde). Hoto ɗaccu maale ɗee puɗɗoo so tawii neɗɗo anndii ɓe ɓuuɓtii tan ko Crocus Autumn, Hemlock ndiyam, Hemlock tooke, walla Hellebore fenaande : colchicine ina jogii fenaande 2 to 12 hour faɗo silki e nder mum ko dekontaminaasiyoŋ guurɗo e opitaal arano tan woni fartaŋŋe haɗde ƴettugol cellal baawngal warde.
2. Mooftu e foto lekki kii, tawa ina waɗi bulbul/root, base stem, e leɗɗe. Waɗde sample mo defaaka e leɗɗe, stem, tuubaaji, walla bulɗi (ina heen kala ko heddii e suukara, pesto, walla salad) e nder saak kaayitaaji walla e nder lowre, ngaddaa ɗum e ñawɗo oo to suudu safrirdu nduu. Tookeeji emergency e botanist en nokkuuji tooke noddaango ina kuutoroo cuuɗi ɗaɗi, ɓuuɓri ƴiye, ɓuuɓri leɗɗe, e uurngol garlic ngam anndude tooke tigi-rigi e nder hojomaaji seeɗa.
3. Woto meeɗ waɗde ɓuuɓri e galle. Woto ndokku siro ipecac, ndiyam lamɗam, walla ɓuuɓri koppi. So tawii lekki kii ko Hemlock ndiyam (Cicuta), seppooji kuuɓtodinɗi bonɗi ina mbaawi fiyde e nder 15 minutes e ɓuuɓde, saabaade aspiraasiyoŋ pulmonaire fatal so tawii neɗɗo oo ina ɓuuɓtoo.
4. Waɗde ñawɗo oo lelnaa e bannge mum, peewnito-ɗaa so tawii ko ɓuuɓri walla ɓuuɓri fooftere.
5. So tawii neɗɗo oo ñaamii ɗaɗol/tuber chambered e sara maayo walla marse (Water Hemlock), ɓuuɓna geɗe ɓutte, ɓuuɓna hoore mum ngam waawde feewnude ɓuuɓri tonik-klonik ɗoon e ɗoon.
6. So tawii neɗɗo oo ñaamii ƴiiƴam ɓuuɓɗam ɓuuɓɗam walla leɗɗe nannduɗe e fern (Poison Hemlock), ƴeew no ɓernde maɓɓe ummortoo no feewi : so koyɗe maɓɓe ina teddi, fooftere maɓɓe ina ɓuuɓtoo walla ina dartoo, fuɗɗoo foftere hisnude / ventilation bag-valve-mask (walla CPR timmuɗo so pulseless) .
7. So tawii neɗɗo oo ina wondi e ɓuuɓri e pulse leelɗo les 45 beats per minute caggal nde ñaami leɗɗe daneeje jaajɗe (False Hellebore), lelnu ɗe, ƴetta koyɗe mum en 30 centimeters (12 inches) ngam wallitde ƴiiƴam ruttaade e ɓernde haa safrooɓe mbaɗa atropine e nder ƴiiƴam.
8. Jeertin kala goɗɗo mo renndini nyaamdu nduu ɗoon e ɗoon. Pesto garlic ladde, suukara rampa, e salaade forage ina keewi renndinde hakkunde terɗe galle, hoɓɓe ñaamde, walla wondiiɓe kammu. Kala neɗɗo ñaamɗo hay lefol gootol walla ɓuuɓri ɓuuɓri coodgu (colchicine e veratrum alkaloids ko timmuɗo e nguleeki, ina ɓuuɓna e nder ndiyam suukara) ina foti yahde safrirde ɗoon e ɗoon hay so ina wondi e cellal.

Lekki kuulal : Anndinde botani e triage toxidrome clinique¶

flowchart TD
    A["Ñawu Ɓooyngu walla Ɓooygol Caggal nde Ñaamde Leɗɗe Ladde"] --> B{"Hol sifaa leɗɗe ɗe njibinaa?"}
    B -->|"Haakooji daneeji jaajɗi (juumtuɗi e garlic ladde / Ramps)"| C{"Ƴeewto Fuɗɗoode Maale & Ƴeewndo Ɓernde"}
    B -->|"Haakooji nannduɗi e Fern walla Puɗi / Daaɗi Umbrella Daneeji (Jumɗinaama e Karoot ladde / Parsnip)"| D{"Ƴeewto Maande Neurologique Dominante"}
    C -->|"Fuɗɗoode jaawnde (30-120 min) + Bradikardiya tiiɗɗo (HR < 45) + Hipotension"| E["HELLEBORE FALSE (Albom Veratrum / viride) - Refleks Bezold-Jarisch"]
    C -->|"Leelgol fuɗɗoode (2-24 h) + Ɓoornugol keewngol nanndungol e kolera + Takikardiya"| F["KROKUS ƁURƊO ƁURDE (Colchicum autumnale) - Tooke Mitotik Kolkisiin"]
    E --> G["Hokkude Kuuɓal Kuuɓtodinngal (< 1-2h); IV 0,9% ndiyam ɓuuɓɗam + IV Atropin (0,5-1,0 mg q3-5m) -> Dopamin/Fenilefrin so ina haani"]
    F --> H["Kuutorgal ɓuuɓngal (MDAC q4-6h) + Wuurtinde ɓuuɓri ICU ko adii + G-CSF ngam pansitopeni"]
    D -->|"Epileptik gonɗo e nder hojomaaji 15-60"| I["ƁIƊƊO NDIYAM (Cicuta maculata / virosa / Oenanthe crocata) - Sikutoksin"]
    D -->|"Ascendant Muscle Flaccid & Paralyse Respiratoire e Hakkille Laaɓɗo"| J["TOOKE HEMLOCK (Konium makulatum) - Koniin Nikotiin Blokaa"]
    I --> K["Reende laawol henndu; Benzodiazepineeji toowɗi IV -> Fenobarbital walla Propofol + Cooyngal kuuɓtodinngal + Bikarbonaat ngam rabdomiolisis"]
    J --> L["Intubaasiyoŋ endotrakeal ko yaawi & ventilaasiyoŋ mekanik fotde waktuuji 24-72 (Rewrude e suksinilkolin) + Kuuɓal kuutorteengal"]

Njiylawu botani e kilinik 4 mborosaaji mborosaaji baawɗi warde¶

Feccere 1: Ko wayi no Laay ladde: Crocus (Colchicine) e Helleboor fenaande (Veratrum)¶

Kala ndunngu e nder Orop, Angalteer, e Amerik worgo, ujunnaaje ujunnaaje yimɓe ina nguura e nder laddeeji ɓuuɓɗi ngam Wild Garlic (Allium ursinum) walla Raamuuji (Allium tricoccum) ngam waɗde pesto ladde ladde, suukara, walla leɗɗe ɓuuɓɗe. Sabu laay ladde ina mawna e nder tapiiji denndaangal rewrude e nokkuuji Autumn Crocus (Colchicum autumnale) e Hellebor fenaande (Veratrum album to Orop; Veratrum viride e nder Amerik worgo), junngo wooto leɗɗe nanngaaɗe ina keewi jogaade sifaaji tati ɗii fof. Yanti heen, so tawii koppi jom jawdi en njuppaama e ndiyam laana ladde ɓuuɓɗam, juuɗe mum en ina ɓuuɓna laana, ina foolna "test sniff" nde ɓe ƴeewtotoo leɗɗe garooje ɗee.

Sindoron 1A: Krokus ndunngu (Colchicum autumnale) e Lily Teddungal ( ).Gloriosa superba): Tooke kolkisin¶

Denndaangal geɗe Colchicum autumnale (leɗɗe, korm/bulbul, aawdi, e puɗi ɓuuɓɗi) e ɓuuɓri Gloriosa superba ɓuuɓndi ina njogii ɓuuɓri toowndi (0.1% to 0.6%) e alkaloid kolkisiin. Innge ko ɓuri... 0.5 mg/kg ko kolkisin (roughly 2 to 5 fresh leaves of Autumn Crocus wonande mawɗo, walla 1 leaf wonande cukalel) ina heewi warde, kadi doseeji ina ɓura 0.8 mg/kg sabaabu ko famɗi fof 100% maayde e sokla kardiyogenik e ŋakkeende terɗe keewɗe.

Patofisiyoloji e daawal 3 kilinik tooke Kolkisiin¶

Kolkisiin ina jokkondiri e dimeruuji alfa- e beta-tubulin nder geese, ina haɗa ɗi polimereede e nder mikrotubuleeji. So mikroo-tubuleeji kuutortooɗi ngalaa, piɓaaji mbaawataa waɗde ƴulɓe mitotik ngam feccude (nanngude denndaangal piɓaaji peccitooji e yaawre e nder metafase), piɓaaji ɗi peccataa (ko wayi no miositeeji ɓernde e nerfuuji periferik) ina mbaasa yahdu e ɓuuɓri nder piɓaaji.

+-------------------------------------------------------------------------+
|            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)         |
+-------------------------------------------------------------------------+

Njuɓɓudi opitaal tookeeji kolkisin¶

1. Dekontaminaasiyoŋ Gut ɗoon e ɗoon e ko heewi (Even if Presenting Late): Sabu kolkisin ina waɗa recirculation enterohepatique yaajnde (ina seerta e bile, ina rewna e nder ɓalndu tokoosru) ina leeltina ɓuuɓri ɓalndu, waɗde aspiration/lavage gastrique précoce (so tawii ko e nder 1 to 2 hours e ñaamde leɗɗe) e fuɗɗoraade Kuuɓal kuuɓtodinngal Doseeji keewɗi (MDAC: 50 grams fuɗɗoode, ndeen 25 grams kala 4 to 6 hours ngam 24 to 48 hours). Kuuɓal kuuɓtodinngal ina jokkondiri e kolkisin no feewi e nder ɓalndu, ko kañum woni feere ɓurnde moƴƴude ngam ustude maayde e nder ɓalndu.
2. Hemodinamik aggressive e Resuscitation ICU: Ƴeewde ɓuuɓri mawndi e kiristalloyid balans e nder daawal 1 ngam lomtaade 5 to 10 liters e ŋakkeende ndiyam GI nannduɗam e kolera. Waɗde ekokardiyogaraafi e leeso ko yaawi : no mbayliigu soklaaji hipovolemik tolno 1 e nder soklaaji kardiyogenik toowɗi daawal 2 (typically at 24 to 72 hours), waylude ndiyam toowɗam feewde e inotropeeji (norepinefriin + dobutamin walla epinefriin) e ƴeewtaade ko yaawi Oksijenaasiyoŋ membrane ekstrakorporeel veno-arteriyel (V-A ECMO) ko adii nde asistol refraktoor waɗata.
3. Faktor cemmbinoowo koloñaal granulosit (G-CSF / Filgrastim): Yiylaade limto ƴiiƴam timmuɗam laabi ɗiɗi ñalawma kala. Wakkati ƴiiƴam ɗam (WBC) limre fuɗɗotoo ko toɓɓere mum ɓuuɓnde ( ).typically Day 3 to 4), fuɗɗoraade les ɓalndu Filgrastim (G-CSF, 5 micrograms/kg/day) e waɗde ñawɗo oo e isolation neutropénique protecteur e antibiotikuuji keewɗi e nder ƴiiƴam e ƴiiƴam ngam wuurde e aplasia nadir ƴiiƴam.
4. Ko waɗi Dialyse ina ŋakki & Fab Fragments: Sabu kolkisin ina yaawi naatde e cellal, ina jogii kadi njuuteendi renndo (2 to 12 L/kg), hemodiyaalisis e hemoperfusion waɗataa ittude kolkisin (hay so CRRT ina huutoree e ñawu nguu e nder reedu e asidosis). Jarribooji pecce antibiotik Fab ovine keertiiɗe e kolkisiin ina mbayla tooke no feewi e nder wiɗtooji safaara, hay so tawii noon njulaagu ina famɗi no feewi e winndere ndee ; ƴeewto Poison Control ɗoon e ɗoon ngam ƴeewde so tawii wiɗtooji ina ngoodi.

Sindoron 1B: Hellebor fenaande (Veratrum album, Veratrum viride, Veratrum californicum): Ñawu nguu ina wiyee Bezold-Jarisch¶

Nandugol e maayde leeltunde e Crocus Autumn, ñaamde leɗɗe False Hellebore (walla yarde liɗɗi gentian gaadoraaɗi e galleeji ɗi njuumri mum en ɓuuɓnaa e ɗaɗi Veratrum album) ina addana maale teskinɗe e nder 30 minutes to 3 hours.

• Mekanisme: Leƴƴi Veratrum ina njogii alkaloyid veratrum (veratridine, protoveratrine A and B, germerine, e jervine). Ɗee tooke ɓuuɓɗe e nder lipid ina njokkondiri e udditde sodium gated voltage (Na+) laabi e nder nerwel vagus, baroreseptooruuji sinus karotiid, e mekanoreseptooruuji ventrikulaar nano, haɗde inaaktiwiteede laabi sodium. Jokkude fiyde fiɓnde vagal sensorik ɓernde ina softina reflex Bezold-Jarisch : ƴiiƴam ngaandi ina anndi ɓernde ina ɓuuɓtoo no feewi, ina jaaboo e yaltinde ton vagal parasimpatik mawɗo, tawa ina uddita ton vaskulaar simpatik.
• Kollirgol kilinik: E nder 30 to 120 minutes, ñawɗo oo ina heɓa ɓuuɓri retrosternal tiiɗndi, ɓuuɓri tiiɗndi, ɓuuɓri e ɓuuɓri saraaji hunduko e koppi (paresthesia), jiiɓru yiytere ( ).xanthopsia), bradikardiya sinus luggiɗiiɗo (heart rate 30 to 45 beats per minute), ƴiiƴam ɓalndu (AV) ɓuuɓri ɓernde, e hipotensiyoŋ ƴiiƴam tiiɗɗo (systolic BP < 60 to 70 mmHg).
• Safaara njiylawu:
• Kuuɓal kuuɓtodinngal dose gooto (50 grams e hunuko so tawii ko e nder 1 to 2 hours e laawol henndu ina selli) + ñawbuuli (ondansetron).
• Bolusuuji ndiyam jaawɗam nder ƴiiƴam: Njuɓɓudi 1 to 2 liters of 0.9% saline no woorunoo.
• Atropin nder ƴiiƴam (The Specific Physiologic Antagonist): Waɗde Atropin 0.5 to 1.0 mg IV pusgol kala 3 to 5 minutes (up to 3 mg total e nder mawɓe; 0.02 mg/kg e nder sukaaɓe). Atropin ina haɗa jaɓɓotooɗe vagal muskarinik e dow nodule sinoatriyal e atrioventrikular, ɗoon e ɗoon ina wayla bradikardiya e uddugol ɓernde.
• Vasopresseurs pour le hipotension persistante : Nde tawnoo refleks Bezold-Jarisch ina addana kadi ustude simpatiik hakkundeejo (vasodilataasiyoŋ periferik) e sara bradikardiya, tansiyoŋ ina waawi heddaade seeɗa hay so atropin artirii ɓuuɓri ɓernde no haanirta nii ; ɓeydu heen ɓuuɓri fenilefrin, dopamin, walla norepinefriin ngam... 12 to 24 hours haa cellal timmungal (virtually 100% of Veratrum patients recover fully within 24 to 48 hours with supportive care).

Feccere 2: Galle-Karoot (Apiaceae) Ko nanndi heen: Hemlock ndiyam (Cicutoxin) vs. Hemlock tooke (Coniine)¶

Ɓiɓɓe leɗɗe Apiaceae (Umbelliferae) ina waɗi geɗe coodguuli belɗe (kaarooji, persi, seleri, persiil, fennel, dille, koriyannde) e saraaji leɗɗe ɗiɗi ɓurɗe maayde e neurotoksik e nder Hemisfeer Fuɗnaange : Water Hemlock (Cicuta sifaaji e Oenanthe crocata) e Hemlok tooke (Conium maculatum). Ɗiɗi fof ina njogii ɓuuɓri daneeri, nanndundi e umbrella (compound umbels), ƴiye jokkondirɗe ɓutte, e baagal kuuɓtidinngal fecciraangal no feewi.

+-------------------------------------------------------------------------+
|     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   |
+-------------------------------------------------------------------------+

Sindoron 2A: Hemlok ndiyam (Cicuta maculata, Cicuta virosa) e Ɓoornugol ndiyam Hemlock (Oenanthe crocata): Sikutoksin ngonka epilepsi¶

Water Hemlock ina yaaji e lekki ɓurki tookeede e nder Amerik worgo e worgo Orop. Kosam tuubakooɓe ɓuuɓɗam, uurɗam parsnip e cuuɗi lesɗi ɗii ina njogii ndiyam ɓuuɓɗam, ɓuuɓɗam, nebam, keewɗam sikutoksin (walla oenanthotoksin e nder Oenanthe crocata, keewɗam e nder Angalteer e Orop hirnaange), ko alifatik mo ɓuuɓnaaka C17 alkol poliasetilenik. Bite gooto (2 to 3 centimeters) e ɗaɗol Water Hemlock, walla hay cukalel huutortooɗo ɗaɗol ngol ina waɗi ɓuuɓri walla ɓuuɓri, ina waawi rokkude doosgal maayngal.

• Mekanisme: Sikutoksin ina taƴa ƴiiƴam-ngaandi e yaawre, ina jokkondiri e **nokku pikrotoksin e nder nerwooji hakkundeeji GABA-A, ina haɗa jolngo kanndaa kuloriid haa laaɓa cer. So GABA haɗaani, neronuuji kortikol e ƴiye ngaandi ina depolarize ko juuti.
• Kollirgol kilinik (15 to 60 minutes): E nder 15 minutes e ɓuuɓnude ɗaɗol ngol, ñawɗo oo ina heɓa ɓuuɓri, ɓuuɓri keewndi, ɓuuɓri epigastrik, ɓuuɓri ƴiiƴam, e ɓuuɓri ɓuuɓri (mydriasis), rewi heen ko ɗoon e ɗoon ɓuuɓri tonik-klonik kuuɓtodinndi, ɓuuɓndi, ɓuuɓndi (status epilepticus). Kosam ɗam ina tiiɗi haa ñawɓe ɓee keewi heɓde ɓuuɓri ɗemngal, opisthotonos, ɓuuɓri ɓalndu, hyperthermie (> 41 degrees Celsius), rabdomiolisis mawɗo (creatine kinase > 50,000 U/L), ɓuuɓri toowndi aniyon asidosis laktik (pH < 6.9), ŋakkeende reedu mioglobinurik, e ŋakkeende ɓernde hipoksiik.
• Njuɓɓudi opitaal emergency:
• Ko yaawi e ɓuuɓri ƴiiƴam e GABA-Agonist: Woto bonnu waktu e fenitoin (ineffective against GABA-A blockade). Waɗde benzodiazepines (lorazepam 4 mg IV walla diazepam 10 mg IV), ina ɓeydoo ɗoon e ɗoon haa wonta fenobarbital (15 to 20 mg/kg) walla ɓuuɓri jaawndi e ɓuuɓri propofol walla midazolam jokkondirndi.
• Blokaade neuromuskulaar e cooynagol kuuɓtodinngol ngam rabdomiyolisi: So tawii ɓuuɓri ɓalndu e hipertermi ina keddii hay so tawii ko sedaasiyoŋ luggiɗiiɗo e GABA-agonist, waɗde blokaajo neuromuskulaar mo depolarizing (rocuronium walla vecuronium; reenaade suksinilkolin sabu baasal hiperkalemiya) e les ƴeewndo EEG jokkondirngo ngam haɗde ɗoon e ɗoon ƴellitaare nguleeki ɓalndu e yaltinde mioglobin.
• Bikarbonaat sodium aggressif e diuresis ndiyam: Ƴeewde kiristalloid isotropik e nder ƴiiƴam e bikarbonaat sodium nder ƴiiƴam ngam feewnude asidosis metabolik tiiɗɗo e alkalinize ƴiiƴam (target urine pH > 6.5), haɗde toɓo ɓuuɓngo (mioglobin) e nder ƴiye renal. Waɗde hemodiyaalisis ko yaawi so tawii hiperkalemiya refrakteer, asidosis, walla ŋakkere renal anurik ina ƴellitoo.

Sindoron 2B: Hemlock tooke (Conium maculatum): Koniine ƴoogirde fooftere¶

Tooke Hemlock (Conium maculatum), lolluɗo e daartol ɓooyngol ko tooke warngo filosof Socrates e hitaande 399 BCE, ina waɗi alkaloyid piperidin jeetati ɓuuɓɗi, ko ɓuri heewde heen ko koniin e gamma-koniin. Sabu baagal maggal lacy, nanndungal e fern ina nanndi e baagal persiil, cervil, walla kartoŋ ladde (e taproot maggal danewal ina nanndi e parsnip), yahooɓe e jardeeji galleeji ina keewi ñaamde maggal e majjere.

• Mekanisme (Blocade Nicotinique Biphasique): Koniin ina jogii sifaa kemikal e golle farmakoloji nannduɗe no feewi e nikotin e kuraar. Ina gollira e fasaadeeji ɗiɗi ceertuɗi e dow ganglia autonome e jokkondiral neuromuskulaar (nicotinic acetylcholine receptors [nAChR]):
• Fase 1 (Stimulaasiyoŋ Nikotiin gadano, 15 to 60 minutes): Ɓuuɓri e nder hunuko e daande, ɓuuɓri keewndi, ɓuuɓri, ɓuuɓri, ɓuuɓri reedu, takikardiya, hipertension, ɓuuɓri puɗi, e fasciculations/tremors musculaire coarse.
• Fase 2 (Blokaade neuromuskulaar depolarisant/non depolarisant, 1 to 4 hours): Jokkondire jaɓɓotooɗe duumotooɗe ina ustoo, ina kaɗa jaɓɓotooɗe asetilkoliin nikotiin to bannge jokkere enɗam, ina addana ɗum paralisis flaccid ascendant like curare.
• "Maande Socrates" (Paralisis ƴeeŋtuɗo e hakkille laaɓɗo): Paralisis fuɗɗotoo ko e koyɗe e koyɗe (ina addana ataxia ɓuuɓɗo e waasde daraade), ina ƴeeŋta no feewi e nder koyɗe, e ɓalndu, e juuɗe, haa joofna ina ɓuuɓna **ɓuuɓri hakkunde-ɓuuɓri e **pa- system central. Haa nde hipoksi cerebral tiiɗɗo naati e ɓuuɓri foofaango, ñawɗo oo ina heddii ina ŋoŋɗi haa laaɓi, ina ɓuuɓtoo, ina hulɓinii, ina waawa diwde walla foofde. Koniin ina waawi kadi saabaade rabdomiolisis toowɗo e nekrosis tuubaako ɓuuɓɗo.
• Njuɓɓudi opitaal emergency:
• Intubaasiyoŋ endotrakeal e ventilaasiyoŋ mekanik (The Definitive Cure): Alaa fof safaara kemikal ngam haɓaade koniin (e antikolinesteraseeji hono neostigmin walla fisostigmin FOTI rokkireede, sibu ina mbaawi bonnude ɓuuɓri nikotiin depolarizing, kadi ina addana ɗum en kiris kolinerjik). E nder heen, ventilaasiyoŋ mekanik ina hisna nguurndam 100%. Intubate ñawɗo oo ko yaawi so tawii doole fooftere doole walla doole fooftere bonɗe ina pamɗi (avoid succinylcholine), rokkude sedaasiyoŋ no haanirta nii ( ).propofol/midazolam so ñawɗo gonɗo e hakkille oo ummotaako e dow ventilateur), rokka charbon activé e laawol tuuba nasogastric, e ventilateur ngam 24 to 72 hours. So heeñere e ɓuuɓri mbayliima, njaltinii koniin, semmbe neuromuskulaar ina ngarta haa laaɓa tawa alaa ko jogori arde e neuromuskulaar duumotooɗo.

Porotokolle diiwaanuuji ngam haɓaade mboros e tooke¶

• Leyɗeele dentuɗe Amerik e Kanadaa: Noddu 911 ɗoon e ɗoon, noddu 1-800-222-1222 (Ballal tooke Amerik) walla 1-844-TOOKE-X (1-844-764-7669 to Kanadaa). To Amerik worgo, Hemlock ndiyam (Cicuta maculata e Cicuta douglasii), Tooke Hemlok (Conium maculatum), e Hellebor fenaande / Lili maaro (Veratrum viride e Veratrum californicum) ina yaaji e nder nokkuuji ɓuuɓɗi, e nder laddeeji koɗli, e nder saraaji laabi ; nokkuuji tooke diiwanuuji ina njogii resooji ƴeewndo natal dijital 24/7 e jokkondirde e tookeeji e annduɓe leɗɗe ngam anndude fotooje leɗɗe neldaaɗe ummoraade e cuuɗi cafrirɗi.
• Dental Dowlaaji Dentuɗi e Dental Orop: Noddu 999 (Angalteer) walla 112 (UE). E nder Almaañ, Otiris, Siwis, Farayse, Itali, Sloveni, e Angalteer, ndunngu ina njiyloo jiiɓru hakkunde Bärlauch / Ramsons (Allium ursinum) e Leɗɗe (Colchicum autumnale) walla Weßer Germer (Veratrum album) ina addana yimɓe heewɓe naatde e ICU e maayde kala lewru abriil e mee. To leydi Angalteer e Orop hirnaange daande maayo, Hemlock Water Dropwort (Oenanthe crocata, "Koppi Maayɗo") tuubaaji loowaaɗi e saraaji maayo e daande maayo ina ngadda oenanthotoxin status epilepticus jaawɗo nannduɗo e Cicuta. Doktooruuji ina poti ƴeewtaade NPIS / TOXBASE (Angalteer) walla nokkuuji tooke ngenndiiji UE (Giftnotruf / Tox Info Suisse / CAPTV) ɗoon e ɗoon.
• Ostarali e Nuwel Selannde: Noddu 000 (Ostarali) walla 111 (New Selannde), e jokkondirde e Nokku humpito tookeeji (13 11 26 to Ostarali ; 0800 764 766 to leydi Nuwel Selannde). Naatgol Tooke Hemlock (Conium maculatum) e pawe Lili Gloriosa (Gloriosa superba, alɗuɓe e kolkisin) ko sabaabuuji maantinɗi tookeeji leɗɗe e nder leyɗeele ɗiɗi ɗee kala.
• Asiya e nokkuuji ɓuuɓɗi: E nder leydi Indiya, Sri Lanka, e Asii fuɗnaange-rewo, tuubaaji Lily Flame / Lily Glory (Gloriosa superba) ko sabaabu mawɗo tooke kolkisiin tiiɗɗe (ko aksidaa e ko anniya), njuɓɓinaaɗe e kuuraa kuutorteeɗo e doseeji keewɗi, hemodinamik ICU, e porotokol G-CSF kuutorteeɗo ngam Colchicum autumnale.

Naamne keewɗe naamneede¶

Hol no yimɓe njiyrata Crocus Autumn maayɗo walla Hellebore fenaande e Garlic ladde ñaameteeɗo ?¶

E fuɗɗoode ndunngu hade puɗi feeñde, Laay ladde (Allium ursinum) e Ramps (Allium tricoccum) ñaameteeɗi ina nelda leɗɗe jaajɗe, daneeje, nannduɗe e lanndaaji e nder leydi ladde ɓuuɓndi, saraaji leɗɗe daneeje ummotooɗe e leɗɗe ɓuuɓɗe (Colchicum Hellebvirise autumnVirese) e F. So jom jawdi nanngii junngo mum e leɗɗe garlic ladde e sahaa gooto, eɓe mbaawi ƴettude lekki Autumn Crocus walla False Hellebore mawnuki e hakkunde paɗe ɗee, kadi nde tawnoo juuɗe maɓɓe ina njuuti e nebam garlic, leɗɗe tooke ɗe ngalaa uurngol ina nanndi e uurngol garlic kadi.

Hol no doktoor anndirta so tawii ñawɗo ladde ina ñaama Autumn Crocus walla False Hellebore ?¶

Waktuuji e ɓuuɓri ɓernde ina ceernda ɗoon e ɗoon ɗiin ɗiɗi : Hellebore fenaande (Veratrum) ina fiyra e yaawre e nder hojomaaji 30 haa waktuuji 3, ina addana ɓuuɓri tiiɗndi tawa ina wondi e ɓuuɓri ɓernde ɓuuɓndi no feewi (bradycardie sinus sévère les 45 bpm) e ɓuuɓri ƴiiƴam ɓuuɓndi e nder reedu. Autumn Crocus (colchicine) ina jogii leelgol foolde waktuuji 2 haa 24 hade mum saabaade ɓuuɓri ƴiiƴam nanndundi e kolera e ɓuuɓri ɓernde yaawndi (tachycardie), ina yahra e balɗe 2 haa 7 haa arti noon e ɓuuɓri ɓernde e ŋakkeende ƴiiƴam.

Hol ko seerndi ƴiiƴam ndiyam (Cicuta) e ƴiiƴam tooke (Conium) ?¶

Hay so kamɓe ɗiɗo fof ɓe ngoni ko e galle kartoŋaaji jogiiɗi puɗi daneeji e ƴiye ɓutte, eɓe njiya ƴiiƴam e laabi luurondirɗi. Water Hemlock (Cicuta species) ina mawna e nder ɓulli ɓuuɓɗi, ina jogii ɗaɗi ɓuuɓɗi ina ɓuuɓna nebam ɗam, ina waɗi cicutoxin, kaɗoowo GABA-A e nder ngaandi ngam saabaade ɓuuɓri ɓuuɓri, jokkondirndi e status epilepticus e nder hojomaaji 15 haa 60. Hemlock tooke (Conium maculatum) ina mawna e leydi njoorndi, ina jogii ƴiye daneeje, ina waɗi kadi koniin, ko ɗum haɗata ƴiye periferik ngam saabaade ɓuuɓri foofaango ɓuuɓndi, tawa ñawɗo oo ina ŋoŋɗi.

Hol ko waɗi charbon activé multi-dose arano ina tiiɗi so neɗɗo ñaamii Autumn Crocus ?¶

So kolkisin naatii e ƴiye ɓernde e ƴiye ƴiye, ina jokkondiri e tuubalin nder ƴiye, hemodiyaalisis waawaa ittude ɗum, tee alaa fof ñawu nguu ina yaaji. Kono tan, kolkisiin ina jokki e yaltinde heeñere ndee e nder bile, ina rewna ɗum e nder ɓalndu tokoosru ; hokkude doseeji keewɗi Charcoal Activated kala waktuuji 4 haa 6 ina nannga kolkisin e nder ɓalndu, ina taƴa mbayliigu biliaire, ina waawi kadi haɗde ɓuuɓri ɓernde Stage 2 bonndi.

Mbele neɗɗo ina waawi wuurde e mboros tooke (Conium maculatum) so fooftere mum dartiima ?¶

Eey, e toppitagol jamaanu, wuurde e Poison Hemlock ina fotnoo 100% so tawii fooftere hisnude e ventilaasiyoŋ mekanik safrirde fuɗɗiima hade bonnugol ngaandi hipoksiik. Sabu coniine bonnataa ngaandi walla nerve haa abada, waɗde ñawɗo oo e ventilateur mekanik tawa ina wondi e sedaasiyoŋ fotde waktuuji 24 haa 72 ina addana ɓalndu nduu waylude e yaltinde tooke ɗee haa semmbe ɓalndu timmuɗo artira.

Mbele ɓuuɓnude walla defde leɗɗe ladde ina bonna tooke e nder Autumn Crocus walla Hemlock ?¶

Alaa, defde, ɓuuɓnude, ɓuuɓnude, walla yoorde, bonnataa kolsiin, alkaloyid veratrum, walla sikutoksin. E goonga, ɓuuɓnude leɗɗe Autumn Crocus walla False Hellebore e nder ndiyam suukara walla paasta ina itta tooke ɗe ndiyam ɓuuɓɗam ɗam, tawa ina tooke kala ñaamoowo ɓuuɓri ndii.

Ngam heɓugo kisal wakkati fijirle yaasi e nder ladde, miijo hoosugo janngirde ballal arandewal e CPR diga Red Cross, St John Ambulance, malla hokkugo nyawndiigu ladde seedtinaaɗo.

Ardiiɓe jokkondirɓe¶

• Ñaamde mborosaaji ladde (Amatoxin) e ñaamde leɗɗe tooke
• Status Epilepsi, ɓuuɓri juutndi, e leɗɗe hisnude
• CPR : Wuurtinde ɓernde e ƴiiƴam e nder njuɓɓudi
• Tooke nguura, Gastroenteritis ɓuuɓɗo, e ŋakkeende ndiyam
• Tookeeji kuuɓtodinɗi Ballal gadanal e Dekontaminaasiyoŋ

Fuɗɗoode e ardorde laawɗunde¶

• Amerik Nokkuuji toppitiiɗi ko fayti e ñawuuji (CDC): Ciimtol yontere ko faati e ñawuuji e maayde (MMWR): Tookeeji ƴiiƴam ndiyam (Cicuta maculata), ƴiiƴam tooke (Conium maculatum), e tooke ƴiiƴam fenaande (Veratrum viride) jokkondirɗi e ñaamde (Dowlaaji Dentuɗi Amerik).
• Duɗal fedde Almaañ ngam ƴeewde baasal (BfR) & nokku humpito tookeeji Suisse (Tox Info Suisse): Jeertinaango ñamlooɓe e ardorde safaara ngam jiiɓrude laay ladde (Allium ursinum) e laay ladde (Colchicum autumnale) e album daneejo (EVerat).
• Serwis toppitiiɗo humpito tookeeji leydi Angalteer (NPIS) / TOXBASE: Njuɓɓudi safaara mboros oo (Kolkisiin), Oenanthe crocata (Toɓɓere ndiyam Hemlock), e mboros Conium maculatum (Dental Dowlaaji Amerik).
• Finkelstein Y, Aks SE, Hutson JR, Juurlink DN, e woɗɓe: Tooke kolkisiin : bannge niɓɓo lekki ɓooyki (Tookeeji kilinik).
• Schep LJ, Slaughter RJ, Becket G, Beasley DM: Tooke ɗe ƴiiƴam ndiyam (mbaydi Cicuta) e ƴiiƴam tooke (Conium maculatum) (Tookeeji kilinik / Nokku tookeeji ngenndiiji Nuwel Selannde).