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Anticholinergic Plants

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Critical Care Toxicology

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Exposure to plants with anticholinergic properties can result in emergency department and intensive care unit (ICU) admissions due to hallucinations, delirium, agitation, seizures, hyperthermia, and rhabdomyolysis among other clinical manifestations of toxicity [1–3]. Alkaloid-containing plants of the Solanaceae (nightshade) family, especially Datura spp., have been used since antiquity as analgesics, hypnotics, aphrodisiacs, hallucinogens, and as herbal remedies. Homer likely referred to Datura in the Odyssey [4]. Dioscorides, in De Materia Medica, described dose-dependent Datura toxicity [5]. Cleopatra lured Caesar with this plant and Marc Antony’s troops suffered confusion and fatalities after eating the plant when retreating from Parthia in 38 AD. An outbreak of Datura poisoning occurred in colonial Virginia in 1676, during Bacon’s Rebellion [3]. In his work, The History and Present State of Virginia,Robert Beverly described behaviors consistent with anticholinergic delirium...

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Authors and Affiliations

  1. Department of Emergency Medicine, The University of Arizona, Tucson, AZ, USA

    Robert N. E. French & Frank G. Walter

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  1. Robert N. E. French
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Editors and Affiliations

  1. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Jeffrey Brent

  2. Office of New Drugs Drug Evaluation and Research, FDA, Silver Spring, Maryland, USA

    Keith Burkhart

  3. Clinical Toxicology, St Thomas' Hospital, London, United Kingdom

    Paul Dargan

  4. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Benjamin Hatten

  5. Med & Toxicological Intensive Care Unit, Lariboisière Hospital Paris-Diderot University, Paris, France

    Bruno Megarbane

  6. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Robert Palmer

Grading System for Levels of Evidence Supporting Recommendations in Critical Care Toxicology, 2nd Edition

Grading System for Levels of Evidence Supporting Recommendations in Critical Care Toxicology, 2nd Edition

  1. I

    Evidence obtained from at least one properly randomized controlled trial.

  2. II-1

    Evidence obtained from well-designed controlled trials without randomization.

  3. II-2

    Evidence obtained from well-designed cohort or case–control analytic studies, preferably from more than one center or research group.

  4. II-3

    Evidence obtained from multiple time series with or without the intervention. Dramatic results in uncontrolled experiments (such as the results of the introduction of penicillin treatment in the 1940s) could also be regarded as this type of evidence.

  5. III

    Opinions of respected authorities, based on clinical experience, descriptive studies and case reports, or reports of expert committees.

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French, R.N.E., Walter, F.G. (2017). Anticholinergic Plants. In: Brent, J., Burkhart, K., Dargan, P., Hatten, B., Megarbane, B., Palmer, R. (eds) Critical Care Toxicology. Springer, Cham. https://doi.org/10.1007/978-3-319-20790-2_111-2

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    Anticholinergic Plants
    Published:
    03 April 2017

    DOI: https://doi.org/10.1007/978-3-319-20790-2_111-2

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    Anticholinergic Plants
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    29 August 2016

    DOI: https://doi.org/10.1007/978-3-319-20790-2_111-1

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