An 11-year-old boy was brought to the ER by some of his friends because he "staed going crazy" after eating seeds from a plant while "trying to get high." The boy was incoherent; his skin was hot and dry. His pupils were dilated and unresponsive to light. Blood pressure was 180/105 mm Hg, pulse 150/min, and rectal temp 40 C (104 F). The presumptive diagnosis was drug toxicity due to the ingestion of wof

Belladonna poisoning:- Occurs due to drug overdose or consumption of seeds and berries of belladonna/datura plant. Children are highly susceptible. Manifestations:- are due to exaggerated pharmacological actions. Dry mouth, difficulty in swallowing and talking. Dry, flushed and hot skin (especially over face and neck), fever, difficulty in micturition, decreased bowel sounds. A scarlet rash may appear. Dilated pupil, photophobia, blurring of near vision, palpitation. Excitement, psychotic behaviour, ataxia, delirium, dreadful visual hallucinations. Hypotension, weak and rapid pulse, cardiovascular collapse with respiratory depression. Convulsions and coma occur only in severe poisoning. Treatment:- If poison has been ingested, gastric lavage should be done with tannic acid (KMnO4 is ineffective in oxidizing atropine). The patient should be kept in a dark quiet room. Cold sponging or ice bags are applied to reduce body temperature. Physostigmine 1-3 mg s.c. or i.v. antagonises both central and peripheral effects. Ref:- kd tripathi; pg num:-120