Lectures on Toad Venom Poisoning

2021-08-07 02:51 PM

Psychiatric and neurological signs: bufotenin can cause hallucinations, delusions, personality disorders. Higher doses can inhibit the respiratory center causing apnea

Toad meat provides a good amount of protein that can be eaten, traditional medicine doctors often recommend, but parts such as skin, subcutaneous, eggs, liver, intestines of toads are very toxic because it contains venom (bufotoxin) consisting of many substances. very strong toxins: bufotalin, bufotenin, bufotenin, and some other organic compounds, have the effect of causing severe arrhythmia, hypertension, cardiac arrest, and respiratory depression leading to rapid death.

Diagnose

Clinical

Symptoms appear 30 minutes - 2 hours after eating.

Digestive disorders: abdominal pain, nausea, vomiting.

Cardiovascular disorders: initially high blood pressure, tachycardia, possibly due to bufotenin. Then, disturbances in ventricular extrasystolic excitability, ventricular tachycardia, ventricular flutter, ventricular fibrillation. Sometimes atrioventricular block, nodal rhythm, leads to heart failure. Arrhythmias may be caused by bufotalin.

Psychiatric and neurological signs: bufotenine can cause hallucinations, delusions, personality disorders. Higher doses can inhibit the respiratory center causing apnea.

Causes kidney damage, anuria, acute tubular inflammation.

Subclinical

Bufotoxin venom acts like digoxin and digitoxin.

ECG:

Monitoring should be monitored: ventricular tachycardia, 1st, and 2nd degree AV block, bradycardia, long PR interval, and short QTc, signs of toxicity similar to digoxin or digitoxin.

Electrolyte:

Potassium increases acute poisoning in large doses.

Increased calcium and decreased magnesium can be seen in the presence of cardiac arrhythmias.

Test liver and kidney function.

The cause of the illness

The poison bufogenin or bufotoxin and other poisons have cardiac glycoside-like activity. These toxins are concentrated in the skin, eggs, liver, intestines of toads, while fresh toad meat does not have this substance, but when processing, making toad meat is often mixed with toxins into poisonous meat, the habit of eating toad meat is the main cause of poisoning, especially in children, can easily lead to death.

Treatment

Gastric lavage if eating toad meat in the first 2 hours.

Drink activated charcoal 1-2g/kg after gastric lavage, or if there is no indication for gastric lavage, still drink activated charcoal, add sorbitol at a dose of 1g/kg to eliminate toxins, activated charcoal through feces.

Place an intravenous line.

If hypokalemia is present, potassium should be replaced by intravenous or oral therapy.

Ventricular arrhythmias: Xylocaine 1mg/kg IV, then maintain 2-4mg/min.

Bradycardia: Atropine 0.5 - 1mg IV, can be repeated after 5 minutes. If not resolved, a pacemaker should be indicated.

Artificial kidneys are not effective against toad venom.

The antidote Digibind (a specific anti-digoxin antibody) is indicated for use in critically ill patients with cardiac arrhythmias and hyperkalemia. Digibind enters the blood rapidly binds to toxins in the form of digoxin, digitoxin, and other glycosides, inactivating this complex and is excreted in the urine.