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jimson weed seed dosage

In the early 1830s, the first of Datura’s active alkaloids, atropine, was isolated. Not long after, scopolamine, another Datura alkaloid, was also isolated. This latter compound had another very specific medical application: eliminating the trauma of childbirth—or at least the memory of it. The treatment was known as Dämmerschlaf (“twilight sleep”) and involved repeated injections of scopolamine and morphine during labor to produce an amnesic effect. Although women still screamed in agony at the time, they didn’t remember it afterward. [57]

[51] Fremantle, F. (1971). A Critical Study of the Guhyasamaja Tantra (Unpublished doctoral dissertation). University of London, UK.

Therapeutic Use

[24] World Health Organization. (2015) 19th WHO Model List of Essential Medicines.

This commonly held assumption is highly suspect. [63] [64] After all, the effectiveness of smoking remedies like Asthmador cigarettes relied on these alkaloids surviving heat. [56] The plant has also long been smoked or burned in traditional ritual contexts for its deliriant and hallucinogenic effects. [2] . It’s safe to assume, based on the historical context of smoking Datura, that burning it does not destroy the tropane alkaloids.

[49] Parker, R. C., “Lux”. (2008). Psychoactive Plants in Tantric Buddhism: Cannabis and Datura Use in Indo-Tibetan Esoteric Buddhism. Erowid Extracts, 14, 6-11.

Stomach and intestinal infections: Jimson weed might slow down the emptying of the stomach and intestines. As a result, “bad” bacteria and the toxins they produce could remain in the digestive tract longer than usual. This could make infections caused by these bacteria worse.

Thompson, H. S. Cornpicker’s pupil: Jimson weed mydriasis. J Iowa Med.Soc. 1971;61(8):475-477. View abstract.

Uses & Effectiveness ?

No one should take jimson weed, but certain people are especially at risk for toxic side effects. These side effects are especially dangerous if you have any of the following conditions:

Steenkamp, P. A., Harding, N. M., van Heerden, F. R., and van Wyk, B. E. Fatal Datura poisoning: identification of atropine and scopolamine by high performance liquid chromatography/photodiode array/mass spectrometry. Forensic Sci.Int 10-4-2004;145(1):31-39. View abstract.

Hassell LH, MacMillan MW. Acute anticholinergic syndrome following ingestion of Angel’s trumpet tea. Hawaii Med J 1995;54:669-70.

Patients with anticholinergic poisoning should be observed by using a cardiac monitor because of the risk for tachyarrhythmia from inhibition of vagal effect on the sinoatrial node.9 Propanolol may be used for treating symptomatic tachyarrhythmia; the dosage for adults is 1 mg given intravenously for one minute and repeated every five minutes (maximum dose, 5 mg); the dosage for children is 0.01 to 0.1 mg/kg, (maximum dose, 1 mg).3

In the ED, the patient was restless, pacing incessantly, and shaking. He was awake, alert, and oriented to name but not to place or time. Vital signs included oral temperature 99.3°F (37.4°C), blood pressure 117/72 mmHg, heart rate 103 beats/min, and respiratory rate 24 breaths/min. Pupils were dilated to 8 mm, symmetric, and minimally reactive to light. Mucous membranes were dry, and bowel sounds were decreased. The extremities were warm to the touch but were not hot. Neurologic examination showed that the patient was confused and mumbling, cranial nerves were intact, and both motor strength and reflexes were within normal limits. During the examination, the patient reached into the air as if trying to catch a nonexistent object.

In severe cases in which patients have symptoms of anticholinergic crisis (eg, dysrhythmia, coma, seizures, clinically significant hypertension, or poorly controlled hyperpyrexia), the use of physostigmine is warranted.5 Physostigmine is an acetylcholinesterase inhibitor and can therefore reverse the peripheral and central manifestations of anticholinergic excess.11 The initial dose of physostigmine is 0.5 to 2 mg in adults or 0.02 mg/kg in children, to whom the drug is given slowly by intravenous route. The maximum dose in adults should not exceed 4 mg in 30 minutes. 3 Clinicians must remember that use of physostigmine carries risks and that excess acetylcholine may induce a cholinergic crisis, symptoms of which include bradycardia, complete atrioventricular block, asystole, emesis, bronchorrhea, and seizures.5 If overcorrection is suspected (eg, as manifested by cholinergic symptoms), 0.5 mg of atropine may be given intravenously for every 1 mg of physostigmine given.9

Discussion

Jimson weed reaches a height of five feet and consists of large, jagged leaves and trumpet-shaped flowers, that may be white or purple. At maturity, the plant bears green fruit, each containing four compartments and holding as many as 100 seeds.1,5 Although all parts of the plant are poisonous, the leaves and seeds contain the highest concentration of atropine, hyoscyamine, and scopolamine. 6 One hundred seeds contain approximately 6 mg of atropine.2,5 A dose of atropine exceeding 10 mg is regarded as potentially lethal.2

A toxicology screen is useful to rule out concomitant use of other drugs. Most documented lethal cases of jimson weed ingestion occur in persons with polysubstance abuse, including use of jimson weed combined with alcohol, marijuana, or cocaine.7 Drug screens usually do not detect pure anticholinergic poisons, and other laboratory tests are usually not helpful for identifying jimson weed as the cause of symptoms.3

The mother of a 15-year-old boy brought him to the emergency department (ED) because of his bizarre behavior, including hallucinating. The mother had been advised by a neighbor that several neighborhood youths had been taken to nearby hospitals after ingesting wild flowers and then hallucinating. The patient’s mother had entered the patient’s room and found him shaking, mumbling, and trying to pick at nonexistent items. She noted several white flowers in his room and brought them to the ED.

Routine use of physostigmine to treat jimson weed intoxication remains controversial. Closely monitored use of physostigmine in very small doses to prevent cholinergic excess may be safe: When used to treat a series of 23 patients with hallucinations from jimson weed intoxication, physostigmine had no adverse effects.11 Physostigmine can quickly reverse signs and symptoms of central and peripheral nervous system dysfunction and can assist diagnosis of anticholinergic excess.12 However, most cases of jimson weed poisoning have a benign outcome after treatment with only supportive care and observation; use of physostigmine is therefore not routine and should be reserved for patients who have clinically significant symptoms or complications.