Psilocybin toxicity: Difference between revisions
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
* [[Hypoglycemia]] | * [[Hypoglycemia]] | ||
* | * [[TBI]] | ||
* [[CO poisoning]] | * [[CO poisoning]] | ||
* [[Meningitis]]/[[Encephalitis]] | * [[Meningitis]]/[[Encephalitis]] | ||
* [[Opioid intoxication]] | * [[Opioid intoxication]] | ||
* [[Antihistamines]]/[[Anticholinergic toxicity]] | * [[Antihistamines]]/[[Anticholinergic toxicity]] | ||
{{Drugs of abuse types}} | |||
==Evaluation== | ==Evaluation== | ||
Revision as of 14:30, 3 December 2016
Background
A compound found in over 200 mushrooms that has mind altering properties similar to LSD. Commonly known as "magic mushrooms" or "shrooms". The mushroom are often taken recreationally for the euphoric and hallucinogenic effects. Typically grown in the Pacific Northwest and southern regions of the United States. For a typical dose (1mg) symptoms will last 1-3 hours.
Toxicity
- Low
- 280mg/kg
- Therapeutic index of 641
Clinical Features
- Euphoria
- Visual hallucinations
- Lethargy
- Depression
- Synesthesia
Physical Effects
- Pupil Dilation
- Tachycardia
- Hypertension
- Hypotension
- Nausea
Adverse Effects
- Anxiety
- Confusion
- Disorientation
- Agitation
- Accidents
Differential Diagnosis
- Hypoglycemia
- TBI
- CO poisoning
- Meningitis/Encephalitis
- Opioid intoxication
- Antihistamines/Anticholinergic toxicity
Drugs of abuse
- 25C-NBOMe
- Alcohol
- Amphetamines
- Bath salts
- Cocaine
- Ecstasy
- Gamma hydroxybutyrate (GHB)
- Heroin
- Inhalant abuse
- Hydrocarbon toxicity
- Difluoroethane (electronics duster)
- Marijuana
- Kratom
- Phencyclidine (PCP)
- Psilocybin ("magic mushrooms")
- Synthetic cannabinoids
- Chloral hydrate
- Body packing
Evaluation
- Clinical Diagnosis
- Urine toxin screen if concerned about co-ingestion
Management
- Supportive Care
- Place patient in a calm and quiet environment
- Monitor Vitals
- If worsening vitals or agitation treat with Benzodiazepines
- Can be discharged if symptoms abate and vitals normalize
Disposition
- Discharge when clinically sober
See Also
References
- Nichols DE. Hallucinogens. Pharmacol Ther 2004; 101:131.
- UpToDate
- van Amsterdam J, Opperhuizen A, van den Brink W (2011). "Harm potential of magic mushroom use: a review" (PDF). Regulatory Toxicology and Pharmacology. 59 (3): 423–9. doi:10.1016/j.yrtph.2011.01.006. PMID 21256914.
- Merck Index, 11th Edition, 7942
- "Comparison of acute lethal toxicity of commonly abused psychoactive substances" (PDF). Addiction. 99 (6): 686–96. doi:10.1111/j.1360-0443.2004.00744.x. PMID 15139867.
- Passie T, Seifert J, Schneider U, Emrich HM (2002). "The pharmacology of psilocybin". Addiction Biology. 7 (4): 357–64. doi:10.1080/1355621021000005937. PMID 14578010.
- "Comparison of acute lethal toxicity of commonly abused psychoactive substances" (PDF). Addiction. 99 (6): 686–96. doi:10.1111/j.1360-0443.2004.00744.x. PMID 15139867.
- Halpern JH1. "Hallucinogens and dissociative agents naturally growing in the United States." Pharmacol Ther. 2004 May;102(2):131-8.