Plant Poisoning

ByGerald F. O’Malley, DO, Grand Strand Regional Medical Center;
Rika O’Malley, MD, Grand Strand Medical Center
Reviewed/Revised Jun 2022
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    A few commonly grown plants are highly poisonous, and many plants are moderately poisonous (see table Moderately Poisonous Plants). Few plant poisonings have specific antidotes. Most plant ingestions, including the plants listed in the aforementioned table, result in minimal symptoms unless the leaves and other components are concentrated into a paste or brewed into a tea.

    Highly toxic and potentially fatal plants include the following:

    • Castor beans and jequirity beans

    • Oleander and foxglove

    • Hemlock

    (See also General Principles of Poisoning.)

    Castor beans and jequirity beans

    Castor beans contain ricin, an extremely concentrated cellular poison. Jequirity beans contain abrin, a related and even more potent toxin. In both, the beans have a relatively impervious shell; thus, the bean must be chewed to release the toxin. However, the seed coating of the jequirity bean is often not intact, and simple bacterial digestion can release the abrin toxin.

    Symptoms of either poisoning may include delayed gastroenteritis, sometimes severe and hemorrhagic, followed by delirium, seizures, coma, and death. Whole-bowel irrigation should be considered because it aims to remove all beans ingested.

    Oleander and foxglove

    Potassium levels are closely monitored. Hyperkalemia may respond only to hemodialysis. Calcium is not recommended for arrhythmias

    Hemlock

    Hemlock poisoning (poison hemlock and water hemlock) can cause symptoms within 15 minutes.

    Poison hemlock has effects on the nicotinic cholinergic receptor, beginning with dry mouth and progressing to tachycardia, tremors, diaphoresis, mydriasis, seizures, and muscle paresis. Rhabdomyolysis and bradycardia may occur.

    Water hemlock seems to enhance gamma-aminobutyric acid (GABA) activity. Symptoms may include gastroenteritis, delirium, refractory seizures, and coma.

    Table
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