Absinthe toxicity: Difference between revisions
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==Background== | ==Background== | ||
* | *Bitter, green liqueur derived from Wormwood tree extract | ||
* | *Active ingredient: thujone, which antagonizes GABA-A receptors (now thujone concentrations are thought to be too small to pose any danger to patient) | ||
* | *Illegal in most countries | ||
[[File:Absinthe.jpg|thumb|]] | |||
==Clinical Features== | ==Clinical Features== | ||
* | *Euphoria | ||
*[[delirium]] | *Confusion, [[delirium]] | ||
* | *Auditory and visual [[hallucinations]] | ||
*Can cause generalized tonic-clonic [[seizures]] | |||
* | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Hallucinogen types}} | |||
{{Sedative/hypnotic toxicity types}} | |||
==Evaluation== | ==Evaluation== | ||
*Typically a clinical diagnosis, based on history | |||
*Evaluate for other causes of symptoms and co-ingestions | |||
==Management== | ==Management== | ||
*Supportive | *Supportive care | ||
==Disposition== | ==Disposition== | ||
*Discharge when clinically sober | |||
==See Also== | ==See Also== | ||
*[[Toxic alcohols]] | |||
==External Links== | ==External Links== | ||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:Toxicology]] | |||
Latest revision as of 19:54, 17 November 2021
Background
- Bitter, green liqueur derived from Wormwood tree extract
- Active ingredient: thujone, which antagonizes GABA-A receptors (now thujone concentrations are thought to be too small to pose any danger to patient)
- Illegal in most countries
Clinical Features
- Euphoria
- Confusion, delirium
- Auditory and visual hallucinations
- Can cause generalized tonic-clonic seizures
Differential Diagnosis
Hallucinations
Serotonin-Like Agents
- Lysergic acid diethylamide (LSD)
- Psilocybin ("magic mushrooms")
- N,N-Dimethyltryptamine (DMT)
- 5-methoxy- dimethyltryptamine (5-MeO-DMT)
- 25C-NBOMe
Enactogens
- Designer amphetamines
- Bath salts
- Ecstasy (MDMA)
- Mescaline (peyote)
- Synthetic cannabinoids
Dissociative Agents
- Phencyclidine (PCP)
- Ketamine
- Dextromethorphan
- Nitrous oxide
Plant-based Hallucinogenics
- Marijuana
- Salvia
- Absinthe
- Isoxazole Mushrooms
- Hawaiian baby woodrose (Argyreia nervosa)
- Hawaiian woodrose (Merremia tuberosa)
- Morning glory (Ipomoea violacea)
- Olili- uqui (Rivea corymbosa)
Organic causes
- Delirium
- Intracranial mass to occipital or temporal lobes
- Encephalitis, limbic encephalitis, anti-NMDA receptor encephalitis
- Migraine
- Seizure
- Hypocalcemia/Hypercalcemia
- Rift valley fever
- Rabies
- Syphilis
- Vitamin B7 deficiency
- Pellagra
- Dementia
Other Toxicologic Causes
- Alcohol withdrawal
- Anticholinergic Toxicity
- Tricyclic (TCA) Toxicity
- Synthetic cannabinoids
- Inhalant abuse
- Nitrogen narcosis
- GHB withdrawal
- Hydrocarbon toxicity
- Heavy metal toxicity
- Multiple medications: montelukast, doxapram, hyoscyamine, tizanidine, peramivir, amantadine, rimantadine, bromocriptine, methylergonovine, benztropine, doxepin, voriconazole, acyclovir, valacyclovir, ganciclovir, cimetidine, penicillin G Procaine, clarithromycin, metoclopramide
- Inhalant abuse
Psychiatric Causes [1]
- Schizophrenia, schizoaffective disorder, schizophreniform disorder
- Depression with psychotic features
- Bipolar disorder
- Charles Bonnet Syndrome (in the visually impaired)
Template:Sedative/hypnotic toxicity types
Evaluation
- Typically a clinical diagnosis, based on history
- Evaluate for other causes of symptoms and co-ingestions
Management
- Supportive care
Disposition
- Discharge when clinically sober
See Also
External Links
References
- ↑ Visual Hallucinations: Differential Diagnosis and Treatment. PMID PMC2660156