What are the symptoms and treatment of Nicotiana glauca (tree tobacco) poisoning?

From the Guidelines

Tree tobacco poisoning requires immediate medical attention, and treatment should focus on supportive care, including removal from exposure, administration of activated charcoal, IV fluids, and respiratory support, as well as hospitalization for monitoring, especially in children or those with severe symptoms. The symptoms of tree tobacco poisoning include nausea, vomiting, dizziness, confusion, muscle weakness, difficulty breathing, low blood pressure, and in severe cases, paralysis and respiratory failure 1. These symptoms occur because the plant contains anabasine and nicotine alkaloids that disrupt normal nerve function by binding to nicotinic acetylcholine receptors, causing both stimulation and subsequent depression of the nervous system.

Some key points to consider in the treatment of tree tobacco poisoning include:

• Removing the person from exposure and calling poison control (1-800-222-1222) immediately
• Administering activated charcoal if ingestion was recent
• Providing IV fluids to maintain blood pressure
• Offering respiratory support if needed
• Considering atropine (0.5-1mg IV for adults) to counteract specific toxic effects
• Hospitalization for monitoring, especially for children or those with severe symptoms

According to the most recent guidelines, treatment of poisoning, including tree tobacco poisoning, should prioritize timely and effective supportive care, including airway management, hemodynamic support, and correction of critical vital sign and metabolic derangements 1. Prevention is also crucial, and individuals should keep the plant away from children and pets, wear gloves when handling it, and never consume any part of it.

From the Research

Tree Tobacco Symptoms

• The provided studies do not directly address tree tobacco symptoms, however, they discuss the effects of tobacco and nicotine use in general 2, 3.
• Tobacco smoking is a major determinant of preventable morbidity and mortality worldwide, and it can cause a range of health problems, including addiction, respiratory diseases, and cardiovascular diseases 2, 3.

Treatment of Tree Tobacco Intoxication

• There is no direct evidence on the treatment of tree tobacco intoxication in the provided studies.
• However, the studies discuss the use of activated charcoal in the treatment of intoxications, including those caused by substances that may be similar to tree tobacco 4, 5, 6.
• Activated charcoal can be effective in reducing the absorption of toxins and enhancing their elimination from the body 4, 5, 6.
• The administration of activated charcoal is indicated to treat moderately severe to life-threatening intoxication, and it should be carried out as soon as possible, within the first hour of the ingestion 4.

Activated Charcoal Dosage and Administration

• The proper dosage of activated charcoal consists of an amount that is 10 to 40 times as much as that of the intoxicating substance, or else 0.5-1 g/kg body weight in children or 50 g in adults 4.
• Repeated application of activated charcoal is indicated for intoxications with agents that persist for a longer time in the stomach and for intoxications with timed-release drugs or drugs with a marked enterohepatic or entero-enteric circulation 4.
• The routine combination of activated charcoal with a laxative is not recommended 4.