Question:
A child accidentally ingested some fruit which he plucked from a tree while playing. After the ingestion of the fruit, he presented with restlessness, painful swallowing, photophobia, dry skin, urinary retention and elevated body temperature. What is the possible poisoning and the appropriate antidote for it?
A child accidentally ingested some fruit which he plucked from a tree while playing. After the ingestion of the fruit, he presented with restlessness, painful swallowing, photophobia, dry skin, urinary retention and elevated body temperature. What is the possible poisoning and the appropriate antidote for it?
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Dry skin, urinary retention, and photophobia point to an anticholinergic toxidrome -- identify the plant and the antidote that crosses the blood-brain barrier.
Updated On: Jun 23, 2026
- Datura & Physostigmine
- Yellow oleander & Physostigmine
- Datura & Pralidoxime
- Yellow oleander & Pralidoxime
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The Correct Option is A
Solution and Explanation
Step 1: Identify the toxidrome. The child presents with restlessness, painful swallowing, photophobia, dry skin, urinary retention and hyperthermia -- this is a classic anticholinergic (atropine-like) toxidrome: dry skin, mydriasis (photophobia), urinary retention, hyperthermia, and CNS excitation.
Step 2: Identify the plant. Datura (thorn apple, Dhatura) contains tropane alkaloids (atropine, scopolamine, hyoscyamine) and produces the anticholinergic syndrome described. Yellow oleander poisoning causes cardiac glycoside toxicity (bradycardia, heart block), not this picture.
Step 3: Identify the antidote. Physostigmine is a tertiary amine cholinesterase inhibitor that crosses the blood-brain barrier (BBB) and reverses both central and peripheral anticholinergic effects. Neostigmine is a quaternary amine and does NOT cross the BBB, so it is inadequate. Pralidoxime is used for organophosphate poisoning (reactivates acetylcholinesterase), not Datura.
Step 4: Conclusion. Datura poisoning treated with Physostigmine.
Step 2: Identify the plant. Datura (thorn apple, Dhatura) contains tropane alkaloids (atropine, scopolamine, hyoscyamine) and produces the anticholinergic syndrome described. Yellow oleander poisoning causes cardiac glycoside toxicity (bradycardia, heart block), not this picture.
Step 3: Identify the antidote. Physostigmine is a tertiary amine cholinesterase inhibitor that crosses the blood-brain barrier (BBB) and reverses both central and peripheral anticholinergic effects. Neostigmine is a quaternary amine and does NOT cross the BBB, so it is inadequate. Pralidoxime is used for organophosphate poisoning (reactivates acetylcholinesterase), not Datura.
Step 4: Conclusion. Datura poisoning treated with Physostigmine.
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