Question:medium
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
Show Solution
The Correct Option is A
Solution and Explanation
Pattern recognition approach:
Symptoms: restlessness, painful swallowing, photophobia, dry skin, urinary retention, hyperthermia.
Mnemonic for anticholinergic toxidrome: Hot as a hare, dry as a bone, red as a beet, blind as a bat, mad as a hatter.
$\text{Datura stramonium}$ (thorn apple) contains $\text{atropine, scopolamine, hyoscyamine}$ -- all muscarinic antagonists -- producing this classic picture.
$\text{Yellow oleander}$ contains cardiac glycosides (thevetin A, B) -- causes bradycardia, heart block, not this picture.
Antidote selection:
- Physostigmine = tertiary amine; crosses BBB; reverses central + peripheral anticholinergic effects -- CORRECT.
- Neostigmine = quaternary amine; does NOT cross BBB.
- Pralidoxime = organophosphate antidote (acetylcholinesterase reactivator); not relevant here.
\[\boxed{\text{Datura and Physostigmine}}\]
Symptoms: restlessness, painful swallowing, photophobia, dry skin, urinary retention, hyperthermia.
Mnemonic for anticholinergic toxidrome: Hot as a hare, dry as a bone, red as a beet, blind as a bat, mad as a hatter.
$\text{Datura stramonium}$ (thorn apple) contains $\text{atropine, scopolamine, hyoscyamine}$ -- all muscarinic antagonists -- producing this classic picture.
$\text{Yellow oleander}$ contains cardiac glycosides (thevetin A, B) -- causes bradycardia, heart block, not this picture.
Antidote selection:
- Physostigmine = tertiary amine; crosses BBB; reverses central + peripheral anticholinergic effects -- CORRECT.
- Neostigmine = quaternary amine; does NOT cross BBB.
- Pralidoxime = organophosphate antidote (acetylcholinesterase reactivator); not relevant here.
\[\boxed{\text{Datura and Physostigmine}}\]
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