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Ricin Toxicity by ingestion, injection or

inhalation. However, its oral absorption is


poor, and most oral poisonings cause
gastroenteritis

Inhibits protein synthesis,


and cause cell necrosis, Not contagious, no need to
preventing healing of isolate victims, use DR
damaged mucosa of vital ABCDE approach by ISTOLS
organs

Anaphylaxis in sensitised
Mild toxicity Moderate toxicity Severe toxicity
individuals

Even a single seed Nausea, Vomiting, Abdominal pain, Persistant Hemorrhagic Pulmonary Intramuscular
Hemorrhagic gastritis CNS depression Hypovolemic shock Delayed Hepatotoxicity Renal Failure administration
ingestion can be lethal Diarrhoea vomiting, Dehydration, edema
Elevated liver enzymes,
Malena

ARDS Suicide transport: Hypotension & multiorgan Due to (hemolysis)


Ricin can cause Glycogen stores deplete produces severe local
destruction of neurons by failure due to necrosis of presents as microscopic
anaphylactic shock & Antiemetics & IV fluids Vitamin K 5-10mg IV resulting in recurrent necrosis with extension
IV fluids, monitoring for retrograde transport of the liver, spleen, and hematuria, cylinduria with
death hypoglycemia into the lymphatics
hypoglycemia, hemolysis & ricin from PNS to CNS kidney elevated creatinine
complications of
hypovolemia Rx- Ventilation with low
PEEP
Gastric decontamination If ECG is not showing signs Alkalinastion of urine by
High flow oxygen, If GCS is <8, Intubate & Replace IV fluids & Blood Rx- Dextrose Normal Saline NaHCO3 infusion 1mEq/kg Systemically causes severe
by stomach wash within of cardiac ischemia,
intravenous fluids Ricin has a special binding ventilate transfusion IV infusion probably has a role in Comatose status & death
one hour of ingestion Terlipressin IV 1mg slowly
protein that enables it to preventing crystallisation
gain access to the of hemoglobin
Inhalation of aerosolized
endoplasmic reticulum in ricin results in increased
GI mucosal cells, where it alveolar-capillary
inhibits cellular protein N Acetyl Cysteine
Epinephrine 0.1mg Activated Charcoal 50g UGI Endoscopy to stop the permeability and airway Despite the obvious
synthesis and causes Delayed CNS toxicity 150mg/kg IV to prevent
(1:1000) Subcutaneously orally bleeders necrosis following a latent toxicity of ricin, death
severe diarrhea Hepatic failure
phase of 4 to 8 hours probably can be prevented Dialysis may help
by early and aggressive
fluid and electrolyte
replacement after oral
ingestion (but not injection
Prophylactic immunization Can Potentially cause toxic involve cranial nerves-
No specific antidote to PRBC, Platelets, Clotting or inhalation)
with ricin toxoid and disaster of mass casualty optic nerve damage
neutralise or counteract factor concentrates (Fresh in multiple victims by its
passive postexposure causing blindness,
toxicity, at present frozen Plasma) aerosol spray
treatment with antiricin Hypoglossal & vagus nerve
antibody have been
reported in animals

Citation: Pillay, VV. Comprehensive Medical Toxicology. 3rd. Ed. Paras Medical Publishers. 2018. Poisonous Plants. p940-43.

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