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A teen living in a state where abortion is newly outlawed ingests something that she has read online is an abortifacient. She presents to the ED with nausea, vomiting, and abdominal pain. Her AST and ALT are elevated, and her acetaminophen level is zero.
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January 8, 2023 at 2:20 pm
A) Pennyroyal
Post Dobbs, online and social media posts purporting to describe herbs that can be used as abortifacients increased. Pennyroyal causes toxicity similar to acetaminophen. Blue cohosh contains glycosides as well as an alkaloid that acts similar to nicotine. Mugwort contains the same chemical used to make absinthe, and can cause hallucinations. Quinine causes “cinchonism” – nausea, diarrhea, headache, dizziness, tinnitus / hearing loss, visual disturbances. Amanita phalloides causes hepatotoxicity, but is not used as an abortifacient. Source: https://journals.lww.com/em-news/fulltext/2022/09000/toxicology_rounds__look_out_for_poisonings_from.5.aspx