Identify the toxin below:
Coniine. Coniine is the most potent of eight nicotinic alkaloids found in poison hemlock (Conium maculatum). According to the cited reference, “These alkaloids are selective nicotinic-type acetylcholine receptor (nAChRs) agonists that have effects on both autonomic and skeletal muscles. Initial symptoms include nausea, vomiting, salivation, bronchorrhea, tachycardia, hypertension, agitation, confusion, and muscle fasciculations. With a higher dose, the alkaloids can cause a delayed phase of toxicity characterized by a paradoxical blockage of the nicotinic receptors. This results in bradycardia, hypotension, muscle paralysis, lethargy, and respiratory muscle paralysis.”
Li K, Bassett H, Fitch B, Lynch K. Mistaken identity: acute respiratory arrest from accidental ingestion of poison hemlock. Clin Toxicol (Phila). 2022 May;60(5):659-661. doi: 10.1080/15563650.2021.2002354. Epub 2021 Nov 17. PMID: 34787039.; Figure from: Yeung KA, Chai PR, Russell BL, Erickson TB. Avian Toxins and Poisoning Mechanisms. J Med Toxicol. 2022 Oct;18(4):321-333. doi: 10.1007/s13181-022-00891-6. Epub 2022 Apr 26. PMID: 35474563; PMCID: PMC9492810.