What is the proposed mechanism of action for penicillin G in cyclopeptide mushroom poisoning?
Prevention of a-Amanitin uptake into hepatocytes via organic anion-transporter polypeptide 1B3 (OATP1B3) inhibition. The suggested dose of 1 MU/kg/day is at least 2-3 times higher than doses typically used for antibiosis. Consistent benefit is not demonstrated and it is not routinely recommended.
Ye Y. Management of Amanita phalloides poisoning: A literature review and update. J Crit Care. 2018;46:17-22. doi: 10.1016/j.jcrc.2018.03.028.
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