Identifying Mushroom Poisoning- A Case Study of Amanita Muscaria and Muscarine Toxicity
From the information in the table, it is clear that the parasympathetic part of the ANS dominates in the given cases. This conclusion has been reached based on a number of signs, including miosis (narrowing of the pupil), bronchorrhea (excessive bronchial secretions), and bradycardia (slowing down of heart rate). Miosis is produced by the contraction of the sphincter pupillae muscle through the sympathetic nervous system, while bronchorrhea and bradycardia are both symptoms that follow an increased parasympathetic activity (Schumann et al., 2020). The presence of these symptoms altogether indicates the increased parasympathetic tone.
Muscarine, which is an ANS neurotoxin, binds to muscarinic acetylcholine receptors. These receptors naturally react to acetylcholine, which is the main neurotransmitter of the parasympathetic nervous system (Kudlak & Tadi, 2020). Through binding to the same receptors, muscarine behaves just like acetylcholine, resulting in the overstimulation of the parasympathetic system and the consequent emergence of symptoms.
Beginning with the presentation of sweating in three of the four patients, the occurrence would appear to be confusing because muscle is known to produce sweat. However, there is no doubt that the raised parasympathetic activity triggers sweating, as the parasympathetic nervous system innervates sweat glands (Wohlrab et al., 2023). Hence, the excessive sweating results from the increased parasympatheticity caused by muscarine intake.
The treatment for muscarine poisoning is administration of atropine, an anticholinergic agent. Atropine acts by blocking the action of acetylcholine at muscarine receptors, thus undoing the consequences of overactivity of parasympathetic stimulation (McLendon & Preuss, 2023). In this particular case, atropine would act as a muscarine antagonist and take care of the parasympathetic nervous system symptoms: bradycardia, bronchorrhea, and profuse sweating.
References
Kudlak, M., & Tadi, P. (2020). Physiology, Muscarinic Receptor. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK555909/
McLendon, K., & Preuss, C. V. (2023, June 23). Atropine. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470551/
Schumann, A., Kietzer, S., Ebel, J., & Karl Jürgen Bär. (2020). Sympathetic and Parasympathetic Modulation of Pupillary Unrest. Frontiers in Neuroscience, 14. https://doi.org/10.3389/fnins.2020.00178
Wohlrab, J., Bechara, F. G., Schick, C., & Naumann, M. (2023). Hyperhidrosis: A Central Nervous Dysfunction of Sweat Secretion. Dermatology and Therapy, 13(2), 453–463. https://doi.org/10.1007/s13555-022-00885-w
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Question 
Four individuals presented to the ER with several signs and symptoms (see Table 1). While taking their history, you ask if they’ve recently ingested anything. At first, they didn’t claim anything but then one remembered they went mushroom hunting and added it to a stew. You’re truffle hunting skills paid off when you identified the mushroom from their photo of it as Amanita Muscaria, a mushroom containing the neurotoxin muscarine.
Identifying Mushroom Poisoning- A Case Study of Amanita Muscaria and Muscarine Toxicity
Instructions
Review the article above, answer the following questions, and save your responses in a Microsoft Word document. Provide a scholarly resource in APA format to support your answers.
Four individuals presented to the ER with several signs and symptoms (see Table 1).
Looking at the signs and symptoms, you notice that one of the two branches of the autonomic nervous system (ANS) is highly upregulated. Which one is it? Name three signs or symptoms that clued you in on it and why.
What receptor do you think muscarine binds to in the ANS? What neurotransmitter usually binds to the receptor?
At first, it seemed odd that three out of four of your patients were sweating. It makes sense now that you know what they ate. W