====== Problems for Discussion - 2 - Colchicine (and colchicine-containing plants) ======


===== PROBLEM 1 =====

  - Why can’t toxicologists agree?
  - Review the HyperTox monograph and Baud (1995).

===== PROBLEM 2 =====

  - Having read Baud’s paper, consider that if you had colchicine antibodies would you use them?
  - Speculate on what factors make digoxin antibodies available when colchicine antibodies are not.

===== PROBLEM 3 =====

A 45 year old female presented 1 hour after ingestion of a single tuber of Gloriosa superba. She appeared well.

  - What is your initial management
  - She refuses all interventions.
  - How would you proceed?

===== PROBLEM 4 =====

A 40 year old male presented 5 hours following ingestion of a long tuber of Gloriosa superba . He appeared unwell with profuse vomiting and blood stained diarrhoea. \\ His pulse was 110 beats per minute and the blood pressure was 70/60mmHg. The arterial blood gas analysis revealed a pH of 7.1, HCO3 of 12mmol/L, CO2 of 13mmHg and a base excess of -5. Total WBC of 32000/mm3 with 90% neutrophils.

  - What is your risk assessment
  - Propose a mechanism for these clinical features
  - What is your management

72 hours afterwards his urine output was 10ml/hour and the FBC revealed: Hb 5g/dL, WBC 1500/mm3 and platelets 10000/mm3.

  - What has happened?
  - What further investigations would you request?
  - What is your management?