A 20-year-old patient presents to your ER with vomiting. They tell you they drank pennyroyal tea to induce an abortion because they did not have access to any safe/legal options.
A brief thread on ☠️PENNYROYAL TOXICITY☠️ and its management 🧵:
Pennyroyal (Mentha pulegium) is a plant that has a pleasant mintlike🍬 odor. It has been used historically as an abortifacient for centuries. The plant can be concentrated into an oil called pennyroyal oil. The plant, and especially the oil, contain the toxin ☠️PULEGONE☠️.
PULEGONE gets metabolized by the body to form toxins (e.g., menthofuran) that cause CENTRILOBULAR HEPATIC NECROSIS (tylenol toxicity also does this). Studies have shown that pulegone can also cause lung necrosis🫁and can interfere with potassium channels in the heart❤️🩹.
This case is made up BUT there are definitely cases of patients taking pennyroyal to induce abortion. Given the current political climate and abundance of medical misinformation out there (see pic below), we need to be prepared for anything so that we can best treat our patients.
Roe v Wade must not be overturned. I fear that if it is, we will see a rise in unsafe abortions that will lead to people getting hurt/dying.
Further reading: Goldfrank's Toxicologic Emergencies 11th edition, PMID 1686249, 7157374, 8909490, 2891472, 22004607, 8633832
#ToxTweets
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