Editing Amanita muscaria (section)

===Treatment===
Medical attention should be sought in cases of suspected poisoning. If the delay between ingestion and treatment is less than four hours, [[activated charcoal]] is given. [[Gastric lavage]] can be considered if the patient presents within one hour of ingestion.<ref>{{cite journal | author=Vale, J. A. |author2= Kulig, K.|author3= American Academy of Clinical Toxicology|others= European Association of Poisons Centres and Clinical Toxicologists | title=Position paper: gastric lavage | journal=Journal of Toxicology: Clinical Toxicology | year=2004 | pages=933–43 | volume=42 | issue=7 | pmid=15641639 | doi=10.1081/CLT-200045006 }}</ref> Inducing vomiting with [[syrup of ipecac]] is no longer recommended in any poisoning situation.<ref>{{cite journal | author=American Academy Of Clinical Toxico | author2=European Association Of Poisons Cen | title=Position paper: Ipecac syrup | journal=Journal of Toxicology: Clinical Toxicology | year=2004 | pages=133–43 | volume=42 | issue=2 | pmid=15214617 | doi=10.1081/CLT-120037421 }}</ref>[[File:Amanita muscaria-Portland.jpg|thumb|Found in a parking lot, Portland Oregon US.]]

There is no antidote, and supportive care is the mainstay of further treatment for intoxication. Though sometimes referred to as a [[deliriant]] and while muscarine was first isolated from ''A. muscaria'' and as such is its namesake, [[muscimol]] does not have action, either as an [[agonist]] or [[Receptor antagonist|antagonist]], at the [[muscarinic acetylcholine receptor]] site, and therefore [[atropine]] or [[physostigmine]] as an antidote is not recommended.<ref>{{cite book | author = Dart, R. C.|title = Medical toxicology | publisher = Lippincott Williams & Wilkins | year = 2004 | location = Philadelphia, PA | pages = 1719–35 | isbn = 978-0-7817-2845-4}}</ref> If a patient is [[Delirium|delirious]] or agitated, this can usually be treated by reassurance and, if necessary, physical restraints. A [[benzodiazepine]] such as [[diazepam]] or [[lorazepam]] can be used to control combativeness, agitation, muscular overactivity, and seizures.<ref name="Benjamin 1992 Mushroom Poisoning in Infants"/> Only small doses should be used, as they may worsen the [[Respiratory depression|respiratory depressant]] effects of muscimol.<ref>{{cite book | author = Brent, J.|author2= Wallace, K. L.|author3= Burkhart, K. K.|author4= Phillips, S. D.|author5= Donovan, J. W. | title = Critical care toxicology: diagnosis and management of the critically poisoned patient | publisher = Elsevier Mosby | year = 2005 | location = Philadelphia, PA | pages = 1263–75 | isbn = 978-0-8151-4387-1}}</ref> Recurrent vomiting is rare, but if present may lead to fluid and electrolyte imbalances; intravenous rehydration or electrolyte replacement may be required.<ref name="Satora05"/>{{sfn|Benjamin|1995|p=313}} Serious cases may develop loss of [[consciousness]] or [[coma]], and may need [[intubation]] and [[artificial ventilation]].<ref name="Hoegberg"/><ref>{{cite journal |author=Bosman, C. K.|author2= Berman, L.|author3= Isaacson, M.|author4= Wolfowitz, B.|author5= Parkes, J. |title=Mushroom poisoning caused by ''Amanita pantherina''. Report of 4 cases |journal=South African Medical Journal |volume=39 |issue=39 |pages=983–86 |date=October 1965 |pmid=5892794}}</ref> [[Hemodialysis]] can remove the toxins, although this intervention is generally considered unnecessary.<ref name="INTOX"/> With modern medical treatment the prognosis is typically good following supportive treatment.<ref name="Tupalska-Wilczyńska">{{cite journal |last1=Tupalska-Wilczyńska |first1=Krystyna |last2=Ignatowicz |first2=Roman |last3=Poziemski |first3=Andrzej |last4=Wójcik |first4=Halina |last5=Wilczyński |first5=Grzegorz |title=Zatrucia muchomorami plamistym i czerwonym—patogeneza, objawy, leczenie |trans-title=Poisoning with spotted and red mushrooms—pathogenesis, symptoms, treatment |language=pl |journal=Wiadomosci Lekarskie |volume=49 |issue=1–6 |pages=66–71 |year=1996 |pmid=9173659 }}</ref><ref name="INTOX"/>