see also: > [!Key Points] > - **risk dose:** > - Antidote:: silibilinin > - [mnemonic::] # Risk assessment - found in adelaide, canberra, melbourne, new zealand - # Toxic Mechanism **amatoxin** - delayed nausea/vomiting/diarrhea - then LATE hepatic, renal failure, coagulopaty beyond 1 day # Clinical features - delayed # Treatment - Decontaminiate charcoal MDAC 50g QID, [[Decontamination#Whole bowl irrigation]], gastric lavage considered - rehydrate - silibilinin 5mg/kg IV QID - benzylpenicillin 600mg/kg IV (massive dose) - [[N-acetyl-cysteine|NAC]] at standard paracetamol odses - prepare for liver transplant # Disposition ICU # Mnemonic