II. Pathophysiology

  1. Tetrodotoxin (TTX) is a potent, often lethal toxin concentrated in liver and gonads of some fish, and the skin of freshwater fish
  2. Illness occurs after ingestion of improperly prepared fish
    1. TTX inhibits Sodium channels within muscles and nerves with secondary Acute Respiratory Failure or Heart Failure

III. Causes

  1. Puffer Fish (most common source, esp. Fugu in Japan)
  2. Porcupine Fish
  3. Ocean sunfish
  4. Trigger Fish
  5. Globe Fish
  6. Toad Fish
  7. Octopus

V. Management

  1. No commercially available antidote (although Monoclonal Antibody agents have been investigated)
  2. Consider Gastric Lavage
  3. Supportive care
    1. Respiratory support or Mechanical Ventilation

VI. Complications

VII. References

  1. Lagu (2015) Mar Drugs 13(10): 6384-406 +PMID:26492253

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Ontology: Tetrodotoxin (C0039705)

Definition (NCI) A neurotoxin with potential analgesic activity. Tetrodotoxin binds to the pores of fast voltage-gated fast sodium channels in nerve cell membranes, inhibiting nerve action potentials and blocking nerve transmission. Although found in various species of fish (such as the pufferfish), newts, frogs, flatworms, and crabs, tetrodotoxin, for which there is no known antidote, is actually produced by bacteria such as Vibrio alginolyticus, Pseudoalteromonas tetraodonis, and other vibrio and pseudomonas bacterial species.
Definition (MSH) An aminoperhydroquinazoline poison found mainly in the liver and ovaries of fishes in the order TETRAODONTIFORMES, which are eaten. The toxin causes paresthesia and paralysis through interference with neuromuscular conduction.
Definition (CSP) aminoperhydroquinazoline poison found mainly in species of puffer fishes, and some newts; the toxin causes paresthesia and paralysis through interference with neuromuscular conduction.
Concepts Hazardous or Poisonous Substance (T131) , Organic Chemical (T109) , Biologically Active Substance (T123)
MSH D013779
SnomedCT 59149006
English Fugu Toxin, Tarichatoxin, Tetradotoxin, Tetrodotoxin, Toxin, Fugu, tarichatoxin, puffer fish toxin, TTX, Tetrodotoxin [Chemical/Ingredient], tetradotoxin, tetrodotoxin, tetrodotoxins, ttx, Puffer fish toxin, Tetrodotoxin (substance)
Swedish Tetrodotoxin
Czech tetrodotoxin
Finnish Tetrodotoksiini
French Toxine de Fugu, Tétrodotoxine, Toxine de tétraodon, Tarichatoxine
Italian Taricatossina, Tossina del pesce palla, Tetrodotossina
Polish Tetrodotoksyna
Japanese スフェロイジン, タリカトキシン, テトロドトキシン, フグ毒
Spanish tetrodotoxina (sustancia), tetrodotoxina, Fugutoxina, Taricatoxina, Tetrodotoxina
German Fugu-Toxin, Tarichatoxin, Tetrodotoxin
Portuguese Fugutoxina, Taricatoxina, Tetrodotoxina