Bufo Toad Toxicosis
Basic Information 
Epidemiology
Geography and Seasonality
• Bufo toads are primarily found in Florida, Texas, Colorado, Arizona, and Hawaii.
• These toads breed during warmer, wetter months and tend to hibernate during the colder, dryer months, making wintertime exposures less likely. Toads appear to be most active around dusk and at night and after rainstorms.
Clinical Presentation
Etiology and Pathophysiology
• Many biologically active compounds, including dopamine, epinephrine, norepinephrine, serotonin, bufotenine, bufagenins, bufotoxins, and indolealkylamines, are secreted from the toad’s large parotid glands. These compounds are readily absorbed across mucous membranes or through open wounds.
• Bufotenine is a pressor substance that may have hallucinogenic properties.
• Bufagenins and bufotoxins are cardiac glycosides that cross-react with digoxin, binding to and inhibiting Na/K-ATPase. These changes inhibit normal myocardial conduction and function.

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