Bs. Nelson et B. Heischober, Betel nut: A common drug used by naturalized citizens from India, Far EastAsia, and the South Pacific Islands, ANN EMERG M, 34(2), 1999, pp. 238-243
Betel nut is a common masticatory drug used in Far East Asia, India, and th
e South Pacific. It is used daily by 600 million people worldwide, yet is u
nknown to most Western physicians. As the world becomes more culturally and
ethnically interconnected, emergency physicians will encounter the use of
betel nut. Significant illness can be associated with its use, including as
thma exacerbation, cholinergic crisis, cardiac arrhythmias, acute psychosis
, milk-alkali syndrome, and oropharyngeal tumors. We describe its source, p
harmacology, composition, presentation, and treatment in the emergency depa
rtment.