Aconite Poisoning with Good Outcome, Case Study and Literature Review

Alalmay, Abdulrahman; Bashabshe, Ali Al; Shamrani, Nouf Al; Othman, Lujain Bin; Alfaifi, Musa; Algarni, Yahya; Awwadh, Ahmed; A, Ali Cherif; Ogran, Hassan; Sinnah, Khalid; Razzaz, Mostafa El

doi:10.4236/crcm.2020.98030

Cited by 2 publications

(2 citation statements)

References 10 publications

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“…The symptoms of aconite poisoning include paresthesia, nausea, and sweating, followed by abdominal pain, diarrhea, vomiting, and then skeletal muscle paralysis, which typically occurs approximately 20 minutes to 2 h after the oral administration of aconitine[ 8 ]. Arrhythmia and neurological symptoms are common clinical manifestations of aconitine poisoning[ 8 , 9 ], but they are not specific and there are very few relevant studies. The mortality rate of aconitine poisoning is very high[ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Treatment of a patient with aconitine poisoning using veno-arterial membrane oxygenation: A case report

Bian,

Hou,

Khakurel

2024

World J Clin Cases

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BACKGROUND Aconitine poisoning is highly prone to causing malignant arrhythmias. The elimination of aconitine from the body takes a considerable amount of time, and during this period, patients are at a significant risk of death due to malignant arrhythmias associated with aconitine poisoning. CASE SUMMARY A 30-year-old male patient was admitted due to accidental ingestion of aconitine-containing drugs. Upon arrival at the emergency department, the patient intermittently experienced malignant arrhythmias including ventricular tachycardia, ventricular fibrillation, ventricular premature beats, and cardiac arrest. Emergency interventions such as cardiopulmonary resuscitation and defibrillation were promptly administered. Additionally, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) therapy was initiated. Successful resuscitation was achieved before ECMO placement, but upon initiation of ECMO, the patient experienced recurrent malignant arrhythmias. ECMO was utilized to maintain hemodynamics and respiration, while continuous blood purification therapy for toxin clearance, mechanical ventilation, and hypothermic brain protection therapy were concurrently administered. On the third day of VA-ECMO support, the patient’s respiratory and hemodynamic status stabilized, with only frequent ventricular premature beats observed on electrocardiographic monitoring, and echocardiography indicated recovery of cardiac contractile function. On the fourth day, a significant reduction in toxin levels was observed, along with stable hemodynamic and respiratory functions. Following a successful pump-controlled retrograde trial occlusion test, ECMO assistance was terminated. The patient gradually improved postoperatively and achieved recovery. He was discharged 11 days later. CONCLUSION VA-ECMO can serve as a bridging resuscitation technique for patients with reversible malignant arrhythmias.

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Section: Discussionmentioning

confidence: 99%

Treatment of a patient with aconitine poisoning using veno-arterial membrane oxygenation: A case report

Bian,

Hou,

Khakurel

2024

World J Clin Cases

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“…Hypotension and bradycardia will occur as a result [ 59 , 60 ]. Furthermore, the ventromedial nucleus in the hypothalamus could be activated by AC, which will lead to hypotension and bradycardic action [ 61 , 62 ]. It is also responsible for the slowing down of the circulatory system [ 63 , 64 ].…”

Section: Poisoned Symptoms and Toxicologymentioning

confidence: 99%

The toxicology and detoxification of Aconitum: traditional and modern views

2021

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Aconitum carmichaeli Debx.-derived herbal medicine has been used for anti-inflammation and anti-arrhythmia purpose for more than two thousand years. It is processed into Chuanwu (Radix Aconiti praeparata) and Fuzi (Radix Aconiti lateralis praeparata) in Traditional Chinese Medicine, which are two useful drugs but with toxic properties. There have been patients poisoned by accidental ingestion of Aconitum plants or misuse of the herbal drug, and this is of great concern to study in-depth. In this review, we provided the traditional and contemporary practice of using Aconitum herbs as medicine, from functions, processing methods to toxicity in ethnomedicine aspects to discuss the underlying connections of traditional and modern understanding on the toxicity of Aconitum plants. We summarized the functions and toxicology of the herbal drugs are analyzed from chemical and clinical aspects, with the help of traditional and modern knowledge of medicine. The medicinal doses and lethal doses determined by researches are summarized, and the usage and processing methods are updated and reviewed in the modern view. In addition, clinical management of poisoned cases using western medicine is discussed. This review provides insights and awareness of safety when using Aconitum-derived herbal medicine, and the application of modern scientific knowledge to optimize the detoxification processes. We suggest the possibility to renew the current standard processing method from the official Pharmacopoeia all over the world.

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Aconite Poisoning with Good Outcome, Case Study and Literature Review

Cited by 2 publications

References 10 publications

Treatment of a patient with aconitine poisoning using veno-arterial membrane oxygenation: A case report

Treatment of a patient with aconitine poisoning using veno-arterial membrane oxygenation: A case report

The toxicology and detoxification of Aconitum: traditional and modern views

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