Acute Poisoning of Aconitum

Abstract

Aconitine, a plant alkaloid is a usual constituent of various over-the-counter herbal remedies and is an uncommon cause of deliberate poisoning. Herein, we describe an unusual case of poisoning in a young male due to accidental ingestion of aconitine tincture. On presentation, his electrocardiogram documented ventricular arrhythmias for which amiodarone was administered promptly. This led to considerable improvement in heart rhythm. The patient recovered gradually with this management and achieved normal sinus rhythm. He was completely asymptomatic within 5 days of treatment and subsequently discharged. Our management with amiodarone narrates the importance of this drug in aconitine poisoning, which can prove to be fatal in the absence of any intervention or delay in diagnosis. Nonexistence of specific antidote also establishes amiodarone as a standard remedy.

Accidental poisoning with aconite overdose: A case report and resuscitative emergency management in a tertiary level hospital of Bangladesh

“…Various chromatographic procedures are available; however, they are normally unavailable in most laboratories, are time-consuming, and might result in diagnostic delays. 2 Because there is no specific antidote, supportive management is the primary therapy for poisoning. 14 This includes careful vital sign monitoring, supportive cardiovascular treatment such as intravenous hydration, and rhythm management using amiodarone for tachyarrhythmias and atropine for bradycardia.…”

“…When antecedent history is unclear, aconite detection in serum might be useful. Various chromatographic procedures are available; however, they are normally unavailable in most laboratories, are time‐consuming, and might result in diagnostic delays 2 …”

“…Aconitum (Ranunculaceae) has hundreds of plant species that contain alkaloids including aconite, which have been associated to gastrointestinal, cardiovascular, and nervous system damage. 2 Aconitum plants have long been utilized to cure a variety of medical conditions in China and other Asian nations. 3 Aconite poisoning is prevalent in Asia because aconite roots (the roots and root tubers of Aconitum species) are still employed in traditional medicine for their analgesic, anti-inflammatory, and cardiotonic properties.…”

“…Furthermore, patients commonly self‐medicate with potentially dangerous items. Aconitum ( Ranunculaceae ) has hundreds of plant species that contain alkaloids including aconite, which have been associated to gastrointestinal, cardiovascular, and nervous system damage 2 …”

Cardiotoxic effects of poisoning from aconite root in a middle-aged man in Bhutan: a case report

“…Bradycardia is typically addressed with atropine. For ventricular arrhythmias linked to aconite poisoning, amiodarone and flecainide as preferred first-line antiarrhythmic agents 9,10 . In cases of polymorphic ventricular tachycardia, magnesium sulphate is recognized as a potential treatment option 11 .…”