Cleistanthus collinus poisoning

Chrispal, Anugrah

doi:10.4103/0974-2700.96486

Cited by 26 publications

(17 citation statements)

References 35 publications

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“…Hypokalemia is a persistent finding in majority of symptomatic patients, usually seen at presentation or within the first 48 h of ingestion . Kaliuresis seems to be the main underlying mechanism, though vomiting and dehydration may have a role . ECG changes observed by us correlated with that of Subrahmanyam et al.…”

Section: Discussion and Literature Reviewsupporting

confidence: 78%

“…Appropriate stabilization of airway, breathing and circulation, urgent 12‐lead ECG with rhythm strip for identification of any rhythm disturbance, continuous cardiac monitoring, estimation of serum sodium, potassium and creatinine, ABG analysis, and a chest radiograph are to be assessed during the initial stages of management . According to the position statement by Vale and Kulig, gastric lavage is not to be performed routinely and the risk‐benefit ratio should be carefully examined before starting the procedure .…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

“…A progression of the severity of renal injury was noticed in one study-metabolic acidosis in patients with mild tubular injury; to more severe forms exhibiting metabolic acidosis and hypokalemia; to the most severe forms showing tubular dysfunction and decreased GFR-resulting in metabolic acidosis, hypokalemia, renal failure and in the majority of these patients, death (17). Treatment-Appropriate stabilization of airway, breathing and circulation, urgent 12-lead ECG with rhythm strip for identification of any rhythm disturbance, continuous cardiac monitoring, estimation of serum sodium, potassium and creatinine, ABG analysis, and a chest radiograph are to be assessed during the initial stages of management (30). According to the position statement by Vale and Kulig, gastric lavage is not to be performed routinely and the risk-benefit ratio should be carefully examined before starting the procedure (31).…”

Section: Toxic Manifestationsmentioning

confidence: 99%

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Fatal Cleistanthus collinus Toxicity: A Case Report and Review of Literature

Das

Hamide

Mohanty

et al. 2014

Journal of Forensic Sciences

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Cleistanthus collinus is an extremely toxic plant poison. We report a case of suicidal ingestion of boiled water decoction of C. collinus where the patient presented with abdominal pain and giddiness. There was persistent metabolic acidosis and fluctuation in the level of serum potassium. The ECG changes indicated a probable myocardial injury with conduction abnormality. At autopsy, the viscera were found to be congested. The toxins were detected in the viscera and blood by TLC and HPLC. Cleistanthin A and B, collinusin, and diphyllin are the principal toxic constituents of the plant. Consumption of a boiled decoction of leaves is highly toxic and, medical management of patients is mainly supportive because the molecular mechanisms of toxin action are unknown. In the recent years, C. collinus has created a considerable amount of interest because of its complex metabolites and their cytotoxic activities. Through this study, the authors have tried to highlight different properties pertaining to C. collinus.

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Section: Discussion and Literature Reviewsupporting

confidence: 78%

Section: Discussion and Literature Reviewmentioning

confidence: 99%

Section: Toxic Manifestationsmentioning

confidence: 99%

See 1 more Smart Citation

Fatal Cleistanthus collinus Toxicity: A Case Report and Review of Literature

Das

Hamide

Mohanty

et al. 2014

Journal of Forensic Sciences

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“…1 Patients with Cleistanthus collinus poisoning present with initial symptoms of diarrhoea, vomiting and leg cramps progressing to hypokalaemia, metabolic acidosis and hypotension. 2,3 The hypotension developed is resistant to standard pressor agents like dopamine and noradrenaline. 4 It was hypothesized that pressor resistant hypotension induced by the poisoning might be due to blockade of alpha adrenoceptors by the active phytochemicals.…”

Section: Introductionmentioning

confidence: 99%

Action of Cleistanthins A and B on Alpha Adrenoceptors in Rats

Lakshmanan¹,

Bobby²,

Raveendran³

2016

JYP

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Objectives: Cleistanthins A and B (CAB), active phytochemicals present in Cleistanthus collinus, have been proven to have alpha 1-adrenoceptor blocking property. However action on alpha 2-adrenoceptor is not studied. We aimed to study the action of CAB on alpha 2-adrenoceptor by measuring platelet aggregation, insulin and blood glucose levels with yohimbine as a standard comparator control and alpha 1-adrenoceptor by measuring the blockade of relaxation induced by phenylephrine in the jejunum of Wistar albino rats. Materials and methods: Forty eight adult male Wistar rats were divided into eight drug groups of six each, namely control (CMC 0.5%), yohimbine 2 mg/kg, 10, 30 and 100 mg/kg doses of cleistanthin A and cleistanthin B. Blood samples were drawn at baseline, after 5 h and after high-epinephrine dose (5 mg/kg) from the retro-orbital sinus and used for estimation of platelet aggregation and plasma insulin levels. Blood glucose levels were estimated at six different time points. Degree of jejunal relaxation was studied by relaxing the acetylcholine pre-contracted jejunum with phenylephrine. Results: All groups, except control and cleistanthin A 10 mg/kg group, significantly inhibited the platelet aggregation when compared to the respective baseline values (p<0.05). No significant difference was observed between different drug groups in plasma insulin and blood glucose levels. With regard to phenylephrine induced jejunal relaxation, the median IC 50 for all three doses of cleistanthin A and cleistanthin B 100 mg/kg differ significantly from that of control (CMC 0.5%). Conclusion: CAB block both alpha 1 and 2-adrenoceptorand hence are non-selective alpha-adrenoceptor blockers.

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“…Various case reports on the C. collinus poisoning showed ECG changes like sinus tachycardia, sinus bradycardia, ST depression, T wave inversion, prolongation of QT interval in patients. [ 34 35 36 ] The direct i.v. administration of the compound cleistanthin A showed a significant increase in RR interval, decrease in heart rate, increase in R amplitude, S amplitude, and ST height and decrease in T amplitude at a dose of 128 μg.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the antihypertensive activity and alpha adrenergic receptor interaction of cleistanthins A and B

Priyadharsini¹,

Parasuraman²,

Raveendran³

2014

J Basic Clin Pharma

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Hypertension was induced in male Sprague Dawley rats with twice weekly administration of deoxycorticosterone acetate (DOCA) salt (20 mg/kg s.c) for 4 weeks. They were divided into eight groups of six animals each viz., hypertensive control, standard (prazosin 1 mg/kg), cleistanthin A 12.5, 25, 50 mg/kg and cleistanthin B 12.5, 25 mg/kg, and 50 mg/kg. One more group served as normal control. The hypertension was induced in 4 weeks, and the animals were given assigned treatment in 5th week. The alteration in blood pressure (BP) was recorded weekly using a rodent noninvasive blood pressure system. At the end of the experiment alpha-adrenergic receptor response of drugs like adrenaline, nor adrenaline, dopamine (doses 1 μg and 2 μg) was recorded invasively. Two-way repeated measures ANOVA followed by Bonferroni post-hoc test was used to analyze the data. The systolic BP and diastolic BP of test groups rose to a higher level after DOCA administration and fell to the normal range (P < 0.05) following the administration of cleistanthins A and B. There were no differences in the weekly heart rate among the groups. In the test group animals pretreated with prazosin and cleistanthins, adrenaline, noradrenaline and dopamine failed to raise the mean arterial pressure and the end-diastolic pressure from baseline (P > 0.05) cleistanthins A and B exert a significant antihypertensive effect through alpha-adrenergic receptor blockade similar to prazosin.

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Cleistanthus collinus poisoning

Cited by 26 publications

References 35 publications

Fatal Cleistanthus collinus Toxicity: A Case Report and Review of Literature

Fatal Cleistanthus collinus Toxicity: A Case Report and Review of Literature

Action of Cleistanthins A and B on Alpha Adrenoceptors in Rats

Evaluation of the antihypertensive activity and alpha adrenergic receptor interaction of cleistanthins A and B

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