Case reports of aconite poisoning in mainland China from 2004 to 2015: A retrospective analysis

Li, Haoran; Liu, Liang; Zhu, Shuguang; Liu, Qian

doi:10.1016/j.jflm.2016.05.016

Cited by 47 publications

(42 citation statements)

References 13 publications

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“…CHM processing methods, known as paozhi, convert or transform the plant contents into secondary derivatives to lower the toxicity and increase the pharmacological efficacy. When Danfupian or Paofupian is prescribed in the formulation, at least 30 min of boiling in the decoction is needed for advanced detoxification prior to the addition of the other herbs; this hydrolyzes the remaining Aconitum alkaloids into derivatives that are almost non-toxic [13,14,16.] Higher doses of Fuzi can require as much as 2 h for decoction.…”

Section: Discussionmentioning

confidence: 99%

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Bradycardia and Hypotension from Improper Use of Aconite Root: A Case Report and Brief Review

et al. 2018

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Background: Adverse reactions associated with Chinese herbal medicines (CHMs) are usually the result of unpredictable active/toxic ingredients, inaccurate or mistaken beliefs, or poor supervision. The herb that most commonly induces severe adverse effects in Hong Kong and China is aconite root. More than 200 species of Aconitum plants are used for medicinal purposes, with aconite roots producing analgesic, anti-inflammatory, cardiotonic, and anti-tumor effects. The active components are alkaloids; these can be toxic, but CHM processing methods lower their toxicity and increase the pharmacological efficacy. However, aconite poisoning can result from inadequate decoction time or exceeding the recommended dose. Case Report: Here we report the case of a 92-year-old woman who presented with life-threatening bradycardia and hypotension. This started 1 h after she inappropriately consumed a herbal decoction containing Fuzi for mood fluctuation and health maintenance; Fuzi, an aconite root, has known cardiotoxicity. Electrocardiography showed supraventricular abnormalities, including sinus bradycardia and low-amplitude P waves. After an infusion of normal saline and inotropic agents for 25 h, the clinical manifestations subsided, her sinus rhythm returned to normal, and she was discharged. At follow-up 2 weeks later, she was in good health and had ceased taking any CHM. Conclusions: Standardized processing methods, stringent regulations, and cooperation between health professions can ensure medication safety and establish a fully-fledged operating process for these valuable drugs. We hope this report will help establish correct attitudes toward CHM and will assist Traditional Chinese Medicine practitioners to become more familiar with Aconitum plants.

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Section: Discussionmentioning

confidence: 99%

“…In Hong Kong, around 0.2% of acute admissions to general medical wards were because of herbal poisoning [11]. The 3 herbs that most commonly induce severe adverse effects are aconite roots ( Aconitum carmichaeli and A. Kusnezoffii ) in Hong Kong and China, followed by Tripterygium wilfordii Hook f. and Isatis tinctoria L. [10,12,13]. …”

Section: Introductionmentioning

confidence: 99%

Bradycardia and Hypotension from Improper Use of Aconite Root: A Case Report and Brief Review

et al. 2018

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“…Moreover, the microscopic examination has been reported to reveal bilateral intrapulmonary haemorrhage and oedema, congestion of multiple organs, and bilateral pleural effusions in different degrees [41]. It is worth noting that eosinophilic granulocytes can also be observed in the lungs, liver, pancreas, spleen, and gastrointestinal mucosal tissue [42].…”

Section: Symptoms Of Aconitine Poisoning and Pathological Changes In mentioning

confidence: 99%

“…It is rather difficult to define precisely the therapeutic dose and toxic dose of aconitine because of its narrow therapeutic index. The cardiotoxicity and neurotoxicity caused by inadequate consumption of aconitine have been occasionally reported in recent years [42,44]. Therefore, the public should be warned of the risk of aconitine poisoning.…”

Section: Toxic Effects Of Aconitinementioning

confidence: 99%

Research progress of aconitine toxicity and forensic analysis of aconitine poisoning

Gao

Zhang

et al. 2018

Forensic Sciences Research

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Chinese herbal medicines have been extensively used in China and other countries for centuries. Aconitine, a diterpenoid alkaloid extracted from Aconitum plants, has anti-inflammatory and analgesic activities, but can also induce severe arrhythmia and neurotoxicity. Aconitine poisoning accidents caused by misuse, suicide, or homicide have been reported in recent years. In China, fatal aconitine poisoning can occasionally happen on account of accidental ingestion of some wild plants or consumption of herbal decoction made from the roots of Aconitum plants. However, it is rather difficult for forensic experts to find the specific results in present forensic autopsy of aconitine-induced death. To further clarify its potential risk following the widespread application of aconitine, toxicological characteristics and pharmacokinetics of aconitine are reviewed. Moreover, gastrointestinal, neurological, and cardiovascular symptoms were observed frequently in aconitine poisoning cases. In addition, the review also aims at providing some convincing evidences for forensic experts to identify unexplained death with postmortem examination. ARTICLE HISTORY

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“…Aconitum is a genus of over 300 species of flowering plants belonging to the family Ranunculaceae. In China alone, 1 there over 200 species of this plant. Toxicity of the plant has been acknowledged since ancient times.…”

Section: Introductionmentioning

confidence: 99%

Recurrent Ventricular Arrhythmia Caused by Ingestion of Aconitum (Monkshood) Flowers

Adami

Paganussi²,

Perone

et al. 2018

Wilderness & Environmental Medicine

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We report the case of a patient who presented with respiratory failure, recurrent ventricular fibrillation, ventricular arrhythmias, and hypotension after an intentional ingestion of aconite flowers. Significant ingestion of this plant can produce life-threatening cardio- and neurotoxicity that may require evacuation from the wilderness to a medical facility capable of advanced treatment and intensive care monitoring.

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Case reports of aconite poisoning in mainland China from 2004 to 2015: A retrospective analysis

Cited by 47 publications

References 13 publications

Bradycardia and Hypotension from Improper Use of Aconite Root: A Case Report and Brief Review

Bradycardia and Hypotension from Improper Use of Aconite Root: A Case Report and Brief Review

Research progress of aconitine toxicity and forensic analysis of aconitine poisoning

Recurrent Ventricular Arrhythmia Caused by Ingestion of Aconitum (Monkshood) Flowers

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