Hochdosiertes Magnesiumsulfat bei Aconitumintoxikation

Abstract

This article reports the case of a 62-year-old male patient who ingested the roots of Monkshood (Aconitum napellus) and white hellebore (Veratrum album) dissolved in alcohol with a suicidal intention and suffered cardiotoxic and neurotoxic symptoms. After contacting the Poison Information Centre ventricular arrhythmia was treated with high-dose magnesium sulphate as the only antiarrhythmic agent and subsequently a stable sinus rhythm could be established after approximately 3 h. Aconitum napellus is considered the most poisonous plant in Europe and it is found in gardens, the Alps and the Highlands. Poisoning is mainly caused by the alkaloid aconite that leads to persistent opening and activation of voltage-dependent sodium channels resulting in severe cardiac and neurological toxicity. As no specific antidote is known so far, poisoning is associated with a high mortality. The therapy with high-dose magnesium sulphate is based on in vitro and animal experiments as well as limited clinical case reports.

Sweroside Alleviated Aconitine-Induced Cardiac Toxicity in H9c2 Cardiomyoblast Cell Line

“…In clinic, herb-induced aconitine poisoning occur from time to time, as the narrow therapeutic index ( Lin et al, 2004 ). However, the detoxification strategies for aconitine are still limited to supportive treatment, such as gastric lavage, charcoal hemoperfusion, catheterization, injection of atropine, or magnesium sulfate, and so on ( Lin et al, 2004 ; Gottignies et al, 2009 ; Clara et al, 2015 ). Although, amiodarone was reported to successfully treat the aconitine-induced life-threatening arrhythmias, lidocaine and other classic antiarrhythmic drugs failed ( Yeih et al, 2000 ), the paucity of effective and specific agents for aconitine poisoning is obvious.…”

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

“…In addition to supportive care, complications are addressed. Amiodarone, flecainide, procainamide, mexiletine, lidocaine, magnesium sulfate, and other medications, as well as electrical cardioversion, have all been investigated with varying degrees of effectiveness 16 . Lidocaine is seldom useful in treating Aconitum‐induced ventricular tachyarrhythmias 17 .…”

Betäubende Samen

“…Bradykarde Herzrhythmusstörungen können am ehesten mit Atropin oder Orciprenalin behandelt werden. Bei Torsades de pointes und anderen ventrikulären Rhythmusstörungen kann hochdosiertes Magnesium eventuell hilfreich sein [6]. Atemdepression erfordert Intubation und maschinelle Beatmung.…”