Toxic Principle Research Articles

Toxic Plants and Mushrooms

Many species of plants and mushrooms exist that, when consumed, can induce poisoning in individuals, causing a range of side effects. As the toxins do not always correspond to an antidote, it is important to have the ability to identify each harmful species to determine the appropriate treatment. This review gives an overview of some of the more prevalent toxic plants and mushrooms, detailing their principles of toxicity, recommendations for immediate stabilization, keys to proper diagnosis and definitive therapy, and patient disposition and outcomes. Figures show photographs of the various toxic plants and mushrooms featured. Tables show a list of toxic species for both plants and mushrooms, including their common names, the toxins contained within, their effects, and the corresponding antidote (if any). This review contains 16 highly rendered figures, 2 tables, and 44 references.

Hydrocarbons

Hydrocarbons (HCs) are organic compounds that contain primarily hydrogen and carbon atoms. Although most HC exposures occur in occupational settings dealing with various solvents, they can be found in products in every household. Therefore, the risk of exposure in everyday life is high. This review discusses the toxicokinetics, pathophysiology, common clinical presentation, and management of HCs. The three major classes of HCs (aliphatic, aromatic, and halogenated) are closely examined. An in-depth look is taken at commonly encountered HCs with unique toxicologic characteristics. The principles of toxicity, immediate stabilization, diagnosis, definitive management, disposition, and outcomes of these specific HCs are defined. Tables describe HCs commonly found in the household, toxic metabolites and viscosities of common HCs, and target organs of the toxic effects of common alihepatic, halogenated, and aromatic HCs both early and late after exposure. Figures show the structure of the various HCs described in the review. This review contains 13 highly rendered figures, 6 tables, and 116 references.

Toxic Plants and Mushrooms

Many species of plants and mushrooms exist that, when consumed, can induce poisoning in individuals, causing a range of side effects. As the toxins do not always correspond to an antidote, it is important to have the ability to identify each harmful species to determine the appropriate treatment. This review gives an overview of some of the more prevalent toxic plants and mushrooms, detailing their principles of toxicity, recommendations for immediate stabilization, keys to proper diagnosis and definitive therapy, and patient disposition and outcomes. Figures show photographs of the various toxic plants and mushrooms featured. Tables show a list of toxic species for both plants and mushrooms, including their common names, the toxins contained within, their effects, and the corresponding antidote (if any). This review contains 16 highly rendered figures, 2 tables, and 44 references.

Psychoactive Medications

Psychoactive medications are defined as medications that affect the central nervous system neurotransmitter pathways with the intention to modulate mood or consciousness. This broad category of medications includes sedative-hypnotic agents such as benzodiazepines and barbiturates, antidepressants, neuroleptics, and mood stabilizers. The principal source of exposure for these medications is through prescription drug use and misuse. This review discusses the principles of toxicity, immediate stabilization, diagnosis and definitive therapy, and disposition and outcomes related to sedative-hypnotics, antidepressants, neuroleptics, and lithium. Tables include common benzodiazepine and barbiturate compounds, dosing instructions for multidose activated charcoal, flumazenil dosing recommendations, commonly available tricyclic and atypical (noncyclic) antidepressants, dosing recommendations for sodium bicarbonate in serum alkalinization, benzodiazepine dosing recommendations in serotonin syndrome, dosing recommendations for cyproheptadine, signs and symptoms that differentiate neuroleptic malignant syndrome from serotonin syndrome, and indications for renal replacement therapy based on lithium concentration and clinical setting. Figures show action potentials in the His-Purkinje syndrome, an electrocardiogram tracing demonstrating a terminal R wave, and a QT interval nomogram. This review contains 2 highly rendered figures, 9 tables, and 101 references.

Heavy Metals

Heavy metal poisoning may be acute, subacute, or chronic, and it is important for the emergency physician to recognize poisonings that are acutely life threatening. Nearly all parts of the human body are affected by heavy metals, including the cardiovascular, gastrointestinal, renal, hematologic and nervous systems. In many heavy metal poisonings, chelation therapy is the standard of care. This review details the principles of toxicity, immediate stabilization, diagnosis and definitive therapy, and disposition and outcomes for patients who have been exposed to arsenic, chromium, cobalt, lead, mercury, and thallium. Figures show the skin manifestations of chronic arsenic toxicity and treatment algorithms for lead exposure and thallium poisoning. Tables list the clinical manifestations of arsenic poisoning, the side effects of common chelators, systemic manifestations of lead toxicity in adults, routes of exposure and clinical manifestations of mercury poisoning, and symptoms following acute thallium overdose. This review contains 3 highly rendered figures, 5 tables, and 92 references.

Psychoactive Medications

Psychoactive medications are defined as medications that affect the central nervous system neurotransmitter pathways with the intention to modulate mood or consciousness. This broad category of medications includes sedative-hypnotic agents such as benzodiazepines and barbiturates, antidepressants, neuroleptics, and mood stabilizers. The principal source of exposure for these medications is through prescription drug use and misuse. This review discusses the principles of toxicity, immediate stabilization, diagnosis and definitive therapy, and disposition and outcomes related to sedative-hypnotics, antidepressants, neuroleptics, and lithium. Tables include common benzodiazepine and barbiturate compounds, dosing instructions for multidose activated charcoal, flumazenil dosing recommendations, commonly available tricyclic and atypical (noncyclic) antidepressants, dosing recommendations for sodium bicarbonate in serum alkalinization, benzodiazepine dosing recommendations in serotonin syndrome, dosing recommendations for cyproheptadine, signs and symptoms that differentiate neuroleptic malignant syndrome from serotonin syndrome, and indications for renal replacement therapy based on lithium concentration and clinical setting. Figures show action potentials in the His-Purkinje syndrome, an electrocardiogram tracing demonstrating a terminal R wave, and a QT interval nomogram. This review contains 2 highly rendered figures, 9 tables, and 101 references.

Nonopioid Analgesics

Acetaminophen is the most common toxic ingestion in the United States, causing 400 deaths per year. Poisoning occurs both intentionally and unintentionally, with suicidal intent, overuse for treatment of pain, and ingestion of multiple medications containing acetaminophen all contributing. Aspirin poisoning remains a concern even though its popularity as an analgesic and antipyretic has decreased over time. Among nonaspirin nonsteroidal antiinflammatory drugs (NSAIDs), ibuprofen and naproxen are the most commonly encountered in overdose, likely due to their easy availability as over-the-counter medications. This review covers the principles of toxicity, immediate stabilization, diagnosis and definitive therapy, and disposition and outcomes related to acetaminophen, aspirin, and ibuprofen and other NSAIDs. Tables describe N-acetylcysteine dosing, King’s College criteria for acetaminophen-induced liver failure, and indications for hemodialysis in aspirin poisoning. Figures include a pie chart showing acetaminophen metabolization, the Rumack-Matthew nomogram, and a graph showing frequency of hepatotoxicity in patients receiving N-acetylcysteine. This review contains 3 highly rendered figures, 3 tables, and 97 references.

Cardiovascular Medications

Multiple classes of xenobiotics have the potential to influence the function of the cardiovascular system. When evaluating the hemodynamic consequences of any toxic exposure and initiating treatment of such abnormalities, the clinician must consider the mechanism by which the toxin exerts its effect. This review focuses on diagnosis and management of toxicity related to common classes of antiarrhythmic drugs and the centrally acting hypertensives. Beta blockers, calcium channel blockers, cardiac glycosides, sodium channel and potassium channel blockers, and clonidine and centrally acting alpha2 agonists are described in relation to principles of toxicity, immediate stabilization, diagnosis and definitive therapy, and disposition and outcome. Tables include classes of antiarrhythmics, various beta-blocker properties, standard dosing regimen for hyperinsulinemia/euglycemia, calcium channel blockers, botanical and animal sources of cardiac glycosides, P-glycoprotein inhibitors, and various alpha agonists. Figures show the mechanisms for beta-receptor activation, hyperinsulinemia/euglycemia, and cardiac glycosides. An electrocardiogram demonstrating digitalis effect is also provided. This review contains 4 highly rendered figures, 7 tables, and 126 references.

English

Amorphophallus is an Aroid family member, native to Asia. Amorphophallus konjac K. Koch ex N.E.Br. is also known as snake plant due to snake like outlines on its stem. In Mount Abu the plant is grown in wild and known for its toxic principles. In Traditional Chinese System of Medicine (TCM), it was mentioned that gel prepared from flour has been used in detoxification, tumor suppression, phlegm liquefaction and skin disorders. In the present research work, attempts were made to authenticate and validate the ethno-medicinal potentials of A. konjac antimicrobial activity which could be alternate for current synthetic antimicrobial agents. The plant was selected for screening of antimicrobial efficacy against eight selected bacterial strains viz. Staphylococcus aureus (ATCC- 2921), Klebsiella pneumoniae  (ATCC 700603), Enterobacter cloacae (ATCC 13047 ), Escherichia coli (ATCC 25922), Staphylococcus aureus (ATCC 25923), Proteus mirabilis (ATCC 12453), Enterobacter cloacae  (ATCC- 13047), Enterococcus faecalis (ATCC 29212) and Streptococcus pneumoniae (ATCC 6305). The results of antimicrobial activity of crude dicholormethane (DCM), ethyl acetate, chloroform and methanol were significant. DCM extract C (10 mg/disc) possess maximum efficacy against S. pneumoniae (IZ = 20 mm; AI = 1.25). The main cause of community acquired pneumonia and septicemia in HIV infected patients is caused by S. pneumoniae microorganism. Further, bioactivity guided fractionation of pure compounds from DCM extract of A. konjac can lead to work as novel antibiotic in future. Therefore, the extract can also be used for isolation of volatiles compounds with potentials so that the extract / active fraction / pure compounds can be used as nasal spray in future therapeutics.   Key words: Amorphophallus konjac, antibacterial activity, antimicrobial agents, ethnomedicinal plant.&nbsp

Toxic Plants and Mushrooms

Many species of plants and mushrooms exist that, when consumed, can induce poisoning in individuals, causing a range of side effects. As the toxins do not always correspond to an antidote, it is important to have the ability to identify each harmful species to determine the appropriate treatment. This review gives an overview of some of the more prevalent toxic plants and mushrooms, detailing their principles of toxicity, recommendations for immediate stabilization, keys to proper diagnosis and definitive therapy, and patient disposition and outcomes. Figures show photographs of the various toxic plants and mushrooms featured. Tables show a list of toxic species for both plants and mushrooms, including their common names, the toxins contained within, their effects, and the corresponding antidote (if any). This review contains ­16 highly rendered figures, 2 tables, 44 references, and 5 MCQs.

Plants poisonous to horses in Europe

SummaryPoisoning of horses by plants is a relatively common veterinary problem and may occur when the fresh plant is ingested in pasture or when the plant contaminates hay, silage and feed. In Europe, horses are particularly at risk of poisoning by Cynoglossum officinale (houndstongue), Datura stramonium (jimson weed), Hypericum perforatum (St. John's wort), Nerium oleander (oleander), Pteridium aquilinum (bracken fern), Robinia pseudoacacia (black locust), Senecio jacobaea (tansy ragwort), Taxus baccata (European yew) and Thuja occidentalis (white cedar). For each of these poisonous plants the information given in this review includes plant distribution, conditions of poisoning, toxic active principles and clinical signs.

Śodhana: An Ayurvedic process for detoxification and modification of therapeutic activities of poisonous medicinal plants.

Ayurveda involves the use of drugs obtained from plants, animals, and mineral origin. All the three sources of drugs can be divided under poisonous and nonpoisonous category. There are various crude drugs, which generally possess unwanted impurities and toxic substances, which can lead to harmful health problems. Many authors have reported that not all medicinal plants are safe to use since they can bear many toxic and harmful phytoconstituents in them. Śodhana (detoxification/purification) is the process, which involves the conversion of any poisonous drug into beneficial, nonpoisonous/nontoxic ones. Vatsanābha (Aconitum species), Semecarpus anacardium, Strychnos nux-vomica, Acorus calamus, Abrus precatorius etc., are some of the interesting examples of toxic plants, which are still used in the Indian system of medicine. Aconite, bhilawanols, strychnine, β–asarone, abrin are some of the toxic components present in these plants and are relatively toxic in nature. Śodhana process involves the purification as well as reduction in the levels of toxic principles which sometimes results in an enhanced therapeutic efficacy. The present review is designed to extensively discuss and understand the scientific basis of the alternative use of toxic plants as a medicine after their purification process.

Efficient synthesis of (R)-harmonine--the toxic principle of the multicolored Asian lady beetle (Harmonia axyridis).

A flexible synthetic route to (R)-harmonine ((R)-1), the toxic principle of the Asian lady beetle Harmonia axyridis (H. axyridis), via reductive olefination of the macrocyclic lactone (S)-5, is reported. High enantiomeric purity is achieved by enantioselective saponification of the lactone rac-5 with horse liver esterase. Minor modifications in the synthetic route give access to racemic and chiral harmonine ()1, analogs and putative biosynthetic precursors. In addition, the antimicrobial activity of harmonine against Leishmania major (L. major) is demonstrated and provides the rationale for harmonine-based drug development against parasitic diseases.

A validated method for quantifying hypoglycin A in whole blood by UHPLC-HRMS/MS.

Hypoglycin A (HGA) is the toxic principle in ackee (Blighia sapida Koenig), a nutritious and readily available fruit which is a staple of the Jamaican working-class and rural population. The aril of the unripe fruit has high concentrations of HGA, the cause of Jamaican vomiting sickness, which is very often fatal. HGA is also present in the samara of several species of maple (Acer spp.) which are suspected to cause seasonal pasture myopathy in North America and equine atypical myopathy in Europe, often fatal for horses. The aim of this study was to develop a method for quantifying HGA in blood that would be sensitive enough to provide toxicological evidence of ackee or maple poisoning. Analysis was carried out using solid-phase extraction (HILIC cartridges), dansyl derivatization and UHPLC-HRMS/MS detection. The method was validated in whole blood with a detection limit of 0.35 μg/L (range: 0.8-500 μg/L). This is the first method applicable in forensic toxicology for quantifying HGA in whole blood. HGA was quantified in two serum samples from horses suffering from atypical myopathy. The concentrations were 446.9 and 87.8 μg/L. HGA was also quantified in dried arils of unripe ackee fruit (Suriname) and seeds of sycamore maple (Acer pseudoplatanus L.) (France). The concentrations were 7.2 and 0.74 mg/g respectively.

Salvianolic acid A, a novel matrix metalloproteinase-9 inhibitor, reduces microvascular damage induced by hypertension

Salvianolic acid A, a novel matrix metalloproteinase-9 inhibitor, reduces microvascular damage induced by hypertension

Screening approach by ultra-high performance liquid chromatography-tandem mass spectrometry for the blood quantification of thirty-four toxic principles of plant origin. Application to forensic toxicology.

Plant poisonings have left their mark on history and still cause many deaths, whether intentional or accidental. The means to show toxicological evidence of such poisonings should be implemented with great care. This article presents a technique for measuring thirty-nine toxic principles of plant origin in the blood, covering a large amount of toxins from local or exotic plants: α-lobeline, α-solanine, aconitine, ajmaline, atropine, brucine, cephalomannine, colchicine, convallatoxin, cymarine, cytisine, digitoxin, digoxin, emetine, gelsemine, ibogaine, jervine, kavain, lanatoside C, lupanine, mitragynine, neriifolin, oleandrin, ouabain, paclitaxel, physostigmine, pilocarpine, podophyllotoxin, proscillaridin A, reserpine, retrorsine, ricinine, scopolamine, senecionine, sparteine, strophanthidin, strychnine, veratridine and yohimbine. Analysis was carried out using an original ultra-high performance liquid chromatography separation coupled with tandem mass spectrometry detection. Extraction was a standard solid phase extraction performed on Oasis(®) HLB cartridge. Thirty-four of the thirty-nine compounds were put through a validation procedure. The assay was linear in the calibration curve range from 0.5 or 5 μg/L to 1000 μg/L according to the compounds. The method is sensitive (LOD from 0.1 to 1.6 μg/L). The within-day precision of the assay was less than 22.5% at the LLOQ, and the between-day precision was less than 21.5% for 10 μg/L for all the compounds included. The assay accuracy was in the range of 87.4 to 119.8% for the LLOQ. The extraction recovery and matrix effect ranged from 30 to 106% and from -30 to 14%, respectively. It has proven useful and effective in several difficult forensic cases.

Identificação e distribuição de lesões cardíacas em bovinos intoxicados por Amorimia exotropica

Amorimia exotropica é um arbusto escandente que pertence à família Malpighiacea, cujo princípio tóxico é o monofluoracetato de sódio e possui ação cardiotóxica em bovinos. Ela é a única representante, na região Sul do país, do grupo de plantas que causam morte súbita associada ao exercício. Este trabalho identificou e mapeou as lesões cardíacas observadas em bovinos intoxicados naturalmente por A. exotropica. Selecionaram-se nove corações bovinos, provenientes de um surto de intoxicação natural pela planta em uma propriedade de gado de corte do Rio Grande do Sul e procedeu-se o mapeamento de oito regiões topográficas distintas (ápice, ventrículos direito e esquerdo, septo interventricular, músculos papilares direito e esquerdo e átrios direito e esquerdo). À avaliação macroscópica quatro bovinos apresentaram lesão focal e bem delimitada no músculo papilar esquerdo. Estas áreas na histologia correspondiam à necrose de coagulação em diferentes estágios de evolução, similares a infartos. Todos os bovinos apresentavam necrose de cardiomiócitos, caracterizadas por retração e hipereosinofilia citoplasmática e fragmentação celular em todas as áreas amostradas. A severidade da injúria celular foi avaliada pela imuno-histoquímica anti-troponina C, a qual demonstrou acentuada perda e/ou diminuição de marcação citoplasmática em células necróticas. O músculo papilar esquerdo foi a região mais acometida nos casos de intoxicação por Amorimia exotropica.

Hepatic Necrosis and Degenerative Myopathy Associated with Cassava Feeding in Pigs.

Forty-three deaths were recorded among pigs fed boiled cassava meal at a private piggery over a period of two years. There were signs of sudden death in some cases with blood exuding from the external nares, vomiting, muscular weakness and pain or reluctance to move, emaciation, and stunted growth. The necropsy lesions included skeletal and cardiac muscle degeneration and necrosis, icterus, hepatic necrosis, and oedema of the dependent parts. The deaths and clinical signs are thought to be due to a non cyanide toxic principle in cassava, possibly the coumarins (scopoletin), which is found in high levels in cassava diet even after heat treatment. Therefore, the use of proper processing technology to obtain cassava products of high quality is recommended.

HEVEA BRASILIENSIS POISONING IN MALNAD GIDDA CATTLE, KARNATAKA, INDIA

Hevea brasiliensis , the rubber tree , is a tropical tree belonging to the family Euphorbiaceae , native to Amazon basin in Brazil and most economically important member of the genus Hevea , because of the milky latex extracted from the tree is the primary source of natural rubber . The young leaves of this tree are poisonous to most animals. In India it is fo und in areas where plantation is done for the commercial purpose. Hence poisoning in ruminants due to rubber tree is a rare phenomenon unless they have access to it. In the present investigation there were deaths of six adult Malnad G idda cattle in Hal e Ik keri village of Shimoga , Karnataka , India in a span of two days. An attempt has been made to know the cause of sudden mortality in Malnad Gidda Cattle. Post - mortem examination was conducted on carcasses and samples were collected for the detection of toxic principle, Hydrocyanic acid (HCN) by Picric acid paper spot test . The young rubber tree leaves showed positive for the presence of toxic principle HCN. HCN is one of the most potent, rapid - acting poisons known. When a lethal dose is consumed, animals die from asphyxiation in a few minutes. Deaths in animals due to HCN poisoning, can be reduced by administering with a mixture of sodium thiosulfate and methylene blue.

Analytical confirmation of Xanthium strumarium poisoning in cattle.

Xanthium strumarium, commonly referred to as "cocklebur," rarely causes poisoning in cattle. When mature, this robust, annual weed bears numerous oval, brownish, spiny burs. Only the seeds in the burs and young seedlings (cotyledonary leaves) contain the toxic principle, carboxyatractyloside. In the Frankfort district of the Free State Province of South Africa, a herd of 150 Bonsmara cows were allowed to graze on the banks of a small river, where mature cocklebur was growing. Four cows died while grazing in this relatively small area. Clinical signs ranged from recumbency, apparent blindness, and hypersensitivity to convulsive seizures. During necropsy, burs completely matted with ingesta were located in the rumen content. The most distinctive microscopic lesions were severe, bridging centrilobular to midzonal hepatocyte necrosis and hemorrhage. Ultrastructurally, periacinar hepatocytes were necrotic, and novel electron-dense cytoplasmic needle-like crystals were observed, often in close association with peroxisomes. Carboxyatractyloside concentrations were determined using liquid chromatography-high-resolution mass spectrometry (LC-HRMS). Carboxyatractyloside was present in rumen contents at 2.5 mg/kg; in burs removed from the rumen at 0.17 mg/kg; in liver at 66 ng/g, and was below the limit of quantitation in the kidney sample, estimated at approximately 0.8 ng/g. Based on the presence of the plants on the riverbank, the history of exposure, the clinical findings, the presence of burs in the rumen, and the microscopic and ultrastructural lesions, X. strumarium poisoning in the herd of cattle was confirmed and was supported by LC-HRMS.