Five cases of aconite poisoning: toxicokinetics of aconitines.
Aconite poisoning was examined in five patients (four males and one female) aged 49 to 78 years old. The electrocardiogram findings were as follows: ventricular tachycardia and ventricular fibrillation in case 1, premature ventricular contraction and accelerated idioventricular rhythm in case 2, AIVR in case 3, and nonsustained ventricular tachycardia in cases 4 and 5. The patient in case 1 was given percutaneous cardiopulmonary support because of unstable hemodynamics, whereas the other patients were treated with fluid replacement and antiarrhythmic agents. The main aconitine alkaloid in each patient had a half-life that ranged from 5.8 to 15.4 h over the five cases, and other detected alkaloids had half-lives similar to the half-life of the main alkaloid in each case. The half-life of the main alkaloid in case 1 was about twice as long as the half-lives in the other cases, and high values for the area under the blood concentration-time curve and the mean residence time were only observed in case 1. These results suggest that alkaloid toxicokinetics parameters may reflect the severity of toxic symptoms in aconite poisoning.
Fujita
Yuji
Y
Poisoning and Drug Laboratory Division, Critical Care and Emergency Center, Iwate Medical University Hospital, 3-16-1 Honchoudori, Morioka, Iwate 020-0015, Japan.
Terui
Katsutoshi
K
Fujita
Megumi
M
Kakizaki
Atsushi
A
Sato
Norio
N
Oikawa
Kohei
K
Aoki
Hidehiko
H
Takahashi
Katsuo
K
Endo
Shigeatsu
S
D016170:Accelerated Idioventricular Rhythm / Q000139:chemically induced; D000157:Aconitine / Q000031:analogs & derivatives / Q000097:blood / Q000493:pharmacokinetics* / Q000506:poisoning / Q000652:urine; D031841:Aconitum; D000368:Aged; D019540:Area Under Curve; D001145:Arrhythmias, Cardiac / Q000139:chemically induced* / Q000503:physiopathology; D001711:Biotransformation; D002851:Chromatography, High Pressure Liquid; D004365:Drugs, Chinese Herbal / Q000493:pharmacokinetics* / Q000506:poisoning; D004562:Electrocardiography; D005260:Female; D006207:Half-Life; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D017180:Tachycardia, Ventricular / Q000139:chemically induced; D053719:Tandem Mass Spectrometry; D014116:Toxicology / Q000379:methods; D014693:Ventricular Fibrillation / Q000139:chemically induced; D018879:Ventricular Premature Complexes / Q000139:chemically induced
D004365:Drugs, Chinese Herbal; C019470:mesaconitine; C069418:jesaconitine; D000157:Aconitine