title: [High-dose magnesium sulfate in the treatment of aconite poisoning].
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.
authors: Abteilung für Anästhesie und Intensivmedizin, Krankenhaus "F. Tappeiner" Meran, 39012, Meran, Italien, andreas.clara@asbmeran-o.it.
authors: A
authors: A
authors: Clara
authors: S
authors: S
authors: Rauch
authors: C A
authors: CA
authors: Überbacher
authors: N
authors: N
authors: Felgenhauer
authors: G
authors: G
authors: Drüge
mesh_terms: D031841:Aconitum / Q000506:poisoning*; D000470:Alkaloids / Q000506:poisoning; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001145:Arrhythmias, Cardiac / Q000139:chemically induced / Q000188:drug therapy; D004562:Electrocardiography; D006331:Heart Diseases / Q000139:chemically induced / Q000188:drug therapy; D006801:Humans; D008278:Magnesium Sulfate / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D020258:Neurotoxicity Syndromes / Q000188:drug therapy; D062687:Sodium Channel Agonists / Q000506:poisoning; D015222:Sodium Channels / Q000187:drug effects; D013406:Suicide, Attempted; D013610:Tachycardia / Q000139:chemically induced / Q000188:drug therapy; D014703:Veratrum / Q000506:poisoning*
chemical_list: D000470:Alkaloids; D000889:Anti-Arrhythmia Agents; D062687:Sodium Channel Agonists; D015222:Sodium Channels; D008278:Magnesium Sulfate