plant induced cardic toxicity

1. Cardiac Poisons
MUHAMMAD SAJID
Pharmacognosy (session 2022-2024)

2. Introduction
Intoxication from cardiotoxic plants may result from direct
ingestion of plant parts, such as
leaves,
flowers,
nectars,
seeds,
or roots

3. or may result from teas (decoctions and infusions)
brewed from the plant. In some cases, toxicity has
occurred from drinking water from a vase that
contained the cut flowers of foxglove or lily of the
valley or, according to common folklore, from
roasting hot dogs on a branch from oleander.

4. Cardioactive steroids or cardiac glycosides are
naturally‐occurring compounds identified in
various plant and animal species. Self-poisoning
with plants is a major problem in certain parts of
the world such as rural Asia, killing thousands of
people each year. One of the most common
poisons used for self-harm in much of South Asia
are the seeds of the yellow oleander tree
(Thevetia peruviana), and the rate of morbidity
and mortality is high.

5. Ingestion of naturally occurring cardiac
glycosides produces a clinically picture very
similar to that of digitalis poisoning.
General symptoms and signs include
nausea, vomiting, and abdominal pain. The
main life-threatening clinical manifestation
is cardiac toxicity.

7. Cardiac Poisons
• Nicotiana Tabacum
• Digitalis Purpurea
• Nerium Odorum
• Cerebera thevetia
• Cerebera Odallam
• Cliastanthus Collinus
• Quinine
• Aconite
• All parts are poisonous except ripe seeds

8. Aconitum napellus
• Also known as Monk’s Hood, Mitha Zaher, Bish.
• All parts are poisonous. Root most potent.
• Dry root-conical or tapering shows the bases of broken
rootless and shriveled with longitudinal wrinkles.
• 5-10 cm long.
• 1.5-2 cm thick at the upper end.
• Dark brown in colour.
• Roots are mistaken for horse radish root.

9. Bio chemistry
• The tubers or root stock) are diterpenoid
alkaloids
(i.e., a nitrogenous base formed from
some Compounds derived from Aconitum
spp. (principally C20-terpenoid
precursors) .
The most toxic alkaloids are aconitine,
mesaconitine, and 3-acetylaconitine.

11. • The presence of a benzoylester
side chain at carbon 14 produces the
arrhythmic effects attributed to these three
alkaloids .
• The alkaloids contained within the plant vary
depending on the species and the geographic
location,with some species being more toxic
than others.

12. Active Principle
• Aconitine
• Pseudo-aconitine
• Indaconitine
• Picraconitine
• Aconine

13. MOA:
It act on sodium channels ,blocks the neuromuscular
transmission and decrease the release of acetylcholine
SIGNS AND SYMPTOMS:
• Nausea and vomiting Salivation
• Tingling and numbness in mouth and lips.

14. Fatal dose:
•Root:-1-2 g Aconitine:-2-5 mg
•Fatal period
2-6 hour
Medico-legal importance:
Aconite is considered as near ideal homicidal poison as it is
sweet in taste and can easily be given with food stuff.

15. Nicotiana tabacum
All parts of the plants are poisonous except the ripe seeds.
Active Principle:
• Nicotine
• Anabasine
• Nornicotine
Toxic part:
Dried tobacco leaves contain 1-8% of nicotine

16. Fatal dose:
• 40-60 mg of nicotine
• 15-30 g crude tobacco
Fatal Period:5-15 minutes
Signs and Symptoms :
• Pain in abdomen,salivation,nausea,vomiting
• Tachycardia followed by Bradycardia.

17. MOF:
• Nicotine is neuromuscular blocking agent
and at large doses it causes seizures and respiratory
arrest

18. Digitilis purpurea
Entire plant is toxic
Over 30 cardiac and steroidal glucosides
1. Digitoxin
2. Digoxin
3. Digitalin
4. Digitonin

20. MOF:
• Digoxin binds to and inhibit the sodium-potassium ATPase
within the plasma membrane.
• It increases the intracellular sodium content which in turn
increases the calcium and lead to increase the cardiac
contractility

21. Sign and symptoms:
• Cardiac
arrhythmias
• block Endocrine
gynaecomastia
• Visual
transient amblyopia , colour aberration , halos

22. • CNS
neuropsychiatric , delirium , hallucinations ,
trigeminal neuralgia
• Death occurs from cardiovascular collapse
Fatal dose:
2 gm leaf, 15 – 30 mg digitalin,10 mg digoxin, 4
mg digitoxin
Fatal period:
1 – 24 hours

23. Nerium odorum
• White oleander or kaner
• All parts except roots , including nectar are
poisonous
Cardiac glycosides:
1. Oleandroside(oleandrin)
2. Nerioside(nerin)
3. Folinerin
4. Rosagenin

25. Sign and symptoms:
• Headache, dizziness, respiratory difficulty, Nausea
• salivation and diarrhea , abdominal pain
• Pulse is first slow and later rapid and weak
• Arrhythmias
• Mydriasis , tetanic spasm, lock jaw ,
• Death usually results from cardiac failure

26. MOF:
Inhibation of Na-K ATPase
Fatal dose:
• 15 – 20 g of root
• 5 to 15 leaves
• 1-2 ng per ml of oleandrin
Fatal period:
• 20 – 36 hours

27. • Root is abortifacient , veneral disease
• Smoke from the burning plant is toxic
• When plant material is used to roast food over
a fire , the poisonous sap transferred to the food
may be lethal

28. Cerebera thevetia
• Yellow oleander / pila kaner
• All parts are poisonous
• Seeds contain:
(A)4% thevetin which is 1/8th as potent as ouabain
Similar to digitalis in action
(B) thevetoxin
( C) nerifolin
(D) Peruvoside (E) Ruvoside (F) Cereberin

30. MOF:
It inhibit Na-k ATPease
• All active principles are glycosides
• Milky juice exudes from all parts of the plant
Signs and symptoms:
Chewing bark /seed lead to numbing sensation
and feeling of heat in the mouth

31. • Mydriasis
• Heart block
• Death due to peripheral circulatory failure
Fatal dose:
• 8 – 10 seed
• 15 – 20 g of root
• 5 – 10 leaves
Fatal period: 2-3 hours

32. Cerebera odallam
Pilikirbir
Contains glycosides:
1. Cerberin 2. Cerebroside 3. Odollin 4. Odolotoxin 5.
Thevetin 6. Cerapain
Milky acrid juice (toxic) from all parts of the plant

34. Sign and symptoms:
• Irregular respiration
• Death from heart failure
• Hyperkalemia and depression of transaminase activity are
chief biochemical changes
Fatal dose:
• Kernel of 1 fruit
Fatal period:
• 1-2 days or more

35. Cleistanthus collinus
• Odovan , karlajuri , karada, garari
• All parts of the plant are poisonous
Toxic principle:
• Oduvin (glucoside) and cleistanthin A
Fatal dose:
• 200 – 400 gm of leaves
Fatal period:
• 1 – 3 days
Signs and symptoms:
Mydriasis,hyperpyrexia

37. MOF:
• The toxin blocks the neuromuscular junction
• It also act on cardic conductive system

38. Species of cinchona plants
Main constituents
• Quinine
• Quinidin
• Cinchonine
• cinchonidinde

40. Signs and symptoms:
• Starts in 15 – 30 min
• Partial deafness, disorders of vision , pupils fixed dilated
• Rash
• Methemoglobinemia
• Death occurs due to respiratory failure
• Large doses cause hemolysis
• Renal tubule block
• uremia

41. Repeated therapeutic doses or over dose causes
Tinnitus, vertigo , deafness, blindness, skin rash ,
hypoglycemia , and cardiac arrhythmias
Fatal dose:
• cinchonine
• 8 – 15 g
Fatal period:
• 6 hours
• Quinidine
• 4 – 6 g

42. Thank you!