Plant Toxins – Phyto

Toxins

Dr. Sarah Subhashini

Department of General Medicine
CHRI
 Overview

Common plants which are toxic

Symptoms of toxicity

Treatment
Castor plant
CASTOR OIL PLANT
 This poisoning is often seen in children, who eat the seeds
of the plant by mistake.
 Symptoms
There is pain in the abdomen associated with nausea,
severe vomiting and burning pain in the throat.

There may be diarrhoea with blood in the stools,

dehydration, a rapid feeble pulse, cold clammy skin,
cramps and prostration.
Collapse and death usually follow.
About ten castor oil seeds are considered a fatal dose.
Treatment
The stomach is washed out and stimulants are
administered, together with an injection of
morphine (15 mg) only if there is no shock.
 Intravenous glucose saline is given for
dehydration, and potassium must be supplemented
ABRUS PRECATORIUS
 ABRUS PRECATORIUS
 The small, 8 mm x 6 mm, scarlet coloured, egg-shaped
seeds of the plant, with black dot at one end, are used by
goldsmiths in India for weighing.

 Symptoms
There is vertigo, fainting, vomiting, dyspnoea, general
prostration with cold extremities.
The pulse becomes fast and irregular, convulsions may
develop, and death follows from cardiac failure within 3 to
5 days.
 Treatment

Treatment is by removal of the ingested beans by emesis or

gastric lavage, and by alkalinising the urine by giving 5-
15 g of sodium bicarbonate daily to prevent precipitation of
haemoglobin and haemoglobin products in the kidneys.
Convulsions are controlled with diazepam.
Intravenous fluids are given for dehydration
Cannabis sativa
 CANNABIS SATIVA OR INDICA
(Indian hemp)
 This grows all over India
 yields a resin, cannabinone, containing an oily liquid called cannabinol,
cannabidiol, cannabinolic acid and several tetrahydro cannabinol
isomers.
 In India, it is used as :
 (a) Bhang, an infusion made from dried leaves and fruiting shoots and
then mixed with sugar and water to prepare an intoxicating drink;
 (b) Majun, a confection prepared from bhang, sugar, flour, milk and
butter. Four to 12 g of the material is enough to produce intoxication;
 (c) Ganja, the flowering or fruiting tops of the female plant, coated
with resin, smoked in a chilam (pipe), mixed with some tobacco. The
American hemp plant is used in cigarettes called "reefers" or "pot",
increasingly used by teenagers in America and England;
 (d) Hashish, the dark green or brown resin of the plant smoked with
tobacco. It is most potent as an intoxicant.
 Symptoms
Acute poisoning : There is a stage of inebriation, followed
by a stage of narcosis, produced after smoking or taking
the drug internally. Symptoms vary according to the dose
and personality of the user.
At first, there is excitement with visual hallucinations,
euphoria, laughter and marked increase of appetite.
There is disorientation, and the person gets frightful
hallucinations, becomes wildly delirious and may display
homicidal tendencies.
He feels giddy, ataxic, complains of tingling and
numbness, becomes drowsy and then passes on to the stage
of narcosis, with dilated pupils and deep sleep.
 There may be generalised anaesthesia in case of severe
poisoning. Recovery usually follows a deep sleep of several
hours. Rarely, death occurs due to respiratory failure.
 Chronic poisoning results from prolonged use. The
symptoms are loss of appetite, general weakness, tremors,
loss of sexual power, moral and mental deterioration, and
on rare occasions, psychotic features.

 Treatment
The stomach is evacuated and the patient treated
symptomatically. Diazepam 0.1 mg/kg orally helps to
control excitement and convulsions.
Datura fastuosa
 DATURA FASTUOUSA (Dhatura)
 There are two varieties of datura
 Seeds and fruits are the most poisonous parts of the plant
 Hyoscine, Hyoscyamin and traces of atropine are the active principles.

Symptoms
Within half an hour of taking the poison, gastric irritation starts. The
patient complains of a bitter taste, dry mouth and throat, burning pain in
the stomach and difficulty in swallowing and talking.
This is followed by giddiness, ataxia, inco-ordination of muscles, a peculiar
flushed appearance of the face, dry hot skin, rise in temperature, diplopia,
dilated pupils with loss of accommodation, reddening of the conjunctiva
and drowsiness.
Sometimes, an erythematous rash appears all over the
body. There is usually a full, bounding pulse, which later
becomes weak and irregular. The patient develops
muttering delirium, tries to run away from the bed,
picks at bed clothes, tries to pull imaginary threads from
the tips of his fingers and develops dreadful
hallucinations of sight and hearing.
The condition may pass on to stupor, convulsions, coma,
and sometimes death from respiratory failure.
Although the fatal dose and fatal period vary, a
decoction of 125 datura seeds has proved fatal. Death
may occur within 4 to 24 hours
 DATURA FASTUOUSA (Dhatura)
 Treatment
The stomach is washed out with 1:10,000 potassium
permanganate solution or 5 per cent tannic acid solution.
Neostigmine 0.5 mg is injected subcutaneously.
Pilocarpine nitrate (6 to 15 mg) or methacholine may be given
subcutaneously, and may need to be repeated.
For delirium, chloral hydrate, paraldehyde or any short-acting
barbiturate is usually given.
Morphine, which depresses the respiratory centre, must not be
given.
Nerium odorum (oleander)
 NERIUM ODORUM
(Pink oleander, arali)
 The plant is commonly grown in the gardens of India for its
beautiful flowers.
 A glycoside (nerin) has been isolated from it. The root has been
employed criminally as an abortifacient. The roots and leaves have
also been used for suicidal purposes in western and southern India
and rarely as homicidal poisons or cattle poisons.
 Symptoms
 These are difficulty in speaking, dysphagia, pain in the abdomen,
vomiting, excessive frothy salivation, diarrhoea, fast respiration,
weak rapid pulse, dilated pupils, muscular twitchings, tetanic spasms,
drowsiness and finally, coma and death. At times, there are
manifestations of "lock-jaw" or tetanus. About 16 g of the powdered
root usually causes death within 24 to 36 hours.
 Treatment
 The stomach is washed out and symptomatic treatment is given.
Cerebra thevetia (yellow oleander)
 CEREBRA THEVETIA (Cerebrum odallum,
Yellow oleander or Pila kaner)
 This is an ornamental plant that is grown for its yellow
bell-shaped flowers in the gardens of India.
 Its milky juice contains two highly poisonous glycosides,
thevetin and cerebrin. The roots and seeds are used as
abortifacients, for suicidal and homicidal purposes and
also as cattle poisons.
 Symptoms
These include dryness of the throat, burning pain in the
mouth, tingling and numbness of the tongue, vomiting,
diarrhoea, dizziness, dilated pupils, muscular weakness,
tetanic convulsions, fainting, a fast, weak and irregular
pulse, and later, collapse and death from circulatory failure.
Heart block is a prominent finding.
 Treatment
The stomach is emptied and the condition treated
symptomatically.
1.2 mg of atropine or orciprenaline (1-2 mg) parenterally
are given for heart block.
Pacemaker insertion may be required
Oduvanthalai poisoning
 Cleistanthus collinus, a toxic shrub, is used for deliberate self-harm
in rural South India.
 The toxic principles in the leaf include arylnaphthalene lignan
lactones — Diphyllin and its glycoside derivatives Cleistanthin A
and B.
 Results in renal tubular dysfunction, commonly dRTA, with
resultant hypokalemia and normal anion gap metabolic acidosis.
 Acute respiratory distress syndrome (ARDS) is seen in severe
cases.
 Cardiac rhythm abnormalities have been demonstrated
 Consumption of decoctions of C. collinus leaves, causes
hypokalemia, renal failure, severe metabolic acidosis, ARDS and
cardiac arrhythmias.
Treatment is mainly supportive.
No specific antidote.
Cardiac pacemaker may be required for life threatening
arrhythmias.
Thank You